Balance training programs could reduce risk of ankle sprains

High school athlete cohort experienced fewer ankle injuries with a 10-minute daily program.

High school athletes who participated in a short balance training program throughout their sport season experience fewer ankle sprains than athletes who did not participate in the program. A subgroup of athletes who had not had prior sprains also had a reduced incidence of injury.

Several previous studies have examined the effectiveness of balance training programs on prevention of injury, but this study, conducted by Timothy A. McGuine, PhD, ATC, of the University of Wisconsin at Madison, was the first to focus solely on high school athletes. According to McGuine, more than 1 million young athletes suffer ankle sprains while playing soccer and basketball every year.

“Our aim was to determine if a balance training program reduces injury potential to athletes,” McGuine said. Researchers also examined the program’s effect on recurrent injuries. The study included 765 high school athletes from 12 Wisconsin high schools; there were 523 girls and 242 boys. All of the athletes were randomized to either the intervention group (27 teams, 373 participants) or the control group (28 teams, 392 participants).

The intervention group began a 10-minute daily balance training program prior to the start of the sport season and continued it throughout the season, supervised by an athletic trainer provided by the research team. “Our athletic trainers were there every day [with every team], recording who sustained injuries and exposures to injury,” McGuine said. He spoke at the American Orthopaedic Society for Sports Medicine 2005 Annual Meeting in Keystone, Colo.

Results

Overall, the athletes sustained a total of 62 ankle sprains over the course of 41,078 exposures to injury. This resulted in an injury rate of 1.51 sprains/1000 exposures; McGuine noted that “most of the injuries were considered mild.” Exposures to injury included team conditioning sessions, practices and competitions.

Researchers found a significantly lower incidence of ankle sprains in the intervention group. Male athletes sustained injuries at rates of 0.87/1000 exposures in the intervention group and 1.34/1000 in the control group; for female athletes, the rates were 1.3/1000 and 2.24/1000, respectively (P=.04). Athletes without prior sprains also sustained fewer injuries in the intervention group than in the control group (0.77/1000 vs. 1.43/1000), and researchers also found a 49% lower incidence of ACL injuries in girls in the intervention group (0.3/1000 vs. 0.59/1000).

“This [study] is important because this is the first study that tells us that an intervention balance training program [reduces risk] of ankle injury in high school athletes,” McGuine said. Because of the large total numbers of ankle sprains in high school athletes every year, instituting programs like this one that may reduce the risk of sprain could “save about $400 million per year in medical costs.”

McGuine noted that the study had several limitations, including the imbalanced number of boys and girls included. “We need to do further studies to determine if we can also reduce injuries using the same protocol in other high school athlete populations, and in other injuries as well,” he said. Furthermore, the secondary findings including the lower risk of ACL injury in girls will require larger cohort studies to interpret their significance.

For more information:
McGuine TA. The effect of a balance training program on prevention of ankle sprains in high school athletes: a prospective randomized controlled intervention study. Presented at the American Orthopaedic Society for Sports Medicine 2005 Annual Meeting. July 14-17. Keystone, Colo.