Human Locomotion

The effectiveness of a balance training intervention in reducing the incidence of noncontact ankle sprains in high school football players. McHugh M, et al. Am J Sports Med 2007, 35;8:1289.

Monthly Research Articles

This is one of my all-time favorite ways to improve balance and/or prevent ankle injuries. In this study, researchers followed 125 high school football players for anywhere from 1 to 4 seasons. Players were classified as low-, moderate-, or high-risk for reinjury, depending upon their body mass index and/or their prior history of ankle sprain. The authors note that at the start of the study, the overweight, previously injured football players were 19 times more likely to be injured than the low-risk athletes. What makes this such a great paper is that the treatment protocol is so simple: The athletes were instructed to stand on a conventional foam stability pad for five minutes on each leg, five days per week for four weeks preseason, then twice per week for nine weeks during the season. The pads were placed in the weight training room, and the subjects were told to just stand on the pad with their sneakers on and their eyes open for five consecutive minutes before switching to the contralateral leg.

At the end of the study, the authors noted that 77% reduction in ankle sprain frequency, which is unheard of in high-risk athletes. In fact, the authors state “the increased risk of a non contact inversion ankle sprain associated with high body mass index and previous ankle sprain was eliminated by the balance training intervention.” I’ve used this protocol for the past 10 years and I’m always surprised by how effective it is. It’s easy, inexpensive, and surprisingly enjoyable to do, as it is a significant challenge, especially for previously injured individuals. If the patient is unwilling to spend 10 minutes performing this protocol, I have them do the proprioceptive training on the injured side, as prior research shows that there is a significant crossover effect, and that balance improves bilaterally when performed unilaterally. The simplicity of this exercise protocol explains why compliance in the study was so high: 91% for anywhere from one to four seasons.