Preventing Ankle Sprains in Basketball Players

Several studies have found that ankle sprains in basketball players not only are among the most common basketball injuries, but also are among the most severe. An ankle sprain generally takes an athlete out of the game, and has a 50 percent chance of recurrence sometime during the season - so preventing an ankle sprain is key to ensuring a safe and healthy athletic season. The most common type of ankle sprain occurs when the ankle rolls excessively toward the outside of the foot, and is called an inversion sprain. A sprain is defined as a stretched or torn ligament. A ligament connects one bone to another, and provides stability to a joint formed by two bones. An ankle sprain occurs when the ankle rolls so far to the side that a ligament stretches or tears. The severity of a sprain ranges from mild (a stretch or partial tear) to severe (a complete tear). Sometimes a severe injury not only stretches or tears a ligament but also pulls a piece of bone loose where the ligament attaches. In that case the injury involves both a sprain and an avulsion fracture. In less severe ankle sprains, the ligament pulls on the bone and may cause it to get stuck in a painful position, rather than to get pulled loose. Signs of ankle sprain include swelling, pain, bruising, and trouble moving the ankle or walking on that foot. Studies have shown that the risk of ankle sprain is significantly higher among female basketball athletes than among males. Researchers have found that women are at increased risk of a first ankle sprain if there is a strength imbalance in the muscles controlling side-to-side movement of the ankle. Other risk factors include loose ankles, which suggest weak ligaments or other structural problems, and significantly greater strength of the dominant leg compared to the non-dominant. Researchers have noted that men are at increased risk of a first ankle sprain if they have undergone one or more leg surgeries, or if they have a combination of decreased ankle flexibility and weak muscles that prevent the ankle from rolling excessively toward the outside of the foot. Studies suggest that the risk of injury after surgery may be due to returning to play before healing is complete or with insufficient rehabilitation. Findings of increased risk of ankle sprain following surgery are similar to the 50% chance of recurrence following a first ankle sprain noted above. Taping the ankle has long been the preventive method of choice for trainers and coaches of many sports. Taping has been shown to reduce the occurrence of ankle sprains despite the fact that tape loosens after only 10 minutes and tape provides little to no measurable restriction of ankle movement after 30 minutes. Researchers hypothesize that the protective effect of ankle taping is due to increased proprioception (i.e., a person's ability to sense the position or movement of a joint such as the ankle) that allows the muscles supporting the ankle to react more rapidly in preventing extreme ankle inversion. In contrast, there is no evidence that elastic wraps, bandages or high top shoes reduce the risk of ankle sprains. However, the combination of taping and high-top shoes was particularly effective in preventing ankle sprains in players with a previous sprain, but not among players who had not previously sprained an ankle. Prevention is the take-home message. To prevent ankle sprains you will need to perform specific exercises that develop flexibility, strength, balance, agility, and proprioception. These exercises should be done during the season and will only take 10-15 minutes each day. During the off season, additional leg strengthening exercises and endurance activities will enhance overall conditioning and injury prevention. Visit our web site at www.ptcentral.org to view a set of ankle exercises. Bridgit A. Finley, PT, DPT, MEd., OCS earned her Doctorate in Physical Therapy at Arizona Health Science Center in 2005 and is a certified Orthopedic Clinical Specialists.