The Link Between Lateral Ankle Sprains and Muscle Reaction Time
Acute Ankle Sprain are among the most prevalent musculoskeletal injuries, particularly affecting physically active individuals. The injuries involve the stretching or tearing of ankle ligaments, with the lateral ankle ligament complex being the most commonly affected.
A history of lateral ankle sprain is recognized as one of the strongest risk factors for future sprains, contributing to a high recurrence rate and an increased likelihood of developing chronic ankle instability (CAI).
Incidence and Risk Factor:
Acute ankle sprains occur frequently across all levels of sports participation, as well as in other active populations such as military personnel. However, research indicates that nearly half of all ankle sprains treated in U.S. emergency departments occur outside of sports settings. Notably, individuals engaged in running, jumping, and cutting activities tend to have a higher incidence of acute ankle sprains. Additionally, despite previous findings suggesting otherwise, recent literature indicates that participants in activities such as dance and gymnastics may have a greater prevalence of CAI compared to other sport populations.
Long-term consequences:
The Long-term consequences of ankle sprains can be significant, with one of the most concerning outcomes being posttraumatic osteoarthritis (PTOA). Individuals who develop PTOA following ankle sprain often experience an earlier onset of the condition compared to those with idiopathic osteoarthritis, with symptoms potentially emerging as early as their 20s and the average age of onset occurring in the fifth decade of life.
Intrinsic Risk Factors:
Several intrinsic factors contribute to the risk of lateral ankle sprain, including body mass index (BMI), range of motion, muscle strength, postural stability, proprioception, and muscle reaction time.
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A meta-analysis identified significant correlations between LAS and specific intrinsic factors, including BMI, slow eccentric inversion strength, fast concentric plantar flexion strength, passive inversion joint position sense, and the reaction time of the peroneus brevis.
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Lateral ankle sprains typically occur during plantar flexion and inversion with excessive ankle supination. As a result, LAS is closely associated with decreased ankle eversion strength or delayed ankle evertor muscle reaction time.
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In cases of chronic ankle instability, reduced ankle eversion strength and delayed ankle evertor muscle reaction timehave been observed. However, these dysfunctions are likely acquired after an initial LAS rather than serving as primary risk factors for the injury itself.
Prevention and rehabilitation:
Given the strong association between prior ankle sprains and an increased risk of future injuries, as well as the potential for long-term joint complications, injury-prevention strategies play a crucial role in reducing these risks. strengthening exercises, balance training, proprioception, and biomechanical improvements have been shown to be effective in both preventing lower extremity musculoskeletal injuries and aiding in recovery from pain and dysfunction.
Rehabilitation and Treatment Approaches:
Physical exercise plays a crucial role in reducing the risk of functional ankle instability and optimizing joint function recovery. However, it remains unclear whether these exercises need to be supervised by a professional. Passive mobilizations should be incorporated to enhance ankle dorsiflexion and improve overall function. Additionally, balance exercises should be maintained throughout rehabilitation to minimize the risk of recurrent injuries.
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In the acute phase of an ankle sprain, the application of ice has been shown to significantly reduce pain compared to the use of analgesic drugs.
Other therapeutic modalities, including ultrasound, diathermy, electrotherapy, and laser therapy, have shown low levels of recommendation. Due to a lack of solid evidence supporting their effectiveness, these treatments are not recommended for managing ankle sprains.
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Surgical Intervention:
Surgical intervention has a very low grade of recommendation due to longer recovery times and potential side effects, such as altered mobility and joint stiffness. However, surgery is strongly advised in cases of chronic injuries or ligament ruptures. For instance, professional athletes often undergo surgical treatment to facilitate a quicker return to sport.
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Effectiveness of Taping:
Taping is a widely used intervention among clinicians and athletic trainers for managing sports injuries and various neuromusculoskeletal disorders. However, no studies have specifically evaluated its effectiveness in improving sports performance and ankle function in athletes with chronic ankle instability (CAI).
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Kinesiology taping (KT) has shown significant effects on select outcomes, including:
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Gait function improvements
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Reduction in ankle joint range of motion (ROM) in inversion and eversion
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Decreased muscle activation of the peroneus longus
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Reduced postural sway in mid-lateral movements​
While these findings highlight some benefits of KT, further research is needed to determine its overall efficacy in sports performance and long-term ankle stability for athletes with CAI.
References
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· Gribble PA, Bleakley CM, Davidson PA. Prevention and rehabilitation of ankle sprains: an evidence-based approach. Sports Med. 2016;46(8):1235-1245. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4789932/
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· Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Recovery from a first-time lateral ankle sprain and the predictors of chronic ankle instability: a prospective cohort analysis. Am J Sports Med. 2016;44(4):995-1003. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6602402/
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· Murawski CD, Kennedy JG. Understanding the role of syndesmosis in ankle instability. Foot Ankle Clin. 2022;27(1):21-39. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9592509/
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· Moisan G, Descarreaux M, Cantin V. Effect of taping on proprioception, muscle activity, and dynamic control in individuals with chronic ankle instability: a systematic review. J Sport Rehabil. 2022;31(5):579-590. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9146435/
