Balance training effectively reduces the risk of ankle sprains with a 36% risk reduction.
Ankle sprains are one of the most common acute injuries occurring in sports.
A large amount of athletes do not fully recover from these injuries.
This develops chronic symptoms such as instability, pain, and recurrent injury.
There is a need to develop effective strategies for the primary prevention of ankle sprains, it is also important that these can easily be implemented into clinical practice as well as day-to-day life.
If you suffer from instability, a previous injury, or just want to prevent ankle sprains we encourage a minimum of 2-3 balance training sessions each week.
Multi-interventional programs that include balance training have been shown to be effective in the primary prevention of lower limb injuries in sports. In this well-performed systematic review and meta-analysis, the authors provide further evidence for incorporating balance-based training into an athlete's weekly training schedule.
In 2022, Al Attar and colleagues conducted a systematic review to investigate whether balance training programs can reduce ankle sprains
A key strength of the review was that the authors analyzed injury incidence rates, rather than simply basing their conclusions on injury prevalence (number of participants with a sprain). By controlling for variations in playing exposure, their results provide a more accurate and powerful estimate of injury risk. The overall effect across the 9 studies was large and clinically important, based on a 34% reduction in ankle sprains per 1000 playing hours. For context, a single professional player will accumulate around 300 playing hours of playing exposure each season.
Although the authors were not able to conclude a dose-dependent response for balance-based interventions, the consensus from available data is that clinicians should encourage a minimum of 2-3 balance training sessions each week. It is also likely that optimal risk reduction is achieved through high levels of athlete compliance, that is sustained over a prolonged period (average intervention duration was 7 months).
We know that even professional sports players' adherence to effective injury prevention strategies (such as the Nordic hamstring curl) can be as low as 20%. It is therefore incumbent on clinicians and coaching staff to create an environment and team culture where athletes buy into key injury prevention strategies such as balance training.
Dr. Chris Bleakley broke down this study,
9 large RCTs were included, with aggregate data from 9634 soccer players,
Recruited across 4 countries.
The age demographic ranged from 7 to 35, and the level of competition varied from youth, to collegiate, to first-division players.
The mean duration of balance training was 7 months (range 10 weeks to 12 months), and intervention adherence was high, with two-thirds of studies reporting figures >75%
An aggregate of 529 ankle sprains occurred over 775,606 exposure hours.
63% 333/529 sprains occurred in the control groups, versus 37% (196/529) in the balance training groups.
There was also a clear effect in favor of balance training when the authors controlled for playing exposure, based on a pooled IRR of 0.64 (95% CIO.54-0.77), equating to risk reduction of ankle sprain of 36%
