The ability of the sole of the foot to convey information about the positioning of the ankle is reduced when wearing smooth soled boots with socks compared with just bare feet. A study was done to see if a textured insole can increase the sensitivity to ankle positioning. If the ankle rolls over too far, damage to the ligaments may occur, this is a sprained ankle. Increasing sensitivity to how far the ankle is inverted may help prevent sprains.The results of the study showed that a textured insole worn in the boot restored movement sensitivity to near bare foot levels. Could this be the next big thing in football boot design? The study was done by Waddington & Adams at the School of Physiotherapy in Sydney, Australia.

British Journal of Sports Medicine April 2003

The Football Association Medical Research Programme carried out an analysis of ankle sprains in English professional football over two seasons. Ankle ligament sprains accounted for 11% of total injuries and 77% of those sprains involved the lateral ligaments (no surprise there). A total of 2033 matches were missed due to ankle sprains - a lot of expensive players out for such a simple injury. More ankle sprains occurred in matches rather than training. Over 30% of players who sustained an ankle sprain were wearing some form of support (was it good enough?). The recurrence rate for ankle sprains was 9%. Nearly half (48%) the ankle sprains occurred in the last 15 minutes of each half.

British Journal of Sports Medicine June 2003

A Randomized, Controlled Trial

Jan D. Rompe, MD¹, John Furia, MD² and Nicola Maffulli, MD, PhD, FRCS(Orth)³

The effectiveness of eccentric exercises in the treatment of Achilles tendinopathy has recently been demonstrated, as has the use of repetitive low-energy shock wave therapy in treating other musculoskeletal conditions. The aim of this study is to verify and compare the effectiveness of both procedures in patients with insertional Achilles tendinopathy.

Fifty patients with a chronic tendinopathy who have received traditional treatment for a minimum of three months with no success were divided into two groups, group one receiving eccentric loading exercises and group two receiving shock wave treatment. Patients were followed up after four months and again after one year.

After four months the rating for function and activity increased more significantly in the shock wave group, and the mean pain rating also decreased considerably, although both groups did demonstrate a significant improvement. These favourable results remained stable at the one-year follow-up.

Further research is needed to better define the indications for using repetitive low-energy shock wave therapy in the treatment of Achilles tendinopathy.

The Journal of Bone and Joint Surgery (American). 2008;90:52-61.

Jane Kennet, BSc; Natalie Hardaker, BSc (Hons); Sarah Hobbs, PhD; James Selfe, PhD

Cryotherapy, or the application of cold to an injury, as been long recognized as the first step in acute injury treatment. This study aimed to compare four common methods of applying cryotherapy to determine which method is most effective. The four methods included were crushed ice, a gel pack, frozen peas and immersion in ice water. Each of the cryotherapeutic methods was applied to the right ankle of nine healthy volunteers on four separate occasions. The skin temperature was recorded using a thermal imaging camera over a 30-minute re-warming period.The results indicated that the crushed ice and water immersion methods were the most effective at reducing surface skin temperature, and sustaining a decreased temperature over 30 minutes, indicting that these methods are the most beneficial in a clinical setting.

Journal of Athletic Training 2007;42(3):343–348