Frequently Asked Questions

Basketball finals and divisionals are coming up. I think I'm ready to get back into the game after a bad ankle sprain. The coach isn't willing to take a chance on me just yet. How can I convince him that I'm AOK?

Ankle sprains are common among athletes like basketball players who plant the foot on the floor and pivot, shift, or make sudden directional changes. Once the joint is damaged, the risk of a second sprain or injury to some other vital part of the ankle increases dramatically. Finding a way to test for ankle stability and predicting safety in a return-to-sports decision can be difficult. There are some ways to evaluate function, as well as identify joint instability and performance deficits. The first is the athlete's report of the ankle giving way. This is a subjective symptom of functional ankle instability. And it's a reliable tool to suggest further rehab is needed. Then there's a series of hopping tests that can add more information. These require muscle strength and stress the outside edge of the ankle (where the original injury occurred). The four tests include: 1) figure-of-8 hop, 2) side hop, 3) 6-meter crossover hop, and 4) square hop. The figure-of-8 test involves hopping on one foot in a figure-8 pattern around two cones set five meters apart (about 15 feet). The pattern is repeated two times as fast as possible. The side-hop test requires you to hop on one foot sideways 30 centimeters (eight inches) and back 10 times (also as fast as possible). The six-meter crossover hop test requires the athlete to hop over a four-inch wide line from the right side to the left side and back along a path that was eight feet long. And finally, in the square hop test, a 10-inch by 10-inch square of tape is placed on the floor. The person being tested has to hop in and out of the square all the way around. The tests are repeated three times and each trial is timed. The athlete who can complete these tests without pain and without a giving-way sensation is more likely to be ready to take to the floor than someone who is slow, unable to complete the tests, and who experiences ankle stability during the testing. If your team has an athletic trainer or physical therapist, ask him or her to work with you on a trial basis to see how strong and agile you are using the involved leg. Have your team staff put you through your paces and testing before putting your at-risk ankle back in the fray. A little front-end investment of time and caution are always advised.

Erin Caffrey, MS, ATC, et al. The Ability of 4 Single-Limb Hopping Tests to Detect Functional Performance Deficits in Individuals with Functional Ankle Instability. In Journal of Orthopaedic & Sports Physical Therapy. November 2009. Vol. 39. No. 11. Pp. 799-806.

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