Does spraining your ankle increase risk of future sprains?
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Increased Risk of Future Ankle Sprains After Initial Sprain
Introduction to Ankle Sprains and Recurrence
Ankle sprains are a common injury, particularly in sports and physically demanding activities. The question of whether an initial ankle sprain increases the risk of future sprains is critical for developing effective prevention and rehabilitation strategies.
Previous Ankle Sprain as a Predictor of Future Sprains
Evidence from Multiple Studies
Several studies have consistently shown that a history of previous ankle sprains significantly increases the risk of future sprains. A systematic review involving 6,567 patients found that individuals with a history of lateral ankle sprain (LAS) had a significantly higher risk of subsequent LAS, with risk ratios ranging from 1.29 to 6.06 . This increased risk was observed in both male and female populations, although the association was stronger in males .
Specific Findings in Different Populations
In adolescent dancers, a previous sprain of the contralateral ankle was a significant predictor of future sprains, with a hazard ratio of 3.90. Similarly, in high school and intercollegiate athletes, a history of previous ankle injury was not directly associated with future sprains, but other factors like balance and taping practices played a role.
Additional Risk Factors for Recurrent Ankle Sprains
Balance and Strength
Balance and strength deficits are critical factors in the recurrence of ankle sprains. The single leg balance (SLB) test has been shown to predict future ankle sprains, with athletes who had a positive SLB test and did not tape their ankles being at a significantly higher risk. Additionally, reduced hip-abductor strength was found to increase the risk of noncontact lateral ankle sprains in male soccer players.
Anatomical and Functional Factors
Anatomical and functional factors such as joint laxity, range of motion, and proprioception also contribute to the risk of recurrent ankle sprains. Reduced dorsiflexion range and postural sway were identified as predictors of ankle sprains. In netball players, a reach distance in the posterior-medial direction of the star excursion balance test of less than or equal to 77.5% of leg length increased the odds of sustaining an ankle sprain.
Chronic Ankle Instability
Recurrent ankle sprains often lead to chronic ankle instability (CAI), characterized by persistent pain, swelling, and dysfunction. This condition further increases the risk of future sprains and can result in long-term limitations and disability. Athletes with CAI are particularly prone to reinjure the same ankle, perpetuating a cycle of injury and instability.
Conclusion
The evidence strongly supports that an initial ankle sprain significantly increases the risk of future sprains. This increased risk is influenced by various factors, including balance, strength, anatomical alignment, and chronic instability. Understanding these risk factors is essential for developing targeted prevention and rehabilitation programs to reduce the incidence of recurrent ankle sprains.
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