Skip to main content
SpringerLink
Log in

Prevention and Treatment of Ankle Sprain in Athletes

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

The frequent nature of ankle sprains and persistent disability that often ensues has lead to considerable medical costs. As prevention of disease and injury becomes an increasingly important part of the practice of medicine today, we strive to understand and identify interventions that optimally reduce the frequency of ankle sprain and re-injury. In doing so, considerable morbidity and unnecessary medical expenditures may potentially be averted. The prophylactic use of ankle braces is fairly common. Recent critical evaluation of their effectiveness supports their use for at least 6 months following injury in athletes who have sustained a moderate or severe sprain; however, their role in primary prevention of ankle sprain is less evident. Functional ankle rehabilitation is the mainstay of acute ankle sprain treatment and in recent reviews has been deemed preferable to immobilisation or early surgery for initial treatment of acutely injured ankles. Furthermore, certain components of ankle rehabilitation, such as proprioceptive exercises, have been found to protect the joint from re-injury. Multifaceted ankle sprain prevention programmes that incorporate a variety of strategies for injury reduction are also effective in sprain prevention, although the relative importance of each component of such programmes warrants further investigation. Surgery for ankle sprain is principally reserved for patients who fail a comprehensive non-operative treatment programme and can be highly successful in treating chronic functional instability. This paper examines the current literature regarding common ankle sprain prevention strategies and provides a review of appropriate treatment schemes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I

Similar content being viewed by others

References

  1. Soboroff SH, Pappius EM, Komaroff AL. Benefits, risks, and costs of alternative approaches to the evaluation and treatment of severe ankle sprain. Clin Orthop 1984; (183): 160–8

    Google Scholar 

  2. Garrick JG, Requa RK. The epidemiology of foot and ankle injuries in sports. Clin Sports Med 1988; 7(1): 29–36

    PubMed  CAS  Google Scholar 

  3. Berger-Vachon C, Gabard G, Moyen B. Soccer accidents in the French Rhone-Alpes Soccer Association. Sports Med 1986; 3(1): 69–77

    Article  PubMed  CAS  Google Scholar 

  4. Ekstrand J, Tropp H. The incidence of ankle sprains in soccer. Foot Ankle 1990; 11(1): 41–4

    PubMed  CAS  Google Scholar 

  5. Jackson DW, Ashley RL, Powell JW. Ankle sprains in young athletes: relation of severity and disability. Clin Orthop 1974; 101(1): 201–15

    PubMed  Google Scholar 

  6. Verhagen RA, de Keizer G, van Dijk CN. Long-term follow-up of inversion trauma of the ankle. Arch Orthop Trauma Surg 1995; 114(2): 92–6

    Article  PubMed  CAS  Google Scholar 

  7. Gerber JP, Williams GN, Scoville CR, et al. Persistent disability associated with ankle sprains: a prospective examination of an athletic population. Foot Ankle Int 1998 Oct; 19(10): 653–60

    PubMed  CAS  Google Scholar 

  8. Handoll HH, Rowe BH, Quinn KM, et al. Interventions for preventing ankle ligament injuries. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 4. Oxford: Update Software, 2002

    Google Scholar 

  9. Amoroso PJ, Ryan JB, Bickley B, et al. Braced for impact: reducing military paratroopers’ ankle sprains using outside-the-boot braces. J Trauma 1998; 45(3): 575–80

    Article  PubMed  CAS  Google Scholar 

  10. Simon JE. Study of the comparative effectiveness of ankle taping and ankle wrapping on the prevention of ankle injuries. J Athl Train 1969; 4: 6–7

    Google Scholar 

  11. Sitler M, Ryan J, Wheeler B, et al. The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball: a randomized study at West Point. Am J Sports Med 1994; 22: 454–61

    Article  PubMed  CAS  Google Scholar 

  12. Surve I, Schwellnus MP, Noakes T, et al. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis. Am J Sports Med 1994; 22(5): 601–6

    Article  PubMed  CAS  Google Scholar 

  13. Hume PA, Gerrard DF. Effectiveness of external ankle support: bracing and taping in rugby union. Sports Med 1998 May; 25(5): 285–312

    Article  PubMed  CAS  Google Scholar 

  14. Thacker SB, Stroup DF, Branche CM, et al. The prevention of ankle sprains in sports: a systematic review of the literature. Am J Sports Med 1999; 27(6): 753–60

    PubMed  CAS  Google Scholar 

  15. Garrick JG, Requa RK. Role of external support in the prevention of ankle sprains. Med Sci Sports 1973; 5(3): 200–3

    PubMed  CAS  Google Scholar 

  16. Barrett J, Bilisko T. The role of shoes in the prevention of ankle sprains. Sports Med 1995; 20(4): 277–80

    Article  PubMed  CAS  Google Scholar 

  17. Osborne MD. Chronic ankle instability. In: Frontera WR, Silver JK, editors. Essentials of physical medicine and rehabilitation. Philadelphia (PA): Hanley & Belfus Inc, 2002: 409–13

    Google Scholar 

  18. Kerkhoffs GM, Rowe BH, Assendelft WJ, et al. Immobilisation for acute ankle sprain: a systematic review. Arch Orthop Trauma Surg 2001 Sep; 121(8): 462–71

    Article  PubMed  CAS  Google Scholar 

  19. Almekinders LC. Anti-inflammatory treatment of muscular injuries in sport: an update of recent studies. Sports Med 1999; 28(6): 383–8

    Article  PubMed  CAS  Google Scholar 

  20. Demaio M, Paine R, Drez D. Chronic lateral ankle instability-inversion sprains: part II. Orthopedics 1992; 15(1): 87–96

    PubMed  CAS  Google Scholar 

  21. Rizzo TD, Osborne MD. Sprains and sprains. In: Sinaki M, editor. Basic clinical rehabilitation medicine. 3rd ed. St Louis (MO): Mosby Year Book. In press

  22. Goldie PA, Evans OM, Bach TM. Postural control following inversion injuries of the ankle. Arch Phys Med Rehabil 1994; 75: 969–75

    PubMed  CAS  Google Scholar 

  23. Tropp H, Ekstrand J, Gilquist J. Stabilometry in functional instability of the ankle and its value in predicting injury. Med Sci Sports Exerc 1984; 16: 64–6

    PubMed  CAS  Google Scholar 

  24. Tropp H, Odenrick P. Postural control in single-limb stance. J Orthop Res 1988; 6: 833–9

    Article  PubMed  CAS  Google Scholar 

  25. Freeman M, Dean M, Hanham I. The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br 1965; 47–B: 678–85

    Google Scholar 

  26. Hoffman M, Payne VG. The effects of proprioceptive ankle disk training on healthy subjects. J Orthop Sports Phys Ther 1995; 21: 90–3

    PubMed  CAS  Google Scholar 

  27. Gauffin H, Tropp H, Odendrick P. Effect of ankle disk training on postural control in patients with functional instability of the ankle joint. Int J Sports Med 1988; 9: 141–4

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  29. Wester JU, Jespersen SM, Nielsen KD, et al. Wobble board training after partial sprains of the lateral ligament of the ankle: a prospective randomized study. J Orthop Sports Phys Ther 1996; 23: 332–6

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  31. Sheth P, Yu B, Laskowski ER, et al. Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain. Am J Sports Med 1997 Jul–Aug; 25(4): 538–43

    Article  PubMed  CAS  Google Scholar 

  32. Osborne MD, Chou LS, Laskowski ER, et al. The effect of ankle disk training on muscle reaction time in subjects with a history of ankle sprain. Am J Sports Med 2001 Sep–Oct; 29(5): 627–32

    PubMed  CAS  Google Scholar 

  33. Noonan TJ, Garrett Jr WE. Muscle strain injury: diagnosis and treatment. J Am Acad Orthop Surg 1999 Jul–Aug; 7(4): 262–9

    PubMed  CAS  Google Scholar 

  34. Ekstrand J, Gillquist J, Liljedahl SO. Prevention of soccer injuries: supervision by doctor and physiotherapist. Am J Sports Med 1983; 11(3): 116–20

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  36. 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 Sci Sports 1999 Feb; 9(1): 41–7

    Article  PubMed  CAS  Google Scholar 

  37. Lynch SA, Renstrom AFH. Treatment of acute lateral ankle ligament rupture in the athlete. Sports Med 1999 Jan; 27(1): 67–71

    Article  Google Scholar 

  38. Kerkhoffs GMMJ, Handoll HHG, de Bie R, et al. Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 4. Oxford: Update Software, 2002

    Google Scholar 

  39. Colville MR. Surgical treatment of the unstable ankle. J Am Acad Orthop Surg 1998; 6(6): 368–77

    PubMed  CAS  Google Scholar 

  40. Peters JW, Trevio SG, Renstrom PA. Chronic lateral ankle instability. Foot Ankle 1991; 12(3): 182–91

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida, 32224, USA

    Michael D. Osborne & Thomas D. Rizzo Jr

Authors
  1. Michael D. Osborne
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas D. Rizzo Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Osborne, M.D., Rizzo, T.D. Prevention and Treatment of Ankle Sprain in Athletes. Sports Med 33, 1145–1150 (2003). https://doi.org/10.2165/00007256-200333150-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-200333150-00005

Keywords

Search

Navigation