Friday, 4 March 2016

Chronic ankle instability in athletes

Ankle ligament injury is very common in sports activities such as basketball, football, ballet and dancing. The majority of ankle ligament injuries are due to sudden flexion and inwards rolling of the foot. This mechanism of injury usually causes damages to the lateral ligamentous and muscular structures. Inversion injury of the ankle tends to recur due to weakened ligaments and this can cause chronic ankle instability.

The two main causes of ankle instability:
  • Mechanical instability: Repeated injury to the ankle can cause structural loss of the supporting ankle ligaments
  • Functional instability: Loss of neuromuscular control such as impaired balancing ability and decreased proprioception (joint position sense). The athlete may have difficulty balancing on the injured foot.

Treatments for chronic ankle instability

1. Functional rehabilitation exercises:
  • Muscle strengthening and neuromuscular control enhancement
  • Improvement of joint position sense (proprioception can be trained by using uneven surfaces such as wobble board or rocker board)
  • Improvement of balancing ability (athletes should be able to perform heel-to-toe walk or one-leg stance with eyes opened or closed)
  • Improvement of posture control ability (strengthening of the peroneal muscle is important as the muscle acts as a lateral dynamic stabilization structure of the ankle)
2. Taping or bracing application for dynamic stabilizer facilitation, proprioception improvement or joint support

3. Ankle-foot orthotics to improve static balance ability (standing and simple linear walking) and posture control ability

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