Balancing ankle injuries and football with… Balance
Injury prevention programs with balance training reduce the number of ankle injuries among football players: a systematic review.
Al Attar WS, Khaledi EH, Bakhsh JM, Faude O, Ghulam H, Sanders RH, J. Physiotherapist. July 2022; 68(3):165-173.
Full text freely available
Take home message
Football players have a lower risk of ankle injuries if they perform an injury prevention warm-up program that includes balance, compared to a standard warm-up.
Background
Ankle injuries occur at all levels of competition and represent 15% of high school and college athletic injuries. While there are many well-researched programs to prevent lower extremity injuries (e.g. FIFA 11, FIFA 11+), balance is often not a major component. It is unclear whether specifically targeted balance exercises can reduce the risk of ankle injuries.
Study aim
The authors conducted a systematic review of randomized controlled trials to determine whether injury prevention programs involving balance training reduce the rate of ankle injuries among soccer players compared to standard warm-up programs.
Methods
The authors searched four databases for articles published between 1985 and 2020 describing randomized clinical trials comparing injury prevention programs that included balance training exercises with a standard warm-up program among soccer players. They included examining whether they also reported the number of ankle injuries or the number of injuries in addition to the number of hours of training/competition.
Results
The authors identified 9 randomized controlled trials involving 9,633 football players of all ages and competition levels. Overall, injury prevention programs that included balance training reduced the risk of ankle injuries by 36%. The authors found consistent results when examining balance training-only warm-up programs (41% reduction) or the FIFA 11 programs (37% reduction).
Viewpoints
The authors found that warm-up programs for injury prevention, including balance training, can reduce the risk of ankle injuries. Five of the nine tests focused on the FIFA11+ program, which includes strength, plyometrics and balance exercises. Two studies assessed warm-up programs that focused solely on balance. These studies showed similar benefits (33% and 40% reduction in injury rates). Most studies focused on male soccer players who benefited from these warm-up programs. However, a large study found that these programs may not be as effective for female adolescent soccer players. It would be useful to further investigate how these programs impact male and female soccer players and whether the benefits of these programs vary by age or level of competition.
Clinical implications
Clinicians should encourage football teams to incorporate balance exercises into their warm-up programs to reduce the number of ankle injuries. Teams should consider using standardized 10- to 15-minute warm-up programs for injury prevention, including balance training.
Questions for discussion
Does your typical warm-up emphasize balance, or do you lean toward more flexibility, strength, or stability-based programs?
related posts
FIFA 11… (but really FIFA 11+) programs are effective in reducing football injuries
Written by Alexandra Bossi
Reviewed by Jeffrey Driban
One Comment