Prevention of Ankle Sprains in Soccer Players
Soccer requires a lot of sudden stops, cutting, jumping and landing movements, which have all been shown to increase the risk of lower extremity injuries, especially to the ankle. Ankle sprains account for about 80% of all soccer related injuries, and the average time lost from play is roughly 48 days. Given the high prevalence and long recovery time associated with ankle injuries, implementing prevention strategies is key to keeping athletes healthy on the field.
Mechanism of Injury
50% of soccer related ankle sprains occur during contact with another player. Other common mechanisms include:
- Tripping on grass;
- Jumping, twisting and landing;
What are the risk factors for an ankle sprain?
- If you have sustained an ankle injury in the past, you are 7 times more likely to injure your ankle again;
- Muscle tightness (specifically in the calves);
- Slower reaction time;
- Poor proprioception;
- Poor balance;
- Playing on artificial turf;
- Poor lower limb power.
While the above risk factors are modifiable and can be changed, it is predicted that 30% of ankle sprains occur due to a chance event that cannot be avoided.
What exercises can you do to prevent an ankle sprain?
- Proprioceptive exercises are designed to optimize the ability of the dynamic stabilizers to protect the joint. Exercises should work on balance in a static position, progressing to dynamic movements, including equipment such as a bosu or balance board to allow adaptation to unstable surfaces. These exercises will eventually become more sport specific to include balancing tasks, along with kicking or throwing motions. The greatest benefit in injury reduction comes from exercises that are sport specific and include a cognitive task at the same time (i.e., reacting to stimuli or decision making).
Easy: Eyes open single leg balance; eyes open single leg balance with leg swings;
Moderate: As above, but with eyes closed;
Harder: Standing on a bosu/balance disc/pillow with single leg balance adding leg swings or ball toss.
- Pick 1-2 balance exercises and repeat on each leg for 30 sec. (2 sets each). Progress the difficulty as you improve.
- Plyometric and agility exercises are designed to enhance joint stabilization and help prevent impending ankle rollover events. Using an agility ladder is a great way to improve footwork, coordination and your ability to react and change direction quickly.
- Ladder drills: In/Out moving forward, in and out moving laterally, 2 feet in and pause, etc. Progress these exercises by increasing speed and adding a ball toss, kicking, dribbling, reaction tasks, etc.
- Reaction time exercises: At SPSC we use Blazepods, a flash reflex training system that uses visual cues (pods that light up), and prompts you to challenge your speed, agility and reaction time. The exercises are fun, challenging and motivational.
- Plank hold with reaction tap: While holding the plank position, the athlete must tap out the pod that lights up. The goal is to get as many hits as possible while maintaining the plank position for 30 seconds.
- Single leg balance with reaction tap: While standing on one foot, the athlete must react and tap out the pod that lights up. The goal is to get as many hits as possible while staying balanced.
- Reaction time, speed and agility. Athlete must run between all 4 pods and tap out the pod that lights up. The goal is to get as many hits as possible in 30 seconds.
- Strengthening exercises of the trunk, hip and knee help optimize neuromuscular control. The three key exercises shown in a recent study include bird dogs, bridges and monster walks.
- Bird Dogs: Begin on all fours, placing your hands under your shoulders and knees under your hips. Maintain a flat back and activate your core. Raise your right arm and left leg keeping your back straight. Hold this position for a couple of seconds and return to the start position. Perform 10 times per side for 3 sets.
- Bridges: Lie face up on the floor, with your knees bent. Tighten your core and squeeze your glutes as you lift your hips off the ground. Hold for a couple of seconds and return to the start position. Repeat 10 times for 3 sets.
- Monster walks: Start in an athletic stance with both knees slightly bent and feet together. Take a step sideways and then bring your feet together again. Repeat 10 steps in one direction and then ten steps back. Place band around knees to start and progress to ankles and feet. Placing the band around the feet will be the hardest, but it has the greatest activation of the glut med and max muscles.
- Stretching exercises, specifically of the calves to improve dorsiflexion, allows the joint to function in a better range.
- Gastrocs: Stand in front of a wall and bring one leg back, ensuring your toes are facing forward. Keep your heel on the ground and lean forward keeping the back leg straight. You should feel a stretch in the back leg. Hold for 30 sec. and repeat twice.
- Soleus: From the same position as above bring your back foot forward. Make sure both heels stay on the ground and bend through your knees. You should feel a stretch in the back leg. Hold for 30 sec. and repeat twice.
The benefit of these exercises, extend beyond prevention of ankle injuries. They can also reduce other lower extremity injures and improve athletic performance. In order for an exercise program to be effective, coaches and trainers need to put emphasis and time into doing these exercises regularly and properly. Incorporating them into the regular dynamic warm up is the easiest way to ensure they get done on a regular basis.
If you’re looking for a sports medicine clinic in the Oakville and Mississauga area to treat your current injuries or help put together a program to prevent future injuries, contact Sheddon Physiotherapy and Sports Clinic at 905-849-4576.
Kaminski et al., (2019). Prevention of Lateral Ankle Sprains. Journal of Athletic Training. 54,6, 650-661.