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Balance Training Reduces Ankle Injuries

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MADISON - In athletics, only one team can go home happy, and the heartbroken faces of members of the losing teams suggest there is no pain like the sting of defeat.
 
But striving valiantly for victory and coming up short is better than not being able to participate at all - the fate of injured athletes.
 
Nationwide, roughly 1.7 million high schoolers participate in basketball and soccer each year. Because these sports require sudden explosion and change of direction, almost one-fifth of the competitors will suffer an ankle injury during their playing careers.
 
So what's the big deal about a bunch of sprained ankles? Missed games are only a small measure of their impact.
 
The U.S. Consumer Product Safety Commission estimates direct medical costs resulting from these ankle sprains at $70 million. Indirect costs, which include variables such as the work time parents miss while taking their son or daughter for treatment, crested the billion-dollar mark in 2004.
 
"Ankle sprains are the most common injury in athletics," says Tim McGuine, PhD, a licensed athletic trainer at UW Health's Sports Medicine Center. "We're spending billions of dollars to treat these injuries and if this causes (high school athletes) to be less active down the road, it's going to cost us more."
 
McGuine joined James Keene, MD, a UW Health orthopedics/rehabilitation physician, to study whether a balance training program implemented during the sports season would significantly reduce the number of ankle injuries suffered by high school basketball and soccer players.
 
McGuine and Keene contacted 126 teams to gauge interest. Fifty-five agreed to participate in the study, which was funded by University of Wisconsin Surgical Associates and the UW Sports Medicine Classic Fund. The teams were separated into two groups. An intervention group of 373 athletes participated in balance training in conjunction with their normal practice sessions. A control group of 392 athletes did nothing outside of team practice.
 
Balance training involved a five-phase program of uncomplicated but increasingly difficult exercises. Athletes started with drills as simple as standing on one foot for a period of time, and progressed to more advanced activities. At phase three, a wobble board - a wooden disc with a ball attached to the bottom - was incorporated into the training. By phase five, members of the intervention group were standing on one foot on the wobble board and integrating sports movements, such as dribbling a basketball.
 
"We were trying to improve reaction time, strength and stability," says McGuine. "You'd think it would be easy for kids, but for people who aren't trained, it's not easy. We're doing things to distract them, like throwing the ball back and forth. When they move, their muscles have to react."
 
For the first four phases of training, the athletes did 10 minutes of balance training five days per week. The final phase was three 10-minute sessions per week.
 
The results? The athletes who participated in the balance training sessions were 40 percent less likely to suffer ankle injuries than the athletes in the control group. The percentage is slightly less than expected but still relevant.
 
"We were hoping to see a 50 percent reduction in injury, but it's still a very significant number," says McGuine. "Put it this way: If my (16-year-old) daughter played basketball, she'd be doing these exercises."
 
The main advantages of a balance training program are simplicity and cost. Balance sessions can be integrated into practice and take only a few minutes. And wobble boards cost about as much as two ankle braces - good news for schools looking to trim expenses due to incessant budget cuts.
 
"This is a win-win situation," says Keene. "The coach can implement it, and it's not taking the kids out of practice. The device is cheap and you don't need one for every kid. It's very reproducible."
 
In February, the American Journal of Sports Medicine published the study, which Keene says is generating quite a bit of buzz in professional sports medicine circles. McGuine and Keene will also present their findings at the Sports Medicine Symposium in May.
 
"We're getting the message out there," says Dr. Keene. "It's too good a thing not to share with other high schools."
 

Date Published: 03/03/2008


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