gameplan forathlete success: treatment and prevention of ankle injuries in soccer

Bauer Physical Therapy wwBauer Physical Therapy www.bauerpt.comw.bauerpt.com

Ankle InjuriesAnkle Injuries

Treatment and PreventionTreatment and Prevention

For theFor the

Soccer AthleteSoccer Athlete


What Is A Sprain?What Is A Sprain?

Sprain (Definition):Sprain (Definition): A sprain involves ligamentsA sprain involves ligaments Ligaments support joints providing Ligaments support joints providing

stabilitystability When stretched or torn, a joint can When stretched or torn, a joint can

become unstablebecome unstable The outside of the ankle is the most The outside of the ankle is the most

commonly sprainedcommonly sprained


Mechanism of InjuryMechanism of Injury

The lateral ankle sprain occurs as a The lateral ankle sprain occurs as a result of turning the outside (lateral) result of turning the outside (lateral) aspect of the ankleaspect of the ankle

This is called an inversion sprainThis is called an inversion sprain This may occur when landing on an This may occur when landing on an

opposing players leg/foot, twisting, opposing players leg/foot, twisting, cutting, or slide tacklingcutting, or slide tackling


Treatment of Ankle SprainTreatment of Ankle Sprain

RestRest – Avoid weight bearing/exercise if – Avoid weight bearing/exercise if painful or swollenpainful or swollen

IceIce – Application of cold pack or soak in – Application of cold pack or soak in cold watercold water

CompressCompress – Wrapping the ankle controls – Wrapping the ankle controls swelling and provides supportswelling and provides support

ElevateElevate – Raising the ankle above the – Raising the ankle above the heart with support helps reduce swellingheart with support helps reduce swelling


Medial ManagementMedial Management

Medical AssessmentMedical Assessment If there is pain, swelling, limited mobility, and If there is pain, swelling, limited mobility, and

is painful when walkingis painful when walking X-rays to rule out fractureX-rays to rule out fracture

Physical TherapyPhysical Therapy Promote healingPromote healing Restore mobility, strength, endurance, and Restore mobility, strength, endurance, and

agilityagility Return to play testingReturn to play testing


Promote HealingPromote Healing

ProtectProtect Immobilize to allow healing of ligaments Immobilize to allow healing of ligaments

(brace, boot, compress wrap)(brace, boot, compress wrap) Crutches may be used to avoid Crutches may be used to avoid

increased stress with gaitincreased stress with gait Must allow ligament to completely heal Must allow ligament to completely heal

or chronic instability may occuror chronic instability may occur


MobilityMobility

Restoring ankle after an injury, or Restoring ankle after an injury, or prevention of ankle injuries, requires prevention of ankle injuries, requires normal mobility of the anklenormal mobility of the ankle

Perform ABC’s one time through Perform ABC’s one time through tracing letters in the air, A to Ztracing letters in the air, A to Z

Perform foot circles in the air, 25 Perform foot circles in the air, 25 each clockwise and 25 each counter-each clockwise and 25 each counter-clockwiseclockwise


Ankle BalanceAnkle Balance

Injury to ligaments can damage joint Injury to ligaments can damage joint positioning and awareness. If not restored, positioning and awareness. If not restored, this may lead to chronic injuries.this may lead to chronic injuries. Beginning BalanceBeginning Balance – Stand on leg with slight – Stand on leg with slight

bend. Practice reaching leg opposite leg bend. Practice reaching leg opposite leg forward, side and backward. Continue for 1 min.forward, side and backward. Continue for 1 min.

Advanced BalanceAdvanced Balance – Perform this exercise with – Perform this exercise with eyes closed.eyes closed.

Specific BalanceSpecific Balance – Stand on injured leg and – Stand on injured leg and practice lightly kicking soccer ball to helper practice lightly kicking soccer ball to helper with inside, outside, and front of free leg.with inside, outside, and front of free leg.


Strength & EnduranceStrength & Endurance

Increasing the strength and Increasing the strength and endurance of the ankle and foot endurance of the ankle and foot muscles helps to provide additional muscles helps to provide additional support and protection of the ankle support and protection of the ankle ligaments/joint.ligaments/joint.

Ankle strength and endurance can be Ankle strength and endurance can be performed with body weight and performed with body weight and resistive exercise (manual, bands).resistive exercise (manual, bands).


Strength & EnduranceStrength & Endurance

Increasing the muscle’s ability to perform Increasing the muscle’s ability to perform repeated work will require adding repeated work will require adding repetitionsrepetitions and and setssets of activity. of activity.

This can begin with This can begin with 1 to 3 sets1 to 3 sets of exercise. of exercise. RepetitionsRepetitions can begin at 10 and build to can begin at 10 and build to

20-30 reps.20-30 reps. Progressing the activities must be Progressing the activities must be

performed without increased pain, performed without increased pain, swelling, or stiffness.swelling, or stiffness.


Return-to-Play GuidelinesReturn-to-Play Guidelines

Criteria for ankle injuries in soccer includes:Criteria for ankle injuries in soccer includes: Restoration of full mobility, strength, and Restoration of full mobility, strength, and

endurance of ankle and leg muscles.endurance of ankle and leg muscles. Restoration of full balance, agility, and speed, Restoration of full balance, agility, and speed,

that meet the demand for performance and skill that meet the demand for performance and skill on the soccer field.on the soccer field.

Physical tests include: Hopping, change of direction, Physical tests include: Hopping, change of direction, jumping, speed in all directions and ball jumping, speed in all directions and ball handling/passing.handling/passing.

Further protection/prevention of ankle injury can be Further protection/prevention of ankle injury can be provided by ankle braces and/or taping of the ankle.provided by ankle braces and/or taping of the ankle.


Ankle InjuriesAnkle Injuries

Randy Bauer PT, ATC Randy Bauer PT, ATC [email protected]@bauerpt.com

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gameplan forathlete success: treatment and prevention of ankle injuries in soccer

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