The Effect of Core Muscle-Strengthening on Pain, Balance and Ankle Function in Athletes with Sub-acute Lateral Ankle Sprain
This triple-blind randomized controlled trial demonstrates that adding core muscle-strengthening exercises to conventional physiotherapy significantly improves pain reduction, static balance, and ankle function in amateur athletes with subacute lateral ankle sprains compared to conventional therapy alone.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Ankle sprains are a familiar injury, a sudden twist that leaves the ligaments on the outside of the foot stretched or torn. While the pain is immediate, the recovery often lingers. Many people find that even after the sharp pain fades, their ankle feels unstable, their balance is off, and they are prone to rolling it again. For decades, rehabilitation has focused on the injured joint itself: stretching the ankle, strengthening the muscles right around it, and using machines to reduce swelling. However, a growing body of thought suggests that the ankle does not work in isolation. It is the end of a long chain of muscles and bones that starts at the hips and runs through the torso. If the muscles in the middle of the body, known as the core, are weak, the entire system can wobble, placing extra stress on the ankle and slowing down recovery.
This idea formed the basis of a recent study conducted by researchers at Tehran University of Medical Sciences. They wanted to know if adding exercises to strengthen the core muscles could help amateur athletes recover faster from a specific type of ankle injury: a mild to moderate sprain that had occurred within the last two weeks. At this stage, known as the subacute phase, the injury is past the initial swelling but still too painful to perform the usual strengthening exercises for the ankle itself. The researchers hypothesized that by training the muscles higher up the body, they could stabilize the whole leg, reduce pain, and improve balance without aggravating the injured foot.
To test this, the team recruited forty amateur athletes who had recently suffered these types of sprains. The participants were randomly divided into two groups. Both groups received standard physical therapy, which included treatments like ultrasound and electrical stimulation to manage pain and inflammation, along with gentle range-of-motion exercises to keep the ankle moving. The difference lay in what happened at the end of each session. The control group simply finished their therapy. The experimental group, however, performed a specific set of core-strengthening exercises. These exercises focused on the muscles along the side of the body. The athletes lay on their sides and practiced lifting their hips and torso, holding the position to build strength, and then progressed to doing the same movements while balancing on an exercise ball. This routine was performed three times a week for four weeks, totaling twelve sessions.
The results, measured before the treatment began and again after the four-week period, showed a clear distinction between the two groups. Both groups experienced a reduction in pain, which is expected as the injury naturally heals and standard therapy takes effect. However, the group that added the core exercises reported a significantly greater decrease in pain. More importantly, the benefits extended beyond just feeling better. The athletes who performed the core strengthening showed marked improvements in their static balance and their ability to perform daily activities and sports. In contrast, the group that received only the standard therapy saw no significant change in their balance or functional ability after the same amount of time.
The researchers suggest that the reason for this success lies in how the body moves. When the muscles on the side of the torso and hips are strong, they act as a stabilizer, preventing the upper body from swaying too much from side to side. This stability travels down the leg, reducing the chaotic movements that often cause the ankle to roll or twist again. By strengthening these proximal muscles, the athletes were able to protect their injured ankle more effectively, allowing it to heal in a more controlled environment. The study indicates that for people in the early stages of recovery from an ankle sprain, simply treating the foot is not enough. Integrating core strengthening into the rehabilitation plan appears to be a powerful tool for reducing pain, restoring balance, and helping athletes return to their normal lives with greater confidence and stability.
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