Sports Medicine

Ankle sprains are one of the most common injuries among physically active people accounting for an estimated 23,000 sprains — daily –that are attributed to athletic activity. (1) Basketball players suffer the highest incidence rate among sports (41.1%) followed by football (9.3%), soccer (7.9%), running (7.2%) and volleyball (4.0%). Unlike the knee and ACL injuries there is no predilection to females over males with ankle sprains occurring 50.3% and 49.7% respectively. (2) Nearly 30% of first time ankle sprains will cause chronic ankle instability (CAI) which has also been reported as a contributing factor to the early onset of osteoarthritis. (3) The effects of CAI are also seen beyond the local area of injury as altered pelvic stability. Although ankle sprains are typically treated in the physical therapy setting there are many things a personal trainer can do to help restore full function and also prevent future injuries.

A history of a previous ankle sprain is the most common predictor of this type of injury, with an incidence rate of 73%. This injury most often occurs when landing either on the ground or on another player’s foot. (4) Other causes include a sharp turn or twist, collision, fall or sudden stop. This results in functional deficits including range of motion, limited ankle dorsiflexion, impaired proprioception and balance control, and increased pelvic neuromuscular reaction time. (5,6)

Ankle Sprain

Anterior cruciate ligament (ACL) injuries are one of the most common among young female athletes occurring at a conservative estimate of 38,000 incidences per year. (1) With the cost of a surgical repair ranging between $17,000-$25,000 (2), the economic impact is significant, not to mention the long term sequela to the athlete which includes a significantly greater risk of osteoarthritis in the future. (3) Approximately 80% of these injuries are non-contact, suggesting many of them can be prevented. (4)

The ACL is a ligament running from the posterior femur anteriorly to the tibia. It originates from deep within the notch of the distal femur and its proximal fibers fan out along the medial wall of the lateral femoral condyle. The ACL attaches in front of the intercondyloid eminence of the tibia and is blended with the anterior horn of the medial meniscus. It provides approximately 85% of the restraining forces preventing anterior tibial translation. It also limits excessive internal or external rotation of the tibia. (5)

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