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4 Ways to Prevent Ankle Injuries in Volleyball Players

Roughly 20% of volleyball players will suffer an injury at some point in their career, with ankle sprains making up roughly 50% of all injuries experienced in volleyball athletes across all skill levels. Luckily, ankle sprains can be prevented with education and coaching on proper skill techniques/mechanics, as well as specific conditioning exercises such as balance and proprioceptive exercises. The therapists at Sheddon Physiotherapy and Sports Clinic have worked with numerous volleyball players from young athletes just learning the sport to higher-level rep players from clubs in Oakville/Mississauga such as Pakmen Volleyball. The team at SPSC can help identify athletes at risk for injury as well as quickly and efficiently rehabilitate volleyball athletes who have suffered an injury.

Causes/Risk Factors

Most ankle sprains (89%) occur around the net from landing after a block or an attack. They generally result from stepping on the foot of an opponent or a teammate. The greatest risk factor for an ankle sprain is a previous history of ankle injuries, especially if it occurred in the past 6-12 months and was not rehabilitated properly.

Prevention Strategies:

  1. One of the most effective prevention strategies is education and training regarding proper take off and landing technique during blocking and attacks. More specifically, players should be taught to jump straight up to hit the ball, instead of forward, so that they will not land on the centre line under the net. In addition, players need to practice take off and landing during 2 man blocks.
  2. Proprioceptive training to improve stability and balance. Proprioceptive exercises should be included in every warm up, and should only take 5 minutes to complete. They will generally involve the use of balance boards, bosu, trampolines, and ladders. For example: a. player standing on one leg and tosses a ball to another player or against wall 10/leg x 5 sets. B. Single leg stance on the balance board/bosu for 30 sec x 2 sets. C. Mini squats on balance board 10x 2 sets. D. Ladder drills to work on agility and coordination.
  3. Proper rehabilitation post ankle injury in order to prevent reoccurrence.
  4. The use of support (brace or tape) to protect the ankle. Research has shown that bracing/taping decreases the incidence of ankle sprains in previously sprained ankles, but not in previously uninjured ankles. The greatest risk of reinjury is during the first year post ankle sprain, due to weakness in the ligament and proprioceptive ability, as such athletes should brace/tape for the first year post injury.

Sheddon Physiotherapy and Sports Clinic has been treating athletes of all ages and skill levels for over 10 years in the Oakville and Mississauga area. If you’re currently injured, book an appointment with one of our physiotherapists, chiropractors, athletic therapists or massage therapists in order to help get you back on the court healthy and pain-free. If you’re not currently injured, the therapists at Sheddon can get you started on an injury prevention and strengthening program by working on your specific weaknesses and imbalances to help prevent any future injuries. If you’re looking for a sports medicine clinic in the Oakville and Mississauga area that has great therapists AND will get you results quickly, then contact Sheddon Physiotherapy and Sports Clinic at 905-849-4576.

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Prevention of Ankle Injuries 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. Roughly 35% of all soccer injuries occur in the ankle, with an average time lost from play of about 48 days. With the high prevalence and long recovery time associated with ankle injuries, identifying modifiable risk factors and prevention strategies is key to keeping athletes healthy on the field.

Mechanism of Injury

Roughly 50% of soccer related ankle injuries occur during contact with another player. Other common mechanisms include:

  • Overuse;
  • Tripping on grass;
  • Jumping, twisting and landing;
  • Tackling;
  • Shooting/kicking.

Common Ankle Injuries

The most common ankle injuries experienced by soccer athletes are ligament sprains (80%), followed by overuse impingement syndromes, tendonitis (achilles, peroneals, posterior tibial tendon), and though rarely, soccer players will experience fractures or osteochondral lesions.

Ligament Sprains

Ankle sprains account for 80% of all soccer athlete injuries, and these athletes are 5x more likely to sustain a recurrent ankle injury upon return to soccer. Initial treatment following a sprain will involve modalities, manual therapy and rest. However, functional treatment is key for long term success, focusing on strengthening, balance, and proprioception required for return to sport.

Anterior Impingement Syndrome

Anterior impingement syndrome, better known as “Soccer Ankle”, has been shown to occur in roughly 60% of professional soccer players. Athletes generally feel pain in the front of the ankle, with feelings of giving way and catching, as well as pain with dorsiflexion movements (moving your foot up), squatting, sprinting and stair climbing. It has been proposed that recurrent ball impact results in microtrauma to the anterior joint, causing extra bony growth, which can become impinged with movement. Physical therapy treatment can be successful; however some athletes will require surgical intervention, which does have a high success rate.

Tendon and Muscle Strains

Tendon and muscle strains are another common overuse injury experienced in soccer players, with the achilles being the most common site of injury. To read a more comprehensive review on achilles tendon injuries and prevention strategies, click here.

Risk Factors

Several risk factors have been shown to predict who will sustain an ankle injury:

  • Previous injuries increased the risk for an ankle injury by up to 7x – especially if previous injuries were poorly rehabilitated. Symptoms that become chronic can be an indicator that the previous injury has not been properly rehabilitated, and overuse will eventually lead to future injury.
  • Muscle tightness or strength imbalance 
  • Slower reaction time 
  • Overuse
  • Joint instability (Mechanical instability due to ligament laxity or functional instability due to poor proprioception, coordination and weakness).
  • Poor balance and lower limb power (vertical jump)
  • Insufficient training
  • Inadequate warm up
  • Increased age:  Adolescent studies showed a high rate of injury in 12-15 year olds.
  • Playing on artificial turf has been associated with a greater risk for ankle sprains
  • Increased likelihood during competitions vs. training

Although there are several risk factors for ankle injuries, it is predicted that 30% of them are caused by a chance event that cannot be avoided.

Prevention Strategies

  • Warm up:
    • An improper or lack of warm-up is one of the easiest ways to injure yourself. Take 5-10 minutes before games to warm up properly. Check out the FIFA11 warm-up program here.
  • Stay in shape:
    • Preseason training should focus on muscle imbalances and weaknesses, with particular attention placed on proprioceptive exercises, especially in young adolescent soccer players.
  • Follow the rules of the sport:
    • Unfair player contact accounts for 25% of soccer related ankle injuries
  • Adequately rehab your injuries with sufficient rest time
  • Protective equipment:
    • Shin guards have been shown to reduce the impact forces to the leg, reducing the occurrence of soft tissue and fracture injuries to the lower extremity. In addition, ankle braces have been shown to provide mechanical stability to the ankle joint, as well as increase proprioception in previously injured ankle joints.
  • Focus on neuromuscular, balance and proprioceptive training:
    • Proprioceptive mechanoreceptors are found in the ligaments in the ankle. As such, injury to the ankle will likely damage these mechanoreceptors, resulting in a proprioceptive deficit and instability in the joint. If proper rehabilitation exercises are not completed prior to return to sport, then the athlete is at an increased risk for re-injury.
    • Proprioceptive exercises should include balance training in a static position progressing to dynamic movements, including equipment such as the bosu, wobble disc and balance boards. Furthermore, plyometric exercises that enhance joint stabilization and reaction time exercises should be part of the return to sport training program.

With cooler weather coming, this marks the start of the indoor soccer season. Ensure your current injuries are well rehabilitated and spend some time working on your weaknesses (strength, proprioception, balance, etc.). Research has shown that indoor soccer is associated with twice as many injuries than outdoor soccer. Possible factors include high-speed movements, smaller size field, and surface changes. Focus on yourself now and don’t get stuck on the bench resting your injuries this indoor season.

Henry et al., (2015). Risk factors for noncontact ankle injuries in amateur male soccer players: A prospective cohort study. Clinical journal of sport medicine. 26:251-258.

Nery et al., (2016). Foot and ankle injuries in professional soccer players. Diagnosis, treatment and expectations. Foot and ankle clinic N. Am. 391-403.

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