Predicting Future Ankle Sprains

Ankle sprains are one of the most common sports injuries and one of the most common we encounter at Mend Physical Therapy.  These injuries lead to pain, lost practice and games, as well as chronic balance impairments up to 1 year after the injury.  As our manual therapy and exercise treatments have evolved we are seeing athletes return to play faster with less long term implications.  With any athletic injury "an ounce of prevention is worth a pound of cure" and this is true with ankle sprains as well.  In a previous post we discussed the ability to prevent ankle injuries in basketball and this post will discuss emerging evidence on the ability to predict ankle sprains in high school and collegiate football players.

The star excursion balance test (SEBT) is a clinical test used to assess the ability of the athlete to maintain their balance as they move their uninvolved leg in three directions.  The distance this leg travels is recorded and compared against their noninvolved side.  The test requires significant amounts of range of motion, strength, and balance to perform correctly.  Most importantly Physical Therapists are interested in symmetry between sides when determining return to sport and future risk of ankle injury.  Prior researchers have reported a side to side difference is predictive of future lower extremity injury among basketball players (Plisky et al. 2006).  A recent article in the American Journal of Sports Medicine analyzed the predictive value of the SEBT among high school and collegiate football players.  

Gribble and colleagues evaluated >500 football players on the FMS, SEBT, and body mass index and then tracked the number of injuries these athletes sustained over the course of the season.  The authors reported 54 lateral ankle sprains among the athletes with significant differences on BMI and SEBT performance between the injured and non injured groups.  The injured group had significantly higher BMI scores and lower reach distances compared to the uninjured group.  The most powerful predictor was forward reach distance on the SEBT.  Conversely, the pre season FMS did not help differentiate between injured and non injured athletes in season.

Coaches, athletes, and Physical Therapists should consider using the SEBT to help predict future injury among high school athletes.