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Workshop #3

How Do We Manage Simple Ankle Injuries in the Complex World of Elite Sport?

Speaker 1: Lee Herrington

Speaker 2: Ros Cooke

Background & Relevance: Ankle ligament injuries within the high-performance sport are common constituting 10% of all consultations for musculoskeletal injury within the UK. These injuries lead to time loss and training restriction impacting on availability for competition and performance outcomes.

Success in rehabilitation is currently judged on grade of injury and time to return to sport with the intention that performance will occur if the athlete is available. With the high rates of recurrence for ankle injuries this approach appears to not be successful and returning the athlete to sport let alone performance.

It is unclear if high recurrence rates are due to inadequate management at time of first occurrence of lateral ligament injury. Of further significance is the emerging research which links ankle ligament injuries to other musculoskeletal injuries primarily within the lower limb so poor resolution of ankle injury not only creates issues at the ankle but in other areas as well. The resolution of laxity is commonly used as a clinical assessment to clear an athlete to return to sport but there is little correlation of this objective marker with a successful return to sport.

Because of the level of burden, the risk of re-injury and development of other musculoskeletal injuries, it would appear to be imperative that the management of ankle ligament injuries is optimized.

This workshop aims to help clinicians to develop their clinical reasoning skills and assist them to develop comprehensive programmes that enable athletes to return to performance and reduce their risk of future injury. This will also consider constraints such as time – preparation for major events Olympic games, World Cup, athlete performance level and sport requirements. The approach used to aid reasoning will be one of performance backwards thinking. Here the end goal of rehabilitation; safe and optimal performance, will be first defined and worked backwards from to develop rehabilitation programmes specific to the athlete’s end goal requirements. Within the workshop participants will also explore contemporary thinking in relation to movement skill development and how this can and should be incorporated into a rehabilitation program in order to prepare the athlete for the performance environment they are returning too.

This problem-solving approach will be developed through a series facilitated case studies workshops, where participants will consider real clinical cases and in small groups develop management and return to performance plans.

Learning Objective 1: To understand and utilise needs analysis of sports or activities to inform rehabilitation intervention and planning for athletes to return to performance following ankle ligament injury.

Learning Objective 2: To utilise a framework underpinned by physical qualities to monitor and  progress athletes through rehabilitation.

Learning Objective 3: Share clinicians own current clinical practice to develop peer to peer learning.