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Relationship Between Balance Ability, Training and Sports Injury Risk

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Abstract

Traditionally, balance training has been used as part of the rehabilitation programme for ankle injuries. More recently, balance training has been adopted to try and prevent injuries to the ankle and knee joints during sport. The purpose of this review is to synthesise current knowledge in the area of balance ability, training and injury risk, highlight the findings and identify any future research needs. A number of studies have found that poor balance ability is significantly related to an increased risk of ankle injuries in different activities. This relationship appears to be more common in males than females.

Multifaceted intervention studies that have included balance training along with jumping, landing and agility exercises have resulted in a significant decrease in ankle or knee injuries in team handball, volleyball and recreational athletes. It is unknown which component of the multifaceted intervention was most effective and whether the effects are additive. As a single intervention, balance training has been shown to significantly reduce the recurrence of ankle ligament injuries in soccer, volleyball and recreational athletes; however, it has not been clearly shown to reduce ankle injuries in athletes without a prior ankle injury. Balance training on its own has also been shown to significantly reduce anterior cruciate ligament injuries in male soccer players. Surprisingly, it was also found to be significantly associated with an increased risk of major knee injuries in female soccer players and overuse knee injuries in male and female volleyball players. The studies with the contrasting findings differed in aspects of their balance training programmes.

It would appear that balance training, as a single intervention, is not as effective as when it is part of a multifaceted intervention. Research is required to determine the relative contribution of balance training to a multifaceted intervention so as to generate an effective and efficient preventative programme that can be adopted by athletes of most levels.

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References

  1. Lephart SM, Fu TH. Proprioception and neuromuscular control injoint stability. Champaign (IL): Human Kinetics, 2000: xxi–xxiii

    Google Scholar 

  2. Brukner P, Khan K. Acute ankle injuries. In: Clinical sports medicine. Sydney: McGraw-Hill, 2000: 553–73

    Google Scholar 

  3. Tropp H, Askling C, Gillquist J. Prevention of ankle sprains. Am J Sports Med 1985; 13 (4): 259–62

    Article  PubMed  CAS  Google Scholar 

  4. Caraffa A, Cerulli G, Projetti M, et al. Prevention of anterior cruciate ligament injuries in soccer: a prospective controlled study of proprioceptive training. Knee Surg Sports Traumaol Arthrosc 1996 Mar; 4 (1): 19–21

    Article  CAS  Google Scholar 

  5. Wester N, Jespersen SM, Nielsen ED, et al. Wobble board training after partial sprains of the lateral ligaments of the ankle: a prospective randomised study. J Orthop Sports Phys Ther 1996 May; 23 (5): 332–6

    PubMed  CAS  Google Scholar 

  6. Soderman K, Werner S, Pietila T, et al. Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players? Knee Surg Sports Traumatol Arthrosc 2000 Dec; 8 (6): 356–63

    Article  PubMed  CAS  Google Scholar 

  7. Verhagen E, van der Beek A, Twisk J, et al. The effect of a proprioceptive balance board training program for the prevention of ankle sprains: a prospective controlled trial. Am J Sports Med 2004 Sep; 32 (6): 1385–93

    Article  PubMed  Google Scholar 

  8. Emery CA, Cassidy JD, Klassen TP, et al. Effectiveness of a home-based balance-training program in reducing sports-related injuries among healthy adolescents: a cluster randomised controlled trial. Can Med Assoc J 2005 Mar; 172 (6): 749–54

    Article  Google Scholar 

  9. Watson AWS. Ankle sprains in players of the field-games Gaelic football and hurling. J Sports Med Phys Fitness 1999 Mar; 39 (1): 66–70

    PubMed  CAS  Google Scholar 

  10. Willems TM, Witvrouw E, Delbaere K, et al. Intrinsic risk factors for inversion ankle sprains in females: a prospective study. Scand J Med Set Sports 2005 Oct; 15 (5): 336–45

    Article  CAS  Google Scholar 

  11. McHugh MP, Tyler TF, Tetro DT, et al. Risk factors for noncontact ankle sprains in high school athletes. Am J Sports Med 2006 Mar; 34 (3): 464–70

    Article  PubMed  Google Scholar 

  12. Tropp H, Ekstrand J, Gillquist J. Stabilometry in functional instability of the ankle and its value in predicting injury. Med Set Sports Exer 1984; 16 (1): 64–6

    CAS  Google Scholar 

  13. Below E, Magnusson SP, Becher K, et al. The effect of supervised rehabilitation on strength, postural sway, position sense and re-injury after acute ankle ligament sprain. Scand J Med Sci Sports 1999 Apr; 9 (2): 104–9

    Google Scholar 

  14. Hrysomallis C, McLaughlin P, Goodman C. Balance and injury in elite Australian footballers. Int J Sports Med. Epub 2007 Mar 20

    Google Scholar 

  15. McGuine TA, Greene JJ, Best T, et al. Balance as a predictor of ankle injuries in high school basketball players. Clin J Sport Med 2000 Oct; 10 (4): 239–44

    Article  PubMed  CAS  Google Scholar 

  16. Beynnon BE, Renstrom PA, Alosa DM, et al. Ankle ligament injury risk factors: a prospective study of college athletes. J Orthop Res 2001 Mar; 19 (2): 213–20

    Article  PubMed  CAS  Google Scholar 

  17. Soderman K, Alfredson H, Piefila T, et al. Risk factors for leg injuries in female soccer players: a prospective investigation during one outdoor season. Knee Surg Sports Traumatol Arthrosc 2001 Sep; 9 (5): 313–21

    Article  PubMed  CAS  Google Scholar 

  18. Hrysomallis C, Buttifant D, Buckley N. Exercise equipment and techniques. In: Weight training for Australian football. Melbourne: Lothian Books, 2006: 105–9

    Google Scholar 

  19. Willems TM, Witvrouw E, Delbaere K, et al. Intrinsic risk factors for inversion ankle sprains in male subjects. Am J Sports Med 2005 Mar; 33 (3): 415–23

    Article  PubMed  Google Scholar 

  20. Lloyd DG. Rationale for training programs to reduce anterior cruciate ligament injuries in Australian football. J Orthop Sports Phys Ther 2001 Nov; 31 (11): 645–54

    PubMed  CAS  Google Scholar 

  21. Galls SK, Woollacott MH. Neural mechanisms underlying balance improvements with short term Tai Chi training. Aging Clin Exp Res 2006 Feb; 18 (1): 7–19

    Google Scholar 

  22. Hurd WJ, Chmielewski TL, Snyder-Mocker L. Perturbationenhanced neuromuscular training alters muscle activity in female athletes. Knee Surg Sports Traumatol Arthrosc 2006 Jan; 14 (1): 60–9

    Article  PubMed  Google Scholar 

  23. Myer GD, Ford KR, McLean SG, et al. The effects of plyometric versus dynastic stabilization and balance training on lower extremity biomcchanics. Am J Sports Med 2006 Mar; 34 (3): 445–55

    Article  PubMed  Google Scholar 

  24. Wedderkopp N, Kaltoft M, Lundgaard B, et al. Prevention of injuries in young female players in European team handball: a prospective intervention study. Scand J Med Set Sports 1999 Feb; 9 (1): 41–7

    Article  CAS  Google Scholar 

  25. Olsen OF, Myklebust G, Engebretsen L, et al. Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial. Br Med J 2005 Feb; 330 (7489): 449–55

    Article  Google Scholar 

  26. Bahr R, Lian O, Bahr IA. A twofold reduction in the incidence of acute ankle sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study. Scand J Med Set Sports 1997 Jun; 7 (3): 172–7

    Article  CAS  Google Scholar 

  27. Myklebust G, Engebretsen L, Braekken IH, et al. Prevention of anterior cruciate ligament injuries in female team handball players: a prospective study over threes seasons. Clin J Sport Med 2003 Mar; 13 (2): 71–8

    Article  PubMed  Google Scholar 

  28. Petersen W, Braun C, Bock W, et al. A controlled prospective case control study of a prevention training program in female team handball players: the German experience. Arch Orthop Trauma Surg 2005 Nov; 125 (9): 614–21

    Article  PubMed  Google Scholar 

  29. Hansen MS, Dieckmann B, Jensen K, et al. The reliability of balance tests performed on the kinesthetic ability trainer (KAT 2000). Knee Surg Sports Traumatol Arthrosc 2000 May; 8 (3): 180–5

    Article  PubMed  CAS  Google Scholar 

  30. Hrysomalfs C, McLaughlin P, Goodman C. Relationship between static and dynastic balance tests among elite Australian footballers. J Set Med Sport 2006 Aug; 9 (4): 288–91

    Article  Google Scholar 

  31. Maki BE, Edmondstone MA, Mellroy WE. Age-related differences in the laterally directed compensatory stepping behaviour. J Gerontol A Biol Set Med Sci. 2000 May; 55 (5): M270–7

    Article  CAS  Google Scholar 

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. The author has no conflicts of interest that are directly relevant to the content of this review.

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Correspondence to Con Hrysomallis.

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Hrysomallis, C. Relationship Between Balance Ability, Training and Sports Injury Risk. Sports Med 37, 547–556 (2007). https://doi.org/10.2165/00007256-200737060-00007

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