Sports Medicine Research: In the Lab & In the Field: Ankle Injury Prevention Programs Work (Sports Med Res)
Thursday, October 6, 2016

Ankle Injury Prevention Programs Work

Ankle Injury Prevention Programs for Soccer Athletes are Protective: A Level-I Meta-Analysis

Grimm NL, Jacobs JC, Kim J, Amendola A, & Shea KG. The Journal of Bone and Joint Surgery. 2016, 98:1436-43. doi: 10.2106/JBJS.15.00933.

Take Home Message: Prevention programs focused on reducing the risk of ankle injury are effective for soccer athletes.

With the increase popularity of soccer and ankle sprains being one of the most common musculoskeletal injuries occurring within soccer, it’s not surprising that several prevention programs have been developed to reduce the risk of an ankle injury. However, the barriers and limitations of different prevention programs can often influence the quality of a study and blur the overall evidence for the effectiveness of prevention programs. Therefore, Grimm and colleagues performed a meta-analysis to evaluate the validity and overall effectiveness of prevention programs for reducing the risk of an ankle sprain for soccer athletes. The authors systematically searched the literature to identify randomized controlled trials of ankle injury prevention programs. They included prevention programs that focused on either neuromuscular, proprioceptive, strengthening or stretching exercises. They omitted programs that used bracing or taping. Further, only soccer athletes of any skill level, sex, or age were included. The search strategy retrieved 10 randomized trials with a total of 4,121 soccer athletes. The authors found that overall injury prevention programs provide a protective effect for reducing ankle injuries among soccer athletes. 

Based on high-quality evidence, the authors confirmed that prevention programs reduce the risk of an ankle injury among soccer athletes. While these results have a direct clinical impact, it remains unclear the influence skill level, sex, age and/or previous injury history may have on these findings. It would be interesting to see if these findings hold up when considering these factors. Furthermore, the injury prevention programs included into this meta-analysis only focused on reducing the risk of an ankle injury. With time restraints often a limiting factor for not implementing a prevention program, it would be useful to know if these prevention programs are effective at reducing other musculoskeletal injuries in soccer athletes (e.g., hamstring strains). Lastly, because this meta-analysis did not compare the multiple prevention programs (e.g. neuromuscular/proprioceptive vs. strengthening), it’s unknown which prevention program is most effective and should be a focus in future research. In the meantime, clinicians should consider implementing a prevention program composed of exercises that they believe are effective and appropriate for their clinical setting and patients.  

Questions for Discussion: In your current setting, what kind of prevention program do you implement for preventing ankle injuries? What are some of the barriers that prevent you from implementing a prevention program?

Written by: Kyle Kosik
Reviewed by: Jeffrey Driban

Related Posts:
To Brace or Not to Brace…That is the Question


Grimm, N., Jacobs, J., Kim, J., Amendola, A., & Shea, K. (2016). Ankle Injury Prevention Programs for Soccer Athletes Are Protective: A Level-I Meta-Analysis The Journal of Bone & Joint Surgery, 98 (17), 1436-1443 DOI: 10.2106/JBJS.15.00933

2 comments:

Kevin said...

Great post! Although the metar-analyses did not specify which prevention plan worked best, I am glad that this information is getting out to the public. However, I believe time is the biggest hurdle when trying to implement any new program into a teams routine. I think proper education to both the coaches and athletes would help us to jump over this hurdle so that we can potentially prevent ankle injuries.

Jeffrey Driban said...

Kevin:
It can be tricky to tell which program is best from just 10 trials. The OA Action Alliance Best Practice Features for Lower Limb Injury Prevention Programs can be informative - http://oaaction.unc.edu/resource-library/for-community-partners/injury-prevention/
Many of these programs can be done in 10-15 minutes and often times you can modify the existing warm-up program by adding one or two exercises to meet the recommended core components of an injury prevention program. Educating the coaches and athletes is definitely key :)

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