Month: May 2024

Ankle sprains and balance

Posted on May 15, 2024 by - Category One

Rugby – Ankle sprains and balance – Melissa Martin

A study by Martin et al.(2021) was conducted to examine differences in objective dynamic
balance outcomes of female rugby players with and without a history of lateral ankle sprains.
The Noraxon myoPressureTM (Zebris) pressure plate was used for this study to measure
objective dynamic balance during 3 sport specific tasks, namely single-leg catch-and-throw,
single-leg jump landing and side stepping with statistically significant differences noted.

Women’s rugby is growing in popularity worldwide (King et al.,2019) The most common type of
ankle injury in female rugby players was identified as lateral ankle sprains, mostly involving the
rupture or tear of the anterior talofibular and calcaneofibular ligaments (Gribble et al.,2016).

Ankle sprains mostly occur in rugby due to impact or collision of players when the ankle twists
inward (Richie & Izadi,2015). The tackle is considered the most dangerous phase of play as it
contributes to 61% of all injuries in rugby, with joint sprains more common to the ball carrier (
Matthewson & Grobbelaar,2015). However, ankle sprains may also occur spontaneously in
rugby during running and cutting manoeuvres particularly on uneven field surfaces. During
cutting manoeuvres, players are required to run, change direction and leap away for other
players at a high velocity. The ankle moves through extreme ranges of movement from
dorsiflexion and inversion to plantarflexion and inversion which stresses the plastic restraint of
the lateral ankle ligaments, resulting in a high risk of inversion sprains (Vijam et al.,2015).

An ankle sprain often results in loss of postural control, leading in turn to loss of proprioception,
nerve conduction and reduced strength as well as range of movement (Richie & Izadi,2015).
Optimal dynamic balance is important for rugby players as they need to be able to avoid falls
whilst performing and executing highly skilled sport specific tasks such as tackling, kicking,
passing and catching (Chiwaridzo et al.,2016). Technological advancements in balance
assessment over time have led to the utilization of pressure or force platform systems to
quantify dynamic balance ( Duarte & Freitas,2010; Mancini &Horak,2010; Schubert &
Kirchner,2014). These systems can objectively assess balance and provide quantitative
feedback to guide clinicians in assessing and monitoring proprioceptive retraining during
rehabilitation before return to play and during the implementation of preventative programmes.

At Physio Plus Cheltenham, we are able to provide a comprehensive assessment of your sport injury utilising
the Strength by Numbers AxIT testing system. The AxIT system can measure the force that you
produce and absorb when completing different exercises, such as Single leg balance, Squat,
Jumps and calf raises to name a few. This system helps to set goals and subsequently
motivates you to keep up with your rehabilitation and exercise plans, even once the pain from
your injury has subsided.

If you need help with your injury rehabilitation, get in contact with us today!

Ottawa Ankle Rules

Posted on May 9, 2024 by - Category One

Ottawa Ankle Rules – When to x-ray an ankle injury? – Wilson Tang
Ankle and foot injuries are extremely common in both contact and non-contact sports. Most of these occur during moments such as landing, contact, or change of direction/agility. This may result in bone, ligament, muscle/tendon injuries or a combination of all. Once an injury has happened, it can be difficult to determine whether to continue play or if medical attention is required at the time.
It is estimated that ~85% of ankle/foot injuries present with no fractures, however many ankle/foot injuries are referred for imaging unnecessarily (Pires et al., 2014). Hence, the Ottawa Ankle Rules were developed by emergency doctors to help identify acute ankle/foot fractures that indeed require x-ray imaging.
It is reported that the Ottawa Ankle Rules are ~97% accurate in ruling OUT fractures, but far less accurate for ruling IN fractures.
Other factors to consider:
– The Ottawa Ankle Rules don’t account for other potential injuries such as ligament, tendon or muscles.
– The initial development of the Ottawa Ankle Rules did not consider utility on athletes under 18 years old.
– Other potential injuries or conditions which may occur concurrently.
Therefore, best judgement should be made when applying the Ottawa Ankle Rules and deciding on returning to play or not after initial injury.
If after using the above framework you still have any doubts, don’t be afraid to refer your player/patient on to your local physiotherapist or doctor.
References:
Pires, R., Pereira, A., Abreu-E-Silva, G., Labronici, P., Figueiredo, L., Godoy-Santos, A., & Kfuri, M. (2014). Ottawa ankle rules and subjective surgeon perception to evaluate radiograph necessity following foot and ankle sprain. Annals of Medical and Health Sciences Research, 4(3), 432–435.
Stiell I. (1996). Ottawa ankle rules. Canadian Family Physician Medecin De Famille Canadien, 42, 478–480.