ABSTRACT:Ankle dorsifl exion range of motion (ROM) typically decreases aft er prolonged immobilization. Anterior-to-posterior talocrural joint mobilizations are purported to increase dorsifl exion ROM and decrease joint stiff ness aft er immobilization. Th e purpose of this study was to determine if a single bout of Grade III anterior-to-posterior talocrural joint mobilizations immediately aff ected measures of dorsifl exion ROM, posterior ankle joint stiff ness, and posterior talar translation in ankles of patients who had been immobilized at least 14 days. Ten physically active patients (5 males, 5 females; age=21.4+3.3 years) participated. Each had the ankle immobilized following a lower extremity injury for at least 14 days and presented with at least a 5° dorsifl exion ROM defi cit compared to the contralateral ankle. A crossover design was employed so that half of the subjects received joint mobilizations fi rst and half of the subjects received the control intervention (no treatment) fi rst. All subjects ultimately received both treatments. Active dorsifl exion ROM was assessed with a bubble inclinometer, and posterior ankle stiff ness and talar translation were assessed with an instrumented ankle arthrometer. Aft er a single application of grade III anterior-to-posterior talocrural joint mobilization, dorsifl exion ROM and posterior ankle joint stiff ness were signifi cantly increased. Th ere was also a trend toward less posterior talar translation immediately aft er mobilization. Th e trend toward decreased posterior talar translation and increased posterior ankle joint stiff ness supports the positional fault theory. Correction of an anterior talar positional fault off ers a possible explanation for these results.

Restrictions in ankle dorsiflexion range of motion (ROM) have been associated with decreased posterior talar glide in individuals with an acute lateral ankle sprain. Talocrural joint mobilizations may be used to restore joint arthrokinematics. Our purpose was to examine the effects of a single bout of anterior to posterior (AP) talocrural joint mobilization on self-reported function, dorsiflexion ROM, and posterior talar translation in individuals with an acute lateral ankle sprain. This single-blinded, randomized controlled trial utilized 17 volunteers (nine treatment and eight control) with an acute lateral ankle sprain (grade I/II) who were immobilized for a period of 1-7 days. The treatment group received a single 30-second bout of grade III AP talocrural joint mobilization the day their immobilization device was removed, while the control group did not receive any intervention. Active dorsiflexion ROM and posterior talar translation were assessed before, immediately after, and 24 hours after receipt of the treatment or control interventions. Self-reported function and pain were assessed before and 24 hours after the receipt of the treatment or control interventions using the foot and ankle disability index. Collectively all groups demonstrated improved dorsiflexion ROM and self-reported function. There was a significant decrease in pain perception at 24-hour follow-up for the treatment group. A single bout of AP talocrural joint mobilizations may not have an immediate effect on ankle dorsiflexion ROM, posterior talar translation, or self-reported function; however, they may have an immediate effect on pain perception in individuals with an acute lateral ankle sprain.

This randomized, controlled, laboratory study was designed to examine the effect of cold water immersion (CWI) as a recovery modality on repeat performance on the yo-yo intermittent recovery test (YIRT), a widely accepted tool for the evaluation of physical performance in soccer, separated by 48 hours. Twenty-two healthy Division I collegiate soccer players (13 men and 9 women; age, 19.8 ± 1.1 years; height, 174.0 ± 9.0 cm; mass, 72.1 ± 9.1 kg) volunteered as participants during the noncompetitive season. The YIRT was used to induce volitional fatigue and was administered at baseline and again 48 hours later. Athletes progressively increased sprint speed between markers set 20 m apart until pace was failed. Countermovement vertical jump (CMVJ) was used to assess anaerobic power and was measured before YIRT, immediately post-YIRT, and 24 and 48 hours post-YIRT. A 10-cm horizontal visual analog scale was administered immediately, 24 hours and 48 hours post-YIRT to assess perceived fatigue (PF) in the legs. Participants were randomly placed into the CWI or control group. The CWI condition consisted of immersion to the umbilicus in a 12°C pool for 15 minutes, whereas the control group sat quietly for 15 minutes. There were no significant differences between intervention conditions on YIRT performance (control, 4,900 ± 884 m; CWI, 5,288 ± 1,000 m; p = 0.35) or PF (control, 9.4 ± 0.5 cm; CWI, 9.3 ± 0.6 cm; p = 0.65) at 48 hours post-YIRT. There was a main time effect for CMVJ over 48 hours, but no group differences (pre-YIRT, 64.6 ± 11.0 cm; post-YIRT, 66.4 ± 10.9 cm; 24 hours post-YIRT, 63.4 ± 9.9 cm; 48 hours post-YIRT, 63.1 ± 9.4 cm; p = 0.02). This study demonstrated that in collegiate soccer players, CWI performed immediately and 24 hours after induced volitional fatigue did not affect subsequent physical performance estimates.