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Published in: Archives of Orthopaedic and Trauma Surgery 8/2011

01-08-2011 | Orthopaedic Surgery

The influence of playing level on functional ankle stability in soccer players

Authors: Susanne Rein, Tobias Fabian, Stefan Weindel, Wolfgang Schneiders, Hans Zwipp

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2011

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Abstract

Objective

The aim of this study was to compare the functional ankle stability between professional and amateur soccer players as well as controls.

Materials and methods

Thirty professional soccer players, 30 amateur soccer players and 30 controls were evaluated. All participants completed a questionnaire. Range of motion (ROM), peroneal reaction time (PRT) and ankle position sense were measured. Balance control was investigated with the Biodex Stability System, measuring the stable level 8 and the unstable level 2.

Results

Professional soccer players cited significantly more frequent ankle sprains than all other groups (P = 0.002). They showed a significantly decreased dorsiflexion of the right foot (amateur: P = 0.017; controls: P = 0.004), an increased pronation of both feet (amateurs: right: P = 0.0048, left: P = 0.006; controls: right: P = 0.017, left: P = 0.007) and a decreased supination of the left foot in comparison to all other groups (amateurs: P = 0.003; controls: P = 0.004). Balance control showed no significant differences among all groups. Significant differences in angle reproduction were observed between professionals and amateurs for the left ankle joint at the positions of 105° (P = 0.0018) and 140° (P = 0.013). Professionals (P = 0.004) and amateurs (P = 0.001) showed a significantly delayed PRT of the right peroneus longus muscle compared to controls. In addition, the PRT of the right peroneus brevis muscle was significantly increased in professional soccer players in comparison to controls (P = 0.017).

Conclusions

Professional soccer players have shown more frequent ankle sprains, limited ROM, and delayed PRT of the right leg which reflects the higher risk of functional ankle instability due to intensified work-related use of feet. Therefore, proprioceptive exercises of the ankle in daily training programs are recommended in order to minimize the risk of ankle injuries and improve functional ankle stability.
Literature
1.
go back to reference Ekstrand J, Tropp H (1990) The incidence of ankle sprains in soccer. Foot Ankle 11(1):41–44PubMed Ekstrand J, Tropp H (1990) The incidence of ankle sprains in soccer. Foot Ankle 11(1):41–44PubMed
2.
go back to reference Fong DT, Hong Y, Chan LK, Yung PS, Chan KM (2007) A systematic review on ankle injury and ankle sprain in sports. Sports Med 37(1):73–94PubMedCrossRef Fong DT, Hong Y, Chan LK, Yung PS, Chan KM (2007) A systematic review on ankle injury and ankle sprain in sports. Sports Med 37(1):73–94PubMedCrossRef
3.
go back to reference Giza E, Fuller C, Junge A, Dvorak J (2003) Mechanisms of foot and ankle injuries in soccer. Am J Sports Med 31(4):550–554PubMed Giza E, Fuller C, Junge A, Dvorak J (2003) Mechanisms of foot and ankle injuries in soccer. Am J Sports Med 31(4):550–554PubMed
4.
go back to reference Kennedy JC, Alexander IJ, Hayes KC (1982) Nerve supply of the human knee and its functional importance. Am J Sports Med 10(6):329–335PubMedCrossRef Kennedy JC, Alexander IJ, Hayes KC (1982) Nerve supply of the human knee and its functional importance. Am J Sports Med 10(6):329–335PubMedCrossRef
5.
go back to reference Nyland J, Brosky T, Currier D, Nitz A, Caborn D (1994) Review of the afferent neural system of the knee and its contribution to motor learning. J Orthop Sports Phys Ther 19(1):2–11PubMed Nyland J, Brosky T, Currier D, Nitz A, Caborn D (1994) Review of the afferent neural system of the knee and its contribution to motor learning. J Orthop Sports Phys Ther 19(1):2–11PubMed
6.
go back to reference Gross MT (1987) Effects of recurrent lateral ankle sprains on active and passive judgements of joint position. Phys Ther 67(10):1505–1509PubMed Gross MT (1987) Effects of recurrent lateral ankle sprains on active and passive judgements of joint position. Phys Ther 67(10):1505–1509PubMed
7.
go back to reference Karlsson J, Andreasson GO (1992) The effect of external ankle support in chronic lateral ankle joint instability. An electromyographic study. Am J Sports Med 20(3):257–261PubMedCrossRef Karlsson J, Andreasson GO (1992) The effect of external ankle support in chronic lateral ankle joint instability. An electromyographic study. Am J Sports Med 20(3):257–261PubMedCrossRef
8.
go back to reference Konradsen L, Ravn JB (1991) Prolonged peroneal reaction time in ankle instability. Int J Sports Med 12(3):290–292PubMedCrossRef Konradsen L, Ravn JB (1991) Prolonged peroneal reaction time in ankle instability. Int J Sports Med 12(3):290–292PubMedCrossRef
9.
go back to reference Löfvenberg R, Karrholm J, Sundelin G (1996) Proprioceptive reaction in the healthy and chronically unstable ankle joint. Sportverletz Sportschaden 10(4):79–83 (in German)PubMedCrossRef Löfvenberg R, Karrholm J, Sundelin G (1996) Proprioceptive reaction in the healthy and chronically unstable ankle joint. Sportverletz Sportschaden 10(4):79–83 (in German)PubMedCrossRef
10.
go back to reference Löfvenberg R, Karrholm J, Sundelin G, Ahlgren O (1995) Prolonged reaction time in patients with chronic lateral instability of the ankle. Am J Sports Med 23(4):414–417PubMedCrossRef Löfvenberg R, Karrholm J, Sundelin G, Ahlgren O (1995) Prolonged reaction time in patients with chronic lateral instability of the ankle. Am J Sports Med 23(4):414–417PubMedCrossRef
11.
go back to reference Schmidt R, Benesch S, Bender A, Claes L, Gerngross H (2005) The potential for training of proprioceptive and coordinative parameters in patients with chronic ankle instability. Z Orthop Ihre Grenzgeb 143(2):227–232 (in German)PubMedCrossRef Schmidt R, Benesch S, Bender A, Claes L, Gerngross H (2005) The potential for training of proprioceptive and coordinative parameters in patients with chronic ankle instability. Z Orthop Ihre Grenzgeb 143(2):227–232 (in German)PubMedCrossRef
12.
go back to reference Richie DH Jr (2001) Functional instability of the ankle and the role of neuromuscular control: a comprehensive review. J Foot Ankle Surg 40(4):240–251PubMedCrossRef Richie DH Jr (2001) Functional instability of the ankle and the role of neuromuscular control: a comprehensive review. J Foot Ankle Surg 40(4):240–251PubMedCrossRef
13.
go back to reference Glencross D, Thornton E (1981) Position sense following joint injury. J Sports Med Phys Fit 21(1):23–27 Glencross D, Thornton E (1981) Position sense following joint injury. J Sports Med Phys Fit 21(1):23–27
14.
15.
go back to reference Freeman MA, Dean MR, Hanham IW (1965) The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br 47(4):678–685PubMed Freeman MA, Dean MR, Hanham IW (1965) The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br 47(4):678–685PubMed
16.
go back to reference Hertel J (2002) Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability. J Athl Train 37(4):364–375PubMed Hertel J (2002) Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability. J Athl Train 37(4):364–375PubMed
17.
go back to reference Benesch S, Putz W, Rosenbaum D, Becker H (2000) Reliability of peroneal reaction time measurements. Clin Biomech (Bristol, Avon) 15(1):21–28CrossRef Benesch S, Putz W, Rosenbaum D, Becker H (2000) Reliability of peroneal reaction time measurements. Clin Biomech (Bristol, Avon) 15(1):21–28CrossRef
18.
go back to reference Forestier N, Teasdale N, Nougier V (2002) Alteration of the position sense at the ankle induced by muscular fatigue in humans. Med Sci Sports Exerc 34(1):117–122PubMedCrossRef Forestier N, Teasdale N, Nougier V (2002) Alteration of the position sense at the ankle induced by muscular fatigue in humans. Med Sci Sports Exerc 34(1):117–122PubMedCrossRef
19.
go back to reference Martina IS, van Koningsveld R, Schmitz PI, van der Meche FG, van Doorn PA (1998) Measuring vibration threshold with a graduated tuning fork in normal aging and in patients with polyneuropathy. European Inflammatory Neuropathy Cause and Treatment (INCAT) group. J Neurol Neurosurg Psychiatry 65(5):743–747PubMedCrossRef Martina IS, van Koningsveld R, Schmitz PI, van der Meche FG, van Doorn PA (1998) Measuring vibration threshold with a graduated tuning fork in normal aging and in patients with polyneuropathy. European Inflammatory Neuropathy Cause and Treatment (INCAT) group. J Neurol Neurosurg Psychiatry 65(5):743–747PubMedCrossRef
20.
go back to reference Khasnis A, Gokula RM (2003) Romberg’s test. J Postgrad Med 49(2):169–172PubMed Khasnis A, Gokula RM (2003) Romberg’s test. J Postgrad Med 49(2):169–172PubMed
21.
go back to reference Höntzsch D (1993) Comments on measuring the mobility of the upper ankle joint by the neutral-0-method]. Aktuelle Traumatol 23(8):376–379PubMed Höntzsch D (1993) Comments on measuring the mobility of the upper ankle joint by the neutral-0-method]. Aktuelle Traumatol 23(8):376–379PubMed
22.
go back to reference Lynch SA, Eklund U, Gottlieb D, Renström PA, Beynnon B (1996) Electromyographic latency changes in the ankle musculature during inversion moments. Am J Sports Med 24(3):362–369PubMedCrossRef Lynch SA, Eklund U, Gottlieb D, Renström PA, Beynnon B (1996) Electromyographic latency changes in the ankle musculature during inversion moments. Am J Sports Med 24(3):362–369PubMedCrossRef
23.
go back to reference Lipke K, Tannheimer M, Benesch S, Gerngross H, Becker HP, Schmidt R (2001) The peroneal reaction time: an analysis in normal ankles. Unfallchirurg 104(12):1157–1161 (in German)PubMedCrossRef Lipke K, Tannheimer M, Benesch S, Gerngross H, Becker HP, Schmidt R (2001) The peroneal reaction time: an analysis in normal ankles. Unfallchirurg 104(12):1157–1161 (in German)PubMedCrossRef
24.
go back to reference Schmidt R, Gergroß H, Friemert B, Herbst A, Claes L (2005) The peroneal reaction time (PRT)—reference data in a healthy sample population. Foot Ankle Int 26(5):382–386PubMed Schmidt R, Gergroß H, Friemert B, Herbst A, Claes L (2005) The peroneal reaction time (PRT)—reference data in a healthy sample population. Foot Ankle Int 26(5):382–386PubMed
25.
go back to reference Rein S, Fabian T, Krishnan K, Benesch S, Schackert G, Zwipp H et al (2009) Evaluation of the proprioceptive influence of the cutaneous afferents to the ankle in patients after sural nerve harvesting. Neurosurgery 64(3):519–525PubMedCrossRef Rein S, Fabian T, Krishnan K, Benesch S, Schackert G, Zwipp H et al (2009) Evaluation of the proprioceptive influence of the cutaneous afferents to the ankle in patients after sural nerve harvesting. Neurosurgery 64(3):519–525PubMedCrossRef
26.
go back to reference Rein S, Fabian T, Zwipp H, Heineck J, Weindel S (2010) The influence of profession on functional ankle stability in musicians. Med Probl Perform Art 25(1):22–28PubMed Rein S, Fabian T, Zwipp H, Heineck J, Weindel S (2010) The influence of profession on functional ankle stability in musicians. Med Probl Perform Art 25(1):22–28PubMed
27.
go back to reference Rein S, Fabian T, Zwipp H, Mittag-Bonsch M, Weindel S (2010) Influence of age, body mass index and leg dominance on functional ankle stability. Foot Ankle Int 31(5):423–432PubMedCrossRef Rein S, Fabian T, Zwipp H, Mittag-Bonsch M, Weindel S (2010) Influence of age, body mass index and leg dominance on functional ankle stability. Foot Ankle Int 31(5):423–432PubMedCrossRef
28.
go back to reference Konradsen L, Ravn JB (1990) Ankle instability caused by prolonged peroneal reaction time. Acta Orthop Scand 61(5):388–390PubMedCrossRef Konradsen L, Ravn JB (1990) Ankle instability caused by prolonged peroneal reaction time. Acta Orthop Scand 61(5):388–390PubMedCrossRef
29.
go back to reference Testerman C, Vander Griend R (1999) Evaluation of ankle instability using the Biodex Stability System. Foot Ankle Int 20(5):317–321PubMed Testerman C, Vander Griend R (1999) Evaluation of ankle instability using the Biodex Stability System. Foot Ankle Int 20(5):317–321PubMed
30.
go back to reference Aydog E, Bal A, Aydog ST, Cakci A (2006) Evaluation of dynamic postural balance using the Biodex Stability System in rheumatoid arthritis patients. Clin Rheumatol 25(4):462–467PubMedCrossRef Aydog E, Bal A, Aydog ST, Cakci A (2006) Evaluation of dynamic postural balance using the Biodex Stability System in rheumatoid arthritis patients. Clin Rheumatol 25(4):462–467PubMedCrossRef
31.
go back to reference Leanderson J, Bergqvist M, Rolf C, Westblad P, Wigelius-Roovers S, Wredmark T (1999) Early influence of an ankle sprain on objective measures of ankle joint function. A prospective randomised study of ankle brace treatment. Knee Surg Sports Traumatol Arthrosc 7(1):51–58PubMedCrossRef Leanderson J, Bergqvist M, Rolf C, Westblad P, Wigelius-Roovers S, Wredmark T (1999) Early influence of an ankle sprain on objective measures of ankle joint function. A prospective randomised study of ankle brace treatment. Knee Surg Sports Traumatol Arthrosc 7(1):51–58PubMedCrossRef
32.
go back to reference McMurray T (1950) Footballer’s ankle. J Bone Joint Surg Br 32(1):68 McMurray T (1950) Footballer’s ankle. J Bone Joint Surg Br 32(1):68
33.
go back to reference Jerosch J (1999) Proprioception-what is it? Orthopädieschuhtechnik 2:12–22 (in German) Jerosch J (1999) Proprioception-what is it? Orthopädieschuhtechnik 2:12–22 (in German)
34.
go back to reference Johnson MB, Johnson CL (1993) Electromyographic response of peroneal muscles in surgical and nonsurgical injured ankles during sudden inversion. J Orthop Sports Phys Ther 18(3):497–501PubMed Johnson MB, Johnson CL (1993) Electromyographic response of peroneal muscles in surgical and nonsurgical injured ankles during sudden inversion. J Orthop Sports Phys Ther 18(3):497–501PubMed
35.
go back to reference Sheth P, Yu B, Laskowski ER, An KN (1997) Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain. Am J Sports Med 25(4):538–543PubMedCrossRef Sheth P, Yu B, Laskowski ER, An KN (1997) Ankle disk training influences reaction times of selected muscles in a simulated ankle sprain. Am J Sports Med 25(4):538–543PubMedCrossRef
36.
go back to reference Perron M, Hebert LJ, McFadyen BJ, Belzile S, Regniere M (2007) The ability of the Biodex Stability System to distinguish level of function in subjects with a second-degree ankle sprain. Clin Rehabil 21(1):73–81PubMedCrossRef Perron M, Hebert LJ, McFadyen BJ, Belzile S, Regniere M (2007) The ability of the Biodex Stability System to distinguish level of function in subjects with a second-degree ankle sprain. Clin Rehabil 21(1):73–81PubMedCrossRef
37.
go back to reference Schmitz RJ, Arnold BL (1998) Intertester and intratester reliability of a dynamic balance control using the biodex stability system. J Sport Rehabil 7:95–101 Schmitz RJ, Arnold BL (1998) Intertester and intratester reliability of a dynamic balance control using the biodex stability system. J Sport Rehabil 7:95–101
38.
go back to reference Gstöttner M, Neher A, Scholtz A, Millonig M, Lembert S, Raschner C (2009) Balance ability and muscle response of the preferred and nonpreferred leg in soccer players. Mot Control 13(2):218–231 Gstöttner M, Neher A, Scholtz A, Millonig M, Lembert S, Raschner C (2009) Balance ability and muscle response of the preferred and nonpreferred leg in soccer players. Mot Control 13(2):218–231
39.
go back to reference Garn SN, Newton RA (1988) Kinesthetic awareness in subjects with multiple ankle sprains. Phys Ther 68(11):1667–1671PubMed Garn SN, Newton RA (1988) Kinesthetic awareness in subjects with multiple ankle sprains. Phys Ther 68(11):1667–1671PubMed
40.
go back to reference Arnold BL, Schmitz RJ (1998) Examination of balance measures produced by the biodex stability system. J Athl Train 33(4):323–327 Arnold BL, Schmitz RJ (1998) Examination of balance measures produced by the biodex stability system. J Athl Train 33(4):323–327
41.
go back to reference Paterno MV, Myer GD, Ford KR, Hewett TE (2004) Neuromuscular training improves single-limb stability in young female athletes. J Orthop Sports Phys Ther 34(6):305–316PubMed Paterno MV, Myer GD, Ford KR, Hewett TE (2004) Neuromuscular training improves single-limb stability in young female athletes. J Orthop Sports Phys Ther 34(6):305–316PubMed
Metadata
Title
The influence of playing level on functional ankle stability in soccer players
Authors
Susanne Rein
Tobias Fabian
Stefan Weindel
Wolfgang Schneiders
Hans Zwipp
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 8/2011
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-011-1275-8

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