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Health & Exercise Forum

Basketball Season is Ankle-Sprain Season: Part 1 of 2

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Dec 12, 2011

Dr. Mackarey's Health & Exercise ForumPart 1 of 2

Guest Columnist: Janet Caputo, PT, DPT, OCS

The Lynett Tournament is only a few weeks away and marks the official start of the basketball season in NEPA and that means ANKLE SPRAINS! Basketball is notorious for causing ankle sprains. According to the statistics, 40% of all high-school basketball injuries are ankle sprains. Because of the prevalence of ankle sprains and the high recurrence rate, ankle sprain prevention is paramount.

The most common ankle sprain occurs when the foot or ankle rolls in (inversion), often when landing on the foot of another player after getting a rebound.  This excessive motion stretches the ankle ligaments beyond their limits.  Because the ligaments hold the ankle bones together and provide ankle stability, even a mild ankle sprain may cause chronic ankle instability and eventually arthritis.

Mild ankle sprains produce some discomfort but these symptoms usually resolve within a couple of days.  Symptoms of moderate ankle sprains include swelling, bruising, and loss of ankle motion, and may persist for several weeks.  Severe ankle sprains typically require a period of immobilization (i.e. cast or brace) and limited weight bearing (i.e. use of crutches).

The strongest predictor of an ankle sprain is a history of a previous ankle sprain for several reasons. First, once the ligaments are stretched, they never return to their original length, resulting in an unstable ankle.  Second, the injured ligaments lose their ability to communicate with the brain, which impairs the ankle’s balance and coordination responses.  Third, residual ankle stiffness places the ankle ligaments at risk for re-injury.

Taping, braces, shoe inserts, and high-top sneakers have been clinically tested for their effectiveness in preventing ankle sprains.  The use of ankle taping in the prevention of
ankle sprains proved to be of limited benefit because the tape eventually loosened.  Ankle braces and shoe inserts reduced the risk for ankle sprains, but did not decrease the severity of the ankle sprain.  Ankle braces also restrict ankle mobility which reduces the athlete’s agility.  High-top sneakers reduced the amount of ankle roll-over, but they did not lower the incidence of ankle sprains.

Footwear, in general, places the ankle at risk for injury.

First, footgear restricts the mobility of the foot.  The bare foot has 28 bones, 33 joints, and 112 ligaments that allow the foot to adapt to the terrain which reduces the possibility of rolling the ankle.

Second, lacing the shoe tightly may become uncomfortable, and if the shoe is not laced tight enough, then the excessive movement of the foot in the shoe makes roll-over more likely.

Third, elevating the foot on a sole increases lever action and produces a point of artificial instability at the outer edge. Despite all these drawbacks, playing basketball barefoot is not the
solution! So what is?

The Ektio® Basketball Sneaker may be the answer! Drs. Katz, Nordstrom, and Dribbon collaborated on The Ektio® and claim that their shoe decreases ankle sprain risk because it provides not only the desired stability, but also the required mobility. The Ektio ® design reduces excessive movement of the foot in the shoe and permits maximum mobility in all directions except inversion.  Ankle sprains typically occur at 50° to 60° of ankle inversion.  Since the Ektio ® limits inversion to 20°, this sneaker style possesses the potential to reduce the incidence of ankle sprains.

According to the designers, this shoe incorporates: (1) an interior strapping system to hold the foot firmly within the shoe, and (2) an exterior “bumper” in the form of a lateral flange that reduces ankle “roll-over” (i.e. inversion). Future prevention of ankle sprains appears hopeful based on preliminary data of the incidence of ankle sprains while wearing the Ektio ® sneaker. Testing conducted at New York’s Hospital for Special Surgery concluded that the Ektio design not only  maintained foot-ankle agility, but also increased ankle stability.  Research at Drexel University in Philadelphia concluded that Ektio significantly increased ankle support and limited ankle roll-over without interfering with ankle mobility in any other
direction.  The inventors of the Ektio ® sneaker report that basketball players have been wearing their shoe for two years with only one, recent, occurrence of an ankle sprain in a college player with chronic ankle instability.

If long term studies prove that this sneaker has value in the prevention of ankle sprains, it will become an invaluable part of the basketball uniform! The Ektio Men’s Wraptor Anti Ankle Sprain Basketball Shoe costs $100 to $149.95 based on options and has been well reviewed by many. For more information on The Ektio® Basketball Sneaker visit:

Join us next week to determine the risk factors for and prevention of ankle sprains.

Guest Columnist: Janet Caputo, PT, DPT, OCS specializes in orthopedic and neurological rehabilitation. Dr. Caputo is clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC.

Read “Health & Exercise Forum” – Every Monday.  This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: Paul J. Mackarey PT, DHSc, OCS is a
Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliate faculty member at the University of  Scranton, PT Dept.