March 2014

Out on a limb: Taking schools to school

1Limb-JordanaThose responsible for high school athletes—coaches, athletic directors, district superintendents—would like us to believe the safety of those athletes is a priority. Unfortunately, the facts suggest otherwise.

In the National Sporting Goods Association’s 2012 report on high school sports protective equipment, half of the high school coaches and athletic directors surveyed said their budgets for protective equipment had decreased in the previous three years.

So perhaps it shouldn’t be a surprise that many high schools are also cutting corners when it comes to ankle sprain prevention in basketball (see “Ankle sprain prevention in basketball: Why some high schools are opting out”).

We’re not talking about concussion, for which preventive measures have yet to be supported by high-level evidence. Published studies clearly show that balance training and ankle bracing each can significantly reduce the risk of ankle sprain in high school basketball players. And, although the consequences of an ankle sprain may not be as damaging as those of a concussion or even an anterior cruciate ligament injury, up to 40% of acute ankle sprains lead to recurrent sprains or chronic ankle instability, which can derail an athletic career and significantly impact quality of life.

Yet, a study done in Wisconsin shows that only half of high school basketball teams perform exercises to prevent ankle sprains, and just 37% use ankle bracing. And LER’s interviews with sources from different parts of the country suggest this trend is in no way limited to the Badger State.

A big part of the problem is simply lack of information on the part of the decision-makers. A 2010 special report by Scripps Howard News Service found that fewer than one-third of US high schools with a sports program have even one full-time professional athletic trainer. That means much—too much—of the responsibility for athlete safety falls on coaches, athletic directors, and, by default, parents. Typically these people are not trained in sports medicine, nor are they up to date on the latest in sports medicine research.

And, to be sure, it’s hard for sports medicine practitioners who don’t work directly with high school teams to effect change. But you know about these teams, because their players end up in your offices with ankle sprains, chronic ankle instability, or worse.

Even if you can’t be on the sidelines, you can help educate those who are. If your practice or organization has a website, write a blog post on this topic or just post links to the relevant studies or to LER’s coverage. Email this issue’s cover story or send a printed copy to your local school district’s athletic director or parent association. If you perform preparticipation physical examinations, that’s another opportunity to inform parents and athletes about what they can do to prevent ankle sprains during the coming season.

Yes, there will still be coaches, athletic directors, and parents who will find reasons not to make ankle sprain prevention a priority. But plenty of others will find ways to make a difference, once they are made aware that this is a solvable problem. And you can help.

Jordana Bieze Foster, Editor

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