Chronic Ankle Instability. Prevention is better than cure.

Ankle sprains are the most common injury in sport. Whilst they are the most common injury, they are often undertreated. People often feel that the sprain isn’t bad and will recover in a couple of days. While it may feel better in a couple of days, often the ligaments are stretched and the muscles are inhibited and not working as well as they should. This can result in recurrent sprains, weakness, and feelings of instability.

What is Chronic Ankle Instability

If these symptoms occur over a prolonged period it is referred to as chronic ankle instability. At least 33% of people who sustain a lateral ankle sprain progress to having chronic ankle instability.

Chronic ankle instability (CAI) has been shown to lead to detriments in many areas of a person’s life, these include, reduced health-related quality of life, decreased ankle function, increased instability and pain, reduced physical activity levels in adults, and an increased risk of post-traumatic ankle osteoarthritis (It has been shown that 68%-78% of people with CAI develop ankle osteoarthritis (Wikstrom & McKeon, 2017)).

Who can get Chronic Ankle Instability

Around 20% of athletes (from adolescent to older athletes) have chronic ankle instability. The biggest risk factor for a person to get an ankle sprain, is a previous ankle sprain. This means that the best way to reduce this number is to reduce ankle sprains from happening in the first place (Or at least stop them from happening again). So even if you have never had an ankle sprain before, you can still complete a program so you are protected further from it happening in the first place.

How can I make sure I don’t get Chronic Ankle Instability

Research shows that ankle bracing/taping (see video here)and preventative exercise programs reduce the incidence and/or recurrence of ankle sprains (Kaminski, Needle, & Delahunt, 2019; Tsikopoulos et al., 2019). These can be done individually (which has been shown to reduce risk), or combined which appears to reduce risk of ankle sprains even further.

Some people do not like ankle braces/tape because of the belief that it might affect performance, however, when wearing an external support performance is affected minimally. This combined with the reduction in risk of injury highlights the important effect that these can have on a player.

Exercises to prevent Chronic Ankle Instability

Preventative exercise programs incorporate a number of components including, stretching, balancing, strengthening, agility and sport specific drills. The combination of these drills assists with reducing the incidence of ankle sprains by improving ankle range of motion, optimising lower limb/trunk neuromuscular control and enhancing static and dynamic postural control, when combined, these components assist with optimising performance. At the forefront of these programs are balancing exercises – Balance exercises have been shown to effectively reduce the risk of ankle sprains, with a risk reduction of 34% per 1000 hours of playing exposure. For context, a professional player will complete about 300 hours of playing exposure per season.

Preventative exercise programs should be completed at least 3x a week, therefore, the perfect time to complete these programs is during your warm up before training and playing.

That way, you know that it is being done consistently, which means that you are doing the best you can to stop injury happening in the first place.

We have helped many local sports clubs in the local Peakhurst, Lugarno, Oatley and Riverwood areas rehabilitate their players from ankle injuries. Reach out to our experienced team to discuss.

By Peakhurst Physio

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