Skip to main content
SpringerLink
Log in

Factors Associated with Ankle Injuries

Preventive Measures

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Summary

A sense of foot position in humans is precise when barefoot, but is distorted by athletic footwear, which accounts for the high frequency of ankle sprains in shod athletes. It is unclear whether taping and rigid and semi-rigid devices protect against ankle sprains, as all of the studies suggesting this are flawed by inadequate controls. If these devices do protect the ankle, it is not through added support but rather through a partial correction of the decreased foot position awareness caused by footwear. Since taping and rigid and semi-rigid devices interfere with normal movement, there is concern that these might actually increase the frequency of injury at the ankle and/or at different locations. In this respect, taping is less of a concern because it interferes least with normal movement. The best solution for reducing ankle sprains in shod athletes is the use of more advanced footwear to retain maximal tactile sensitivity, thereby maintaining an awareness of foot position comparable to that of the barefoot state or perhaps even improving on it.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mach RP. Ankle injuries in athletics. Clin Sports Med 1982; 1: 71–9

    Google Scholar 

  2. Garrick JG. Epidemiologic perspective. Clin Sports Med 1982; 1: 13–8

    PubMed  CAS  Google Scholar 

  3. Garrick JG, Requa RK. The epidemiology of foot and ankle injuries in sports. Clin Sports Med 1988; 7: 29–36

    PubMed  CAS  Google Scholar 

  4. Robbins SE, Waked EG, McClaran J. Proprioception and stability: foot position awareness as a function of age and footwear. Age Ageing 1995; 24: 67–72

    Article  PubMed  CAS  Google Scholar 

  5. Robbins SE, Waked EG, Allard P, et al. Aging in relation to optimization of footwear in older men. J Am Geriatr Soc 1997; 45: 61–7

    PubMed  CAS  Google Scholar 

  6. Black HM, Brand RL. Injuries of the foot and ankle. In: Scott WN, Nisonson B, Nicholas JA, editors. Principles of sports medicine. Baltimore: Williams & Wilkins, 1984: 348–62

    Google Scholar 

  7. Renström P. Swedish research in sports traumatology. Clin Orthop 1984; 191: 144–58

    PubMed  Google Scholar 

  8. Barrett J, Bilisko T. The role of shoes in the prevention of ankle sprains. Sports Med 1995; 20: 277–80

    Article  PubMed  CAS  Google Scholar 

  9. Liu SH, Jason WJ. Lateral ankle sprains and instability problems. Clin Sports Med 1994; 13: 793–809

    PubMed  CAS  Google Scholar 

  10. Brostrom L. Sprained ankles, I: sprained ankles and anatomic lesions in recent sprains. Acta Chir Scand 1964; 128: 483–95

    Google Scholar 

  11. Miller EA, Hergenroeder AC. Prophylactic ankle bracing. Pediatr Clin North Am 1990; 5: 1175–85

    Google Scholar 

  12. Diamond JE. Rehabilitation of ankle sprains. Clin Sports Med 1989; 4: 877–91

    Google Scholar 

  13. Bahr R, Karlsen R, Lian O, et al. Incidence and mechanism of acute ankle inversion injuries in volleyball. Am J Sports Med 1994; 22: 595–600

    Article  PubMed  CAS  Google Scholar 

  14. Trott AW. Foot and ankle problems in children and adolescents: sports aspects. In: Kiene RH, Johnson KA, editors. Symposium on the foot and ankle. St Louis: Mosby, 1983: 34–49

    Google Scholar 

  15. Caine D, Cochrane B, Caine C, et al. An epidemiologic investigation of injuries affecting young competitive female gymnasts. Am J Sports Med 1989; 17: 811–20

    Article  PubMed  CAS  Google Scholar 

  16. Hamilton WG. Foot and ankle injuries in dancers. Clin Sports Med 1988; 7: 143–74

    PubMed  CAS  Google Scholar 

  17. Yde J, Nielsen AB. Sports injuries in adolescents’ ball games: soccer, handball and basketball. Br J Sports Med 1990; 24: 51–4

    Article  PubMed  CAS  Google Scholar 

  18. Cox JS. Surgical and nonsurgical treatment of ankle sprains. Clin Orthop 1985; 198: 118–26

    PubMed  Google Scholar 

  19. McCloskey DI. Kinesthetic sensibility. Physiol Rev 1978; 58: 763–819

    PubMed  CAS  Google Scholar 

  20. Clark FJ, Burgess RC, Chapin JW, et al. Role of intramuscular receptors in the awareness of limb position. J Neurophysiol 1985; 54: 1529–40

    PubMed  CAS  Google Scholar 

  21. McCloskey DI, Gandevia SC. Role of inputs from skin, joints and muscles and of corollary discharges, in human discrimination tasks. In: Gordon G, editor. Active touch: the mechanism of recognition of objects by manipulation: a multidisciplinary approach. Oxford: Pergamon Press, 1977: 177–88

    Google Scholar 

  22. Magnusson M, Enbom H, Johansson R, et al. Significance of pressor input from the human feet in anterior-posterior postural control. Acta Otolaryngol 1990; 110: 182–8

    Article  PubMed  CAS  Google Scholar 

  23. Goodwin GM, McCloskey DI, Matthews PBC. The persistence of appreciable kinesthesia after paralyzing joint afferents but preserving muscle afferents. Brain Res 1972; 38: 326–9

    Article  Google Scholar 

  24. Clark FJ, Horch KW. Kinesthesia. In: Boff KR, Jauffman L, Thomas JP, editors. Handbook of perception and human performance. New York: John Wiley & Sons, 1986: 13.1–62

    Google Scholar 

  25. Feurerbach JW, Grabiner MD, Koh TJ, et al. Effect of an ankle orthosis and ankle ligament anesthesia on ankle joint proprioception. Am J Sports Med 1994; 22: 223–9

    Article  Google Scholar 

  26. Browne K, Lee J, Ring PA. The sensation of passive movement at the metatarso-phalangeal joint of the great toe in man. J Physiol 1954; 126: 448–58

    PubMed  CAS  Google Scholar 

  27. Knibestol M, Valbo AB. Intensity of sensation related to activity of slowly adapting mechanoreceptive units in the human hand. J Physiol 1980; 300: 251–67

    PubMed  CAS  Google Scholar 

  28. Robbins SE, Hanna AM, Jones L. Sensory attenuation induced by modern footwear. J Test Eval 1988; 16: 412–6

    Article  Google Scholar 

  29. Robbins SE, Hanna AM, Gouw GJ. Overload protection: avoidance response to heavy plantar surface loading. Med Sci Sports Exerc 1988; 20: 85–92

    Article  PubMed  CAS  Google Scholar 

  30. Gregory JE, Morgan DL, Proske U. Errors in position sense attributed to after-effects in muscle spindles. Proc Aust Physiol Pharmacol Soc 1986; 17: 52P

    Google Scholar 

  31. Robbins SE, Waked EG, Rappel R. Ankle taping improves proprioception before and after exercise in young men. Br J Sports Med 1995; 29: 242–7

    Article  PubMed  CAS  Google Scholar 

  32. Gregory JE, Morgan DL, Proske U. Aftereffects in the responses of cat muscle spindles and errors of limb position sense in man. J Neurophysiol 1988; 59: 1220–30

    PubMed  CAS  Google Scholar 

  33. Robbins SE, Gouw GJ. Athletic footwear: unsafe due to perceptual illusions. Med Sci Sports Exerc 1991; 22: 217–24

    Google Scholar 

  34. Robbins SE, Hanna AM. Running-related injury prevention through barefoot adaptations. Med Sci Sports Exerc 1987; 19: 148–56

    PubMed  CAS  Google Scholar 

  35. Nitz AJ, Dobner JJ, Kersey D. Nerve injury and Grades II and III ankle sprains. Am J Sports Med 1985; 13: 177–82

    Article  PubMed  CAS  Google Scholar 

  36. Freeman MAR, Dean MRE, Hanham IWF. The aetiology and prevention of functional instability of the foot. J Bone Joint Surg Br 1965; 47: 678–85

    PubMed  CAS  Google Scholar 

  37. Garn SN, Newton RA. Kinesthetic awareness in subjects with multiple ankle sprains. Phys Ther 1988; 68: 1667–71

    PubMed  CAS  Google Scholar 

  38. Glencross D, Thornton E. Position sense following joint injury. J Sports Med Phys Fitness 1981; 21: 23–7

    PubMed  CAS  Google Scholar 

  39. Milch LD. Rehabilitation exercises following inversion ankle sprains. J Am Podiatry Assoc 1986; 76: 577–86

    CAS  Google Scholar 

  40. Tropp H, Askling C, Gilquist J. Prevention of ankle sprains. Am J Sports Med 1985; 13: 259–62

    Article  PubMed  CAS  Google Scholar 

  41. Rzonca EC. TEMPER: an acronym for ankle sprain rehabilitation. Clin Podiatr Med Surg 1988; 3: 661–75

    Google Scholar 

  42. Rovere GD, Clarke TJ, Yates CS, et al. Retrospective comparison of taping and ankle stabilizers in preventing ankle injuries. Am J Sports Med 1988; 16: 228–32

    Article  PubMed  CAS  Google Scholar 

  43. Surve I, Schwellnus MP, Noakes T, et al. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis. Am J Sports Med 1994; 22: 601–6

    Article  PubMed  CAS  Google Scholar 

  44. Garrick JG, Requa RK. Role of external support in the prevention of ankle sprains. Med Sci Sports Exerc 1973; 5: 200–3

    CAS  Google Scholar 

  45. Firer P. Effectiveness of taping for the prevention of ankle ligament sprains. Br J Sports Med 1990; 24: 47–50

    Article  PubMed  CAS  Google Scholar 

  46. Quigley TB, Cox J, Murphy J. Protective device for the ankle. J Am Med Assoc 1946; 123: 924

    Article  Google Scholar 

  47. Fumich RM, Ellison AE, Guerin RK, et al. The measured effect of taping on combined foot and ankle motion before and after exercise. Am J Sports Med 1981; 9: 165–70

    Article  PubMed  CAS  Google Scholar 

  48. Larsen E. Taping the ankle of chronic instability. Acta Orthop Scand 1984; 55: 551–3

    Article  PubMed  CAS  Google Scholar 

  49. Gross MT, Bradshaw MK, Ventry LC. Comparison of support provided by ankle taping and semi-rigid orthosis. J Orthop Sports Phys Ther 1987; 9: 33–9

    PubMed  CAS  Google Scholar 

  50. Myburgh KH, Vaughan CL, Isaacs SK. The effects of ankle guards and taping on joint motion before, during and after a squash match. Am J Sports Med 1984; 12: 441–6

    Article  PubMed  CAS  Google Scholar 

  51. Thonnard JL, Bragard D, Willems PA, et al. Stability of the braced ankle: a biomechanical investigation. Am J Sports Med 1996; 24: 356–61

    Article  PubMed  CAS  Google Scholar 

  52. Perlman M, Leveille D, DeLeonibus J, et al. Inversion lateral ankle trauma: differential diagnosis, review of literature, and prospective studies. J Foot Surg 1987; 26: 95–135

    PubMed  CAS  Google Scholar 

  53. Paris DL, Vardaxis V, Kokkaliaris J. Ankle ranges of motion during extended activity periods while taped and braced. J Athlet Train 1995; 30: 223–8

    CAS  Google Scholar 

  54. Shapiro MS, Kabo JM, Mitchell PW, et al. Ankle sprain prophylaxis: an analysis of the stabilizing effects of braces and tape. Am J Sports Med 1994; 22: 1–5

    Article  Google Scholar 

  55. Hughes LY, Stetts DM. A comparison of ankle taping and a semi-rigid support. Physician Sports Med 1983; 11: 99–103

    Google Scholar 

  56. Greene TA, Hillman SK. Comparison of support provided by a semi-rigid orthosis and adhesive ankle taping before, during and after exercise. Am J Sports Med 1990; 18: 498–506

    Article  PubMed  CAS  Google Scholar 

  57. Burks, RT, Bean BG, Marcus R, et al. Analysis of athletic performance with prophylactic ankle devices. Am J Sports Med 1991; 10: 104–6

    Article  Google Scholar 

  58. Glick JM, Gordon RB, Nishimoto D. The prevention and treatment of ankle injuries. Am J Sports Med 1976; 4: 131–41

    Article  Google Scholar 

  59. Karlsson J, Andreasson GO. The effect of external ankle support in chronic lateral ankle instability: an electromyographic study. Am J Sports Med 1992; 20: 11–5

    Google Scholar 

  60. Paris DL. The effects of the Swede-O, New Cross, and McDavid ankle braces and adhesive ankle taping on speed, balance, agility, and vertical jump. J Athlet Train 1992; 27: 253–6

    CAS  Google Scholar 

  61. Gehlsen GM, Pearson D, Bahamonde R. Ankle joint strength, total work, and ROM: comparison between prophylactic devices. J Athlet Train 1991; 26: 62–5

    Google Scholar 

  62. Greene TA, Wight CR. A comparative support evaluation of three ankle orthoses before, during and after exercise. J Orthop Sports Phys Ther 1990; 11: 453–6

    Article  PubMed  CAS  Google Scholar 

  63. Paulos LE, Drawbert JP, France P, et al. Lateral knee braces in football: do they prevent injury? Physician Sports Med 1986; 14: 119–25

    Google Scholar 

  64. Rovere GD, Haupt HA, Yates S. Prophylactic knee bracing in college football. Am J Sports Med 1987; 15: 111–6

    Article  PubMed  CAS  Google Scholar 

  65. Grace TG, Skipper BJ, Newberry JC, et al. Prophylactic knee braces and injury to lower extremity. J Bone Joint Surg Am 1988; 70: 422–7

    PubMed  CAS  Google Scholar 

  66. Teitz CC, Hermanson BK, Knonmal RA, et al. Evaluation of the use of braces to prevent injury to the knees in collegiate football players. J Bone Joint Surg Am 1987; 69: 2–8

    PubMed  CAS  Google Scholar 

  67. Robbins S, Waked EG. Humans amplify impact to compensate for instability caused by balance and vertical impact in sports: role of shoe sole materials. Arch Phys Med Rehabil 1997. In press

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, Concordia University, Montreal, Quebec, Canada

    Steven Robbins

  2. Centre for Studies in Aging, McGill University, Montreal, Quebec, Canada

    Steven Robbins

  3. Divisions of Geriatric Medicine and Experimental Medicine, Montreal General Hospital, Montreal, Quebec, Canada

    Steven Robbins & Edward Waked

Authors
  1. Steven Robbins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Edward Waked
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven Robbins.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Robbins, S., Waked, E. Factors Associated with Ankle Injuries. Sports Med. 25, 63–72 (1998). https://doi.org/10.2165/00007256-199825010-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199825010-00005

Keywords

Search

Navigation