SLR- November 2022- Mark Boissonneault, DPM
Title: Hip Abductor Muscle Strength Deficit as a Risk Factor for Inversion Ankle Sprain in Male College Soccer PlayersReference: Kawaguchi K, Taketomi et al. Hip Abductor Muscle Strength Deficit as a Risk Factor for Inversion Ankle Sprain in Male College Soccer Players: A Prospective Cohort Study. Orthop J Sports Med. 2021 Jul 26;9(7)
Level of Evidence: II
Reviewed by: Mark Boissonneault, DPM
Residency Program: Christiana Care Health Services
Podiatric Relevance: Lateral ankle sprains are a common pathology seen by foot and ankle surgeons. There are numerous etiologies for ankle sprains, with one of them being weak supporting musculature. This article discusses how weak hip abductor musculature can lead to lateral ankle sprains. Surgeons can consider sending patients to physical therapy to strengthen their proximal lower extremity musculature if they are concerned for recurrent lateral ankle sprains. This could be important during the conservative and post-operative management for patients with lateral ankle sprains.
Methods: A level II prospective cohort study was performed with 145 collegiate Japanese male soccer players in 2009. Data was collected preseason and postseason. No athletes were injured at the start of the season, and no athletes had previous lower extremity injuries in the 3 months prior to the start of the season. Measurements included anthropometric, joint laxity and flexibility tests, muscle flexibility, strength and balance tests. Measurements were taken and diagnosis was made by the orthopedic team physician.
Results: Lateral ankle sprains occurred in 31 players and no participants were lost to follow up. The study found no statistically significant difference in player demographics, anthropomorphic measurements, range of motion, muscle flexibility or balance measurements. However, the multivariate regression analysis, which compared athletes with lateral ankle sprains to those without, found that there was a statistically significant association with isometric hip abductor strength and lateral ankle sprains.
Conclusion: Hip abductor muscle strength was found to have a positive correlation with lateral ankle sprains in the study population. Some limitations to this study would be not including assessment of functional and mechanical instability after the ankle sprain and not measuring muscle strength of tendons crossing the ankle joint. It also focused on only male soccer athletes, which could limit it to gender and sport. The study also did not distinguish whether injuries were contact related. These factors being considered, hip abductor muscle strength should be assessed during the workup of lateral ankle sprains and strengthened when sending patients for physical therapy.