The Effect of Lateral Ankle Sprain on Dorsiflexion Range of Motion, Posterior Talar Glide, and Joint Laxity

Abstract

Study Design: Retrospective study. Objective: Assess range of motion, posterior talar glide, and residual joint laxity following ankle sprain in a population of athletes who have returned to unrestricted activity. Background: Lateral ankle sprains occur frequently in athletic populations and the reinjury rate may be as high as 80%. In an effort to better understand risk factors for reinjury, the sequelae to injury in a sample of college athletes were assessed. Methods and Measures: Twelve athletes with a history of lateral ankle sprain within the last 6 months and who had returned to sport participation were tested. Only athletes who reported never injuring the contralateral ankle were included. The injured and uninjured ankles of subjects were compared for measures of joint laxity, ankle dorsiflexion range of motion, and posterior talar glide. Friedman's test of rank order was used to analyze the laxity measures and a MANOVA was used to assess the dorsiflexion and posterior talar glide measures. Results: Laxity was significantly greater at the talocrural and subtalar joints of the injured ankles. There were no significant differences in any of the ankle dorsiflexion measurements between injured and uninjured ankles, but posterior talar glide was significantly reduced in injured ankles as compared to uninjured ankles. Conclusion: In our sample of subjects, residual ligamentous laxity was commonly found following lateral ankle sprain. Dorsiflexion range of motion was restored in the population studied despite evidence of restricted posterior glide of the talocrural joint. Although restoration of physiological range of motion was achieved, residual joint dysfunction persisted. Further research is warranted to elucidate the role of altered arthrokinematics after lateral ankle sprain.

Increased treatment durations lead to greater improvements in non-weight bearing dorsiflexion range of motion for asymptomatic individuals immediately following an anteroposterior grade IV mobilisation of the talus

“…Indeed, the baseline characteristics of the participants were analogous to normative ranges in healthy adults (Hoch & McKeon, 2011b). Individuals who have sustained lateral ankle sprains often have DF-ROMs below 0 0 (Soucie et al, 2011), due to the propensity of the talus towards anteriorly subluxation following ligament disruption (Denegar et al, 2002). As such, symptomatic populations possess a larger range in which improvements can occur than asymptomatic groups.…”

“…Restrictions in the noncontractile tissues surrounding the ankle may inhibit the posterior talar glide decreasing ROM (Hertel, 2002). Static stretching techniques may not be sufficient to address these arthrokinematic restrictions, justifying the use of talocrural joint mobilisations (Denegar et al, 2002). A Maitland anteroposterior (AP) glide of the talus within the mortise has been shown to lead to improvements in DF-ROM (Landrum et al, 2004;Van der Wees et al, 2006).…”

Estudo da confiabilidade da força aplicada durante a mobilização articular ântero-posterior do tornozelo

“…Desde a década de oitenta, a terapia manual vem sendo amplamente empregada no tratamento fisioterápico das disfunções musculoesqueléticas, como nas algias da coluna vertebral 1 , nas epicondilalgias 2 e nas entorses de tornozelo [3][4][5] .…”

“…A mobilização articular refere-se aos movimentos acessórios passivos que visam à recuperação da artrocinemática, ou seja, dos movimentos de giro, rolamento e deslizamento entre as superfícies articulares 3,4 . O seu restabelecimento promove a congruência articular, diminui o atrito mecânico na articulação 3 , melhora a dor 4 , edema 4,5 e, conseqüentemente, a função do segmento corporal comprometido 5 .…”

“…O seu restabelecimento promove a congruência articular, diminui o atrito mecânico na articulação 3 , melhora a dor 4 , edema 4,5 e, conseqüentemente, a função do segmento corporal comprometido 5 .…”