Eversion strength analysis of uninjured and functionally unstable ankles.

OBJECTIVE Functional ankle instability (FAI) afflicts many athletes. Several causes of FAI have been implicated, including peroneal muscle weakness. Traditional musculoskeletal rehabilitation programs have focused on concentric muscle strength. The purpose of our study was to compare concentric and eccentric isokinetic and isometric eversion ankle strength measurements between subjects identified as having unilateral FAI and subjects having no history of inversion ankle sprain. DESIGN AND SETTING Employing a matched-pairs technique, subjects with no history of ankle injury were compared with subjects with unilateral FAI using isokinetic and isometric measures of eversion ankle strength. Strength testing was performed in a sports medicine clinic setting. SUBJECTS Forty-two subjects volunteered for this study: 21 subjects suffered from unilateral FAI (age = 19.3 +/- 1.1 years, wt = 84.0 +/- 9.5 kg, ht = 181.5 +/- 9.2 cm), while 21 subjects served as matched-paired controls (age = 19.5 +/- 1.2 years, wt = 82.5 +/- 10.9 kg, ht = 179.5 +/- 7.9 cm). MEASUREMENTS Ankle eversion concentric and eccentric strength (peak torque) was assessed at 0 degrees /s, 30 degrees /s, 60 degrees /s, 90 degrees /s, 120 degrees /s, 150 degrees /s, and 180 degrees /s using an isokinetic dynamometer. RESULTS We found no significant differences in concentric, eccentric, or isometric eversion ankle strength between the 2 groups of subjects. CONCLUSIONS The exact cause of FAI remains elusive. Based on our results, those who suffer from unilateral FAI do not appear to have eversion strength deficits. Unless clear evidence of weakness exists, clinicians may find that eversion strength training exercises are unnecessary. Future research should examine other causes of FAI, including reciprocal muscle group strength ratios and proprioception deficits.

[1]  J. Powell,et al.  Ankle sprains in young athletes. Relation of severity and disability. , 1974, Clinical orthopaedics and related research.

[2]  L. McGuire,et al.  The contributions of proprioceptive deficits, muscle function, and anatomic laxity to functional instability of the ankle. , 1995, The Journal of orthopaedic and sports physical therapy.

[3]  J. Grond The surgical treatment of injuries of the fibular collateral ligaments of the ankle. , 1973, Archivum chirurgicum Neerlandicum.

[4]  T. Kaminski,et al.  The Reliability and Validity of Ankle Inversion and Eversion Torque Measurements From the Kin Com II Isokinetic Dynamometer , 1995 .

[5]  M A Freeman,et al.  Instability of the foot after injuries to the lateral ligament of the ankle. , 1965, The Journal of bone and joint surgery. British volume.

[6]  L. Ryan Mechanical stability, muscle strength and proprioception in the functionally unstable ankle. , 1994, The Australian journal of physiotherapy.

[7]  S N Garn,et al.  Kinesthetic awareness in subjects with multiple ankle sprains. , 1988, Physical therapy.

[8]  O. S. Staples Result study of ruptures of lateral ligaments of the ankle. , 1972, Clinical orthopaedics and related research.

[9]  T. Malone,et al.  Ankle injuries: anatomical and biomechanical considerations necessary for the development of an injury prevention program. , 1980, The Journal of orthopaedic and sports physical therapy.

[10]  H. Hansen,et al.  Clinical and social status following injury to the lateral ligaments of the ankle. Follow-up of 144 patients treated conservatively. , 1979, Acta orthopaedica Scandinavica.

[11]  O. S. Staples,et al.  Residual disability following acute ankle sprains. , 1955, The Journal of bone and joint surgery. American volume.

[12]  O. S. Staples Ruptures of the fibular collateral ligaments of the ankle. Result study of immediate surgical treatment. , 1975, The Journal of bone and joint surgery. American volume.

[13]  G. C. Mookerjee Injuries to the Ankle , 1951, Indian medical record.

[14]  D H Perrin,et al.  Effect of unilateral functional instability of the ankle on postural sway and inversion and eversion strength. , 1997, Journal of athletic training.

[15]  P. Hardcastle,et al.  Acute rupture of the lateral ligament of the ankle. To suture or not to suture? , 1984, The Journal of bone and joint surgery. British volume.

[16]  G. McCluskey,et al.  Prevention of ankle sprains , 1976, The American journal of sports medicine.

[17]  Treatment approaches following foot and ankle injury. , 1994, Clinics in sports medicine.

[18]  P. Renström,et al.  Treatment for acute tears of the lateral ligaments of the ankle. Operation, cast, or early controlled mobilization. , 1991, The Journal of bone and joint surgery. American volume.

[19]  A. Jackson,et al.  Concentric and eccentric torque comparisons for knee extension and flexion in young adult males and females using the Kinetic Communicator , 1988, The American journal of sports medicine.

[20]  H Tropp,et al.  Stabilometry Recordings in Functional and Mechanical Instability of the Ankle Joint , 1985, International journal of sports medicine.

[21]  Margaret B. Freeman,et al.  The etiology and prevention of functional instability of the foot. , 1965, The Journal of bone and joint surgery. British volume.

[22]  Eccentric and concentric force-velocity relationships of the quadriceps feimoris muscle. , 1992, The Journal of orthopaedic and sports physical therapy.

[23]  G. Wilkerson,et al.  Invertor vs. evertor peak torque and power deficiencies associated with lateral ankle ligament injury. , 1997, The Journal of orthopaedic and sports physical therapy.

[24]  S M Lephart,et al.  The effect of sudden inversion stress on EMG activity of the peroneal and tibialis anterior muscles in the chronically unstable ankle. , 1997, The Journal of orthopaedic and sports physical therapy.

[25]  B. Cahill Chronic orthopedic problems in the young athlete , 1973, The Journal of sports medicine.

[26]  L. Broström Sprained ankles. 3. Clinical observations in recent ligament ruptures. , 1965, Acta chirurgica Scandinavica.

[27]  M. R. Walters,et al.  The Relationship between Muscle Function and Ankle Stability. , 1990, The Journal of orthopaedic and sports physical therapy.

[28]  J. Ashton-Miller,et al.  What Best Protects the Inverted Weightbearing Ankle Against Further Inversion? , 1996, The American journal of sports medicine.

[29]  H. Hansen,et al.  Radiological and muscular status following injury to the lateral ligaments of the ankle. Follow-up of 144 patients treated conservatively. , 1979, Acta orthopaedica Scandinavica.

[30]  D. H. O'donoghue,et al.  Treatment of Injuries to Athletes , 1979, Northwest medicine.

[31]  M. Cornwall,et al.  Postural sway following inversion sprain of the ankle. , 1991, Journal of the American Podiatric Medical Association.

[32]  Mark L. Mitchell,et al.  Research Design Explained , 1987 .

[33]  Judith F. Baumhauer,et al.  A Prospective Study of Ankle Injury Risk Factors , 1995, The American journal of sports medicine.

[34]  R. Gordon,et al.  The prevention and treatment of ankle injuries , 1976, The American journal of sports medicine.

[35]  H. Tropp Pronator Muscle Weakness in Functional Instability of the Ankle Joint , 1986, International journal of sports medicine.

[36]  R. Donatelli Normal biomechanics of the foot and ankle. , 1985, The Journal of orthopaedic and sports physical therapy.

[37]  J Kärrholm,et al.  Prolonged Reaction Time in Patients with Chronic Lateral Instability of the Ankle , 1995, The American journal of sports medicine.

[38]  D Glencross,et al.  Position sense following joint injury. , 1981, The Journal of sports medicine and physical fitness.

[39]  Staples Os Result study of ruptures of lateral ligaments of the ankle. , 1972 .

[40]  The Role of Ankle Strength in Functional Ankle Instability , 1997 .

[41]  J. Garrick The frequency of injury, mechanism of injury, and epidemiology of ankle sprains* , 1977, The American journal of sports medicine.