Practice Balance to Protect Accident-Prone Ankles

Dutch researchers recently discovered that a home-based program designed to increase ankle stability after a sprain can substantially reduce the risk of reinjuring the joint.

The ankle joint is inherently unstable, making ankle sprains the most common injury encountered in many sports. Once the ligaments are stretched during a sprain, they are much more likely to do so again, often more easily than the first time around. In order to prevent re-spraining the ankle, some experts recommend a type of strength and stability conditioning called “proprioceptive” training.

It’s all in the balance

First used in the 1980’s on Swedish soccer players with ankle instability, proprioceptive training involves balancing on the side of the injured ankle on a “wobble board.” The board is positioned on a hemispheric structure, with the flat edge on its underside. While using the board, the person maintains his or her balance by adjusting the position of the ankle, while holding the foot, leg, and body in the same place.

The new study evaluated the effectiveness of proprioceptive training carried out at home on the recurrence of ankle sprain in 522 athletes during the year following the initial injury. Half of the people were shown how to do the proprioceptive training; the others served as the control group.

Over the course of the study, 33% of the people in the control group experienced a repeat ankle sprain, compared with only 22% in the training group, a statistically significant reduction.

“The entire range of athletes, from young elite to intermediate and recreational senior athletes, would benefit from using the training program for the prevention of recurrences of ankle sprain,” said the study’s authors. They noted that at least six weeks of proprioceptive training seems to be necessary to reduce the risk of reinjury.

Ankle sprain home care

If you’ve recently sustained an ankle sprain, make sure to get plenty of RICE:

• Rest is key to allow the tissues to heal. Don’t be tempted to do more, sooner, if your ankle is still in pain. Avoid bearing weight on the ankle for at least 24 hours after the injury.
  
  
• Ice the ankle intermittently for the first day following the sprain.
  
  
• Compression helps minimize swelling. Use an ACE bandage and wrap securely, being careful not to cut off circulation.
  
  
• Elevation helps decrease pain and swelling. Keep the foot higher than the heart to decrease fluid retention.

(BMJ 2009;doi:10.1136/bmj.b2684)

August 6, 2009

Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI, and now sees patients in East Greenwich and Wakefield. Inspired by her passion for healthful eating and her own young daughters, Dr. Beauchamp is currently writing a book about optimizing children’s health through better nutrition.

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