November 1st, 2013

Health N' Sports: Ankle sprains

Staff Report


Health N' Sports: Ankle sprains
Basketball players sprain ankles easily / file photo

As a part of the Louisville Orthopaedic Clinic, the Sports Rehab Team physical therapists are knowledgeable and trained in the latest advancements and techniques available in sports rehabilitation.

On a weekly basis, the Health N’ Sports Update will give information on prevention, recovery, and include special offers, as well as general health tips that would be beneficial to all. If there is a specific topic you’d like to know or hear more about, email future suggestions to editor@catholicsportsnet.com.

Ankle Sprains: Factors to Consider

Ankle sprains are a frequent injury, and very common in basketball due the physical demands such as jumping, landing, and changing direction frequently and suddenly.  I can remember my first ankle sprain like it was yesterday.  The research I’ve done and used for reference are closely associated to the stability of the ankle joint or research into patients who may suffer from frequent ankle sprains. My search yielded two articles in the Journal of Orthopaedic & Sports Physical Therapy.  The two research reports that I selected were; “The Relationship Between Passive Ankle Plantar Flexion Joint Torque and Gastrocnemius Muscle and Achilles Tendon Stiffness: Implications for Flexibility” and “Relationship Between Functional Ankle Instability and Postural Control.”  These two articles fall under the five components of physical fitness; muscular strength, muscular endurance, cardiovascular fitness, flexibility and body composition. 

Flexibility and Functional Instability

The research design for the flexibility report was an experimental laboratory study, while the research design for the functional instability and postural control (factors include core strength, balance, and good posture) study was a controlled laboratory study with a cross section.  In the flexibility report, the researchers wanted to test the hypothesis of “muscle fibers and the connective tendinous structures, combined in series, provide the resistance to passive joint movement at the ankle.”  The functional ankle instability research team investigated the relationship between postural control and functional ankle instability during a hop landing task.  They also had a second investigation into whether postural control is altered in people with functional ankle instability.  The hypothesis for both studies would be considered research hypothesis, because the authors felt there would be a difference in the two groups. 

 

Demonstration of an activity that requires functional stability.

Balance stability

The number of subjects in the functional ankle instability group totaled 60 subjects and was divided into two groups, an external control group and an instability group.  The two groups were assembled by using the Cumberland Ankle Instability Tool (CAIT), which measured the stability of the subject’s ankles. The subjects would hop from a 16 cm high step and land on a force platform.  The examiner instructed the subject to resume the upright stable position for 7 seconds.  At no time, did the examiner instruct the subject on how to land.  5 trials for each lower extremity with a 30 second rest period were administered to all 60 subjects.  A subject had a successful trial if they did not have an extraneous movement 3 seconds prior to the hop and 7 seconds after the hop.  Sensors were placed on the lower extremities to measure movement. 

With 60 subjects, 31 in the external control group and 29 in the instability group, the standard deviation of the group would yield a valid and reliable summation of the research, allowing researchers to determine if the hypothesis correlated to their findings.  The conclusion of their study found that subjects in the instability group took longer to regain postural control than those in the external control group. 

The flexibility research team only had 12 subjects, consisting of 6 men and 6 women.    The researchers constructed their own measurement tool to assess the passive plantar flexion torques, with the ankle joint in different positions.    At the end of their research, the examiners found that the data indicated extensibility (the ability of a muscle to stretch) of the muscle-tendon unit is related to passive ankle plantar flexion joint torque.

The flexibility study did not provide the most valid or reliable data due to several factors, one being the method of measuring the subjects anatomical landmarks. Another factor was the small number of subjects being tested, however the researchers acknowledged this in their conclusion.  The functional ankle instability project appeared to be a more organized study, with tools that allowed for valid and reliable outcomes, due to the ability for their methods to be easily reproduced, versus having to fabricate a special measurement tool like the study on flexibility.

Conclusion

The study demonstrates the importance of building muscular strength and flexibility in order for the ankle to have a full range of motion and joint stability to perform quick movements, whether it is an athlete, or an average individual. 

-Tommy Board, PTA-

Kawakami Y. Kanehisa H. Fukunaga T.  The relationship between passive ankle plantar flexion joint torque and gastrocemius muscle and achilles tendon stiffness: Implications for flexibility.  Journal of Orthopaedic & Sports Physical Therapy.  2008; 38: 269-275.

Noronha M. Refshauge K. Crosbie J.  Relationship between functional ankle instability and postural control.  Journal of Orthopaedic & Sports Physical Therapy.  2008; 38: 782-789

DeSales Basketball Head Coach John Mingus and Strength and Conditioning Coach Luke Price give insight on basketball injuries:

1) What exercises do you suggest for your student athletes before they play to try to keep them safe?

Dynamic and static stretches to warm up to prevent injury are helpful for student athletes.

2) What are common injuries you see in high school basketball?

Common injuries deal with the Ankle, hip pointer, shoulder, and back.

3) What are common causes for ankle sprains?

The causes for ankle sprains depend on the situation. Ankle sprains are common when players land on their feet incorrectly or from running.

4) What do you suggest for treatment for ankle sprains?

I recommend ice and strength exercises with the injured ankle.

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