In the studies that we examined, it took at least 6 weeks to 3 months before ligament healing occurred. However, at 6 weeks to 1 year after injury, a large percentage of participants still had objective mechanical laxity and subjective ankle instability. Direct comparison among articles is difficult because of differences in methods. More research focusing on more reliable methods of measuring ankle laxity is needed so that clinicians can know how long ligament healing takes after injury. This knowledge will help clinicians to make better decisions during rehabilitation and for return to play.
T he tendency toward repeated ankle sprains and recurring symptoms (eg, pain, weakness, giving way) has been termed "chronic ankle instability" (CAI) 35 and reported to occur in as high as 40% to 70% of individuals who have sustained a lateral ankle sprain. 7,23,45 Changes in sensorimotor system function are thought to be involved in the decreased postural control and joint position awareness and increased instability found in individuals with CAI. 13,24,46 T T STUDY DESIGN: Prospective cohort study. T T OBJECTIVE:To assess the effect of 6 weeks of balance training on sensorimotor measures previously found to be deficient in participants with chronic ankle instability (CAI). T T BACKGROUND:CAI is the tendency toward repeated ankle sprains and recurring symptoms, occurring in 40% to 70% of individuals who have previously sustained a lateral ankle sprain. Recent studies have found deficits in sensorimotor measures in individuals with CAI. As balance training is a common component of ankle rehabilitation, understanding its effect on the sensorimotor system in individuals with CAI may enable us to optimize protocols to better utilize this rehabilitation method. T T METHODS:Twelve participants with CAI and 9 healthy volunteers participated. Independent variables were group (CAI, control) and time (pretraining, posttraining). Participants with CAI who completed a 6-week balance training program and healthy controls who did not get any training were pretested and posttested at the beginning and at the end of 6 weeks. T T RESULTS:The individuals in the CAI group who performed balance training demonstrated better performance than control participants on baselineadjusted posttraining measures of dynamic balance in the anterior medial (P = .021), medial (P = .048), and posterior medial directions (P = .030); motoneuron pool excitability Hmax/Mmax ratio (P = .044) and single-limb presynaptic inhibition (P = .012); and joint position sense inversion variable error (P = .017). It may be of note that no systematic differences were detected for static balance or plantar flexion joint position sense tasks. T T CONCLUSIONS:After 6 weeks of balance training, individuals with CAI demonstrated enhanced dynamic balance, inversion joint position sense, and changes in motoneuron pool excitability compared to healthy controls who did not train. T T LEVEL OF EVIDENCE:Therapy, level 2b.
Context Single-sport specialization (SSS) is becoming more prevalent in youth athletes. Deficits in functional movement have been shown to predispose athletes to injury. It is unclear whether a link exists between SSS and the development of functional movement deficits that predispose SSS athletes to an increased risk of knee injury. Objective To determine whether functional movement deficits exist in SSS athletes compared with multi-sport (M-S) athletes. Design Cross-sectional study. Setting Soccer practice fields. Patients or Other Participants A total of 40 (21 SSS [age = 15.05 ± 1.2 years], 19 M-S [age = 15.32 ± 1.2 years]) female high school athlete volunteers were recruited through local soccer clubs. All SSS athletes played soccer. Intervention(s) Participants were grouped into 2 categories: SSS and M-S. All participants completed 3 trials of the standard Landing Error Scoring System (LESS) jump-landing task. They performed a double-legged jump from a 30-cm platform, landing on a rubber mat at a distance of half their body height. Upon landing, participants immediately performed a maximal vertical jump. Main Outcome Measure(s) Values were assigned to each trial using the LESS scoring criteria. We averaged the 3 scored trials and then used a Mann-Whitney U test to test for differences between groups. Participant scores from the jump-landing assessment for each group were also placed into the 4 defined LESS categories for group comparison using a Pearson χ2 test. The α level was set a priori at .05. Results Mean scores were 6.84 ± 1.81 for the SSS group and 6.07 ± 1.93 for the M-S group. We observed no differences between groups (z = −1.44, P = .15). A Pearson χ2 analysis revealed that the proportions of athletes classified as having excellent, good, moderate, or poor LESS scores were not different between the SSS and M-S groups ( = 1.999, P = .57). Conclusions Participation in soccer alone compared with multiple sports did not affect LESS scores in adolescent female soccer players. However, the LESS scores indicated that most female adolescent athletes may be at an increased risk for knee injury, regardless of the number of sports played.
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