Volleyball and Lateral Ankle Sprains
Volleyball is an explosive sport which requires multi-directional movement and both feet leaving the ground for the most effective placement of the ball in the opposition’s side of the court. Both, the change in the direction and instability of leaving the ground place the foot at an increased risk of a lateral ankle sprain.
Lateral ankle sprains have been identified as the most common structural injury amongst athletes outside of non-specific bruising. There have been a number of predictive factors flagged throughout identifying both intrinsic and extrinsic influences which have potential to cause lateral ankle sprains. One of the most positively linked intrinsic factor associated with lateral ankle sprains, is in fact previous history of a sprain. The initial injury is believed to cause a partial differentiation of the ankle, rendering it unstable biomechanically as a result of ligament compromise. Additionally, muscle reaction time, more specifically closed-loop efferent reflex response, was shown to be slower in previously injured athletes reducing the stabilizing effect of the gastrocnemius and tibialis anterior, suggesting a neuromuscular deficit.
Postural sway has also been shown to influence an athlete’s risk of ankle sprain. Taking into consideration that an athlete changes their centre of gravity multiple times within seconds of play, this is a key finding when it comes to rehabilitation as it is influenced by both the central and peripheral nervous system. Other intrinsic predictive influences which have been flagged but to date have not been individually proven include; gender, height, weight, limb dominance, anatomical foot type, foot size, hypermobility and muscle strength although clinically these finding may help in developing an overall reasoning for the injury.
Extrinsic risk factors influencing ankle sprains have primarily been observed through prospective studies inclusive of bracing, taping, shoe type and the duration and intensity of competition.
There have been a number of studies looking at the use of ankle braces and rigid taping in the prevention of ankle sprains, many of which have shown nil association in the prevention of an initial ligamentous injury; however consensus amongst researchers appears to be that the use of n ankle brace or taping has a positive influence in reducing a re-occurrence of injury. Given these findings contradict each other from a biomechanical standing, it is reasonable to deduct that the presence of a compressive force such as that previously mentioned provides proprioceptive feedback to the athlete.
Shoe Type has been found to have nil association with the incidence of ankle sprain injury. In two well-controlled studies comparing high top basketball shoes to light weight infantry boots and high top basketball shoes vs low top basketball shoes during military training exercises it was shown there was no difference in the incidence of ankle sprains. Additionally, when addressing duration of time played on field, field position and intensity of competition, no difference was found over one thousands hours of basketball game play. However, it should be noted that injury was more likely to take place during officiated game play rather than practice.
So how do we prevent such an injury which can leave an athlete out of game play anywhere from seven days to twelve weeks? The answer unfortunately is not a straight forward one, in fact, in terms of developing a prevention program for ankle sprains it is suggested clubs establish more specific technical training based on landing, take off and lateral cutting movements. As mentioned previously, tape has only been found to have a positive preventative effect on athletes who have already sustained an injury, the same can be said for the use of custom orthoses which are recommended for at least twelve months following a serious ankle sprain due to duration it takes for ligaments to reach full repair and regain proprioceptive ability.
Until Next Time