Balance training protects the ankles from sprains

By Megan Rauscher

NEW YORK (Reuters Health) - High school athletes can markedly reduce their risk of ankle sprains, especially those with a history of ankle sprains, by spending five to ten minutes of practice time doing simple balance exercises, a study shows.

"It has been recognized for a number of years that balance training helps people post-injury, whether it is a knee injury or ankle injury," Dr. Timothy A. McGuine, Senior Athletic Trainer at the University of Wisconsin Health Sports Medicine Center in Madison told Reuters Health.

Balance training has also been shown to reduce the incidence of injuries in adult soccer players.

"Our goal was to see if could get similar results with high school athletes by designing a balance training program that was easily incorporated into practices," McGuine noted.

A total of 765 male and female high school soccer and basketball players were randomly assigned to an intervention group that participated in balance training or to a control group that performed only standard conditioning exercises.

Early in the season, McGuine explained, the intervention group did balance exercises five days per week. They started with basic balance training like standing on one leg with their eyes shut and standing on one leg while trying to dribble a basketball or kick a soccer ball. They then progressed to standing on a balance or "wobble board."

Once the regular soccer or basketball season started, athletes performed these simple balance exercises three times per week. The balance exercises took about 7 to 10 minutes out of practice time.

Sixty-two of the 765 athletes sustained an acute ankle sprain during their sports season.

According to McGuine and colleagues, the rate of ankle sprains was significantly lower in the balance trainers (6 percent versus 10 percent in the control group).

"The results of this study document that a simple, inexpensive, balance training program performed during a high school sport season will reduce the rate of ankle sprains by 38 percent in male and female high school soccer and basketball players," the investigators report in The American Journal of Sports Medicine.

Ankle sprains are very common in high school athletes and they have a "profound impact on healthcare costs and resources," McGuine and colleagues point out.

A decrease of 38 percent of ankle sprains in this population would reduce direct health care costs by $26 million and indirect health care costs by $380 million each year if the program were used on a national level for these two sports alone, the team calculates.

Consistent with other studies, the current study found that athletes who sustained an ankle sprain within the previous 12 months had more than double the risk of sustaining another sprain. The balance-training program reduced the risk of re-injury in these athletes by nearly half.

The balance-training program also appeared to reduce the incidence of ankle sprains in athletes without a history of ankle sprains, although the difference was not statistically significance. The rate of ankle sprains for athletes without a history of ankle sprains was 4.3 percent in the balance-training group and 7.7 percent in the control group.

McGuine also noted that "our initial data looks like we have more ACL tears, more knee problems in the kids who didn't do the balance exercises."

The balance-training program used in this study "is low tech -- it doesn't take a lot of time -- it doesn't cost a lot," and could be easily incorporated into most athletic team practices and physical education classes, McGuine said. "There is no down side to it."

SOURCE: The American Journal of Sports Medicine, July 2006.