JORR
Journal of Orthopedics Research and Rehabilitation

The Journal of Orthopedics Research and Rehabilitation welcomes scholarly papers inorthopaedic surgery, physical therapy and rehabilitation, neurosurgery, neurology and clinic anesthesiology and reanimation. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-0560
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Review
Biomechanics, pathomechanics, diagnosis, treatment, and return to play criterias of lateral ankle sprains: an evidence-based clinical guideline
Abstract
Lateral ankle sprain (LAS), which is common in recreational and professional athletes, recurs and becomes chronic if left untreated. Since the number of mechanoreceptors it contains is high, LAS should not be considered only as a musculoskeletal disorder. A detailed clinical evaluation is recommended. Clinically, the patient presents with limitation of dorsiflexion range of motion (ROM), muscle atrophy and unequal strength between the muscles, deterioration in walking, running and jumping, and proprioceptive losses. The patient should be approached from a biopsychosocial perspective both in the evaluation and treatment phases. The treatment of the patient is carried out in 3 phases and the transition between phases should be based on mentioned criterias. In the acute phase of rehabilitation, emphasis should be placed on eliminating pain and edema, and preventing loss of ROM and muscle strength. In the subacute and chronic stages, emphasis should be placed on increasing the proprioceptive sense and muscle strength, improving the biomechanics of daily life and sports-specific movements such as walking, running, jumping. If the patient is an athlete, return to sports should be planned after the criterias met.

Keywords : Lateral ankle sprain, rehabilitation, foot, ankle

Download Article


1. McKeon PO, Hertel J, Bramble D, Davis I. The foot core system: a newparadigm for understanding intrinsic foot muscle function. Br J SportsMed. 2015;49(5):290. doi:10.1136/bjsports-2013-092690
2. Renström PA, Konradsen L. Ankle ligament injuries. Br J Sports Med.1997;31(1):11-20. doi:10.1136/bjsm.31.1.11
3. Hupperets MD, Verhagen EA, van Mechelen W. Effect ofsensorimotor training on morphological, neurophysiological andfunctional characteristics of the ankle: a critical review. Sports Med.2009;39(7):591-605. doi:10.2165/00007256-200939070-00005
4. Hertel J. Sensorimotor deficits with ankle sprains and chronicankle instability. Clin Sports Med. 2008;27(3):353-vii. doi:10.1016/j.csm.2008.03.006
5. Weerasekara RM, Tennakoon SU, Suraweera HJ. Contrast therapy andheat therapy in subacute stage of grade I and II lateral ankle sprains.Foot Ankle Spec. 2016;9(4):307-323. doi:10.1177/1938640016640885
6. Huson A. Joints and movements of the foot: terminology and concepts.Acta Morphol Neerl Scand. 1987;25(3):117-130.
7. Lundberg A, Goldie I, Kalin B, Selvik G. Kinematics of the ankle/footcomplex: plantarflexion and dorsiflexion. Foot Ankle. 1989;9(4):194-200. doi:10.1177/107110078900900409
8. Burks RT, Morgan J. Anatomy of the lateral ankle ligaments. Am JSports Med. 1994;22(1):72-77. doi:10.1177/036354659402200113
9. Cass JR, Settles H. Ankle instability: in vitro kinematics inresponse to axial load. Foot Ankle Int. 1994;15(3):134-140.doi:10.1177/107110079401500308
10. Hertel J. Functional Anatomy, Pathomechanics, and Pathophysiologyof Lateral Ankle Instability. J Athl Train. 2002;37(4):364-375.
11. Kavanagh J. Is there a positional fault at the inferior tibiofibular jointin patients with acute or chronic ankle sprains compared to normals?.Man Ther. 1999;4(1):19-24. doi:10.1016/s1356-689x(99)80005-8
12. Denegar CR, Miller SJ 3rd. Can chronic ankle instability be prevented?rethinking management of lateral ankle sprains. J Athl Train.2002;37(4):430-435.
13. Mulligan B. Manual therapy “NAGS”,“SNAGS”,“MWMS” etc. planeview services. Wellingt New Zeal. Published online 1995.
14. Ashton-Miller JA, Ottaviani RA, Hutchinson C, Wojtys EM. What bestprotects the inverted weightbearing ankle against further inversion?Evertor muscle strength compares favorably with shoe height, athletictape, and three orthoses. Am J Sports Med. 1996;24(6):800-809.doi:10.1177/036354659602400616
15. Sinkjaer T, Toft E, Andreassen S, Hornemann BC. Muscle stiffnessin human ankle dorsiflexors: intrinsic and reflex components. JNeurophysiol. 1988;60(3):1110-1121. doi:10.1152/jn.1988.60.3.1110
16. van den Bekerom MP, Kerkhoffs GM, McCollum GA, Calder JD, vanDijk CN. Management of acute lateral ankle ligament injury in theathlete. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1390-1395.doi:10.1007/s00167-012-2252-7
17. Wikstrom EA, Hubbard-Turner T, McKeon PO. Understanding andtreating lateral ankle sprains and their consequences: a constraints-based approach. Sports Med. 2013;43(6):385-393. doi:10.1007/s40279-013-0043-z
18. Donovan L, Hertel J. A new paradigm for rehabilitation of patients withchronic ankle instability. Phys Sportsmed. 2012;40(4):41-51. doi:10.3810/psm.2012.11.1987
19. McCriskin BJ, Cameron KL, Orr JD, Waterman BR. Management andprevention of acute and chronic lateral ankle instability in athleticpatient populations. World J Orthop. 2015;6(2):161-171. Published 2015Mar 18. doi:10.5312/wjo.v6.i2.161
20. Freeman MA. Instability of the foot after injuries to the lateral ligamentof the ankle. J Bone Joint Surg Br. 1965;47(4):669-677.
21. Croy T, Koppenhaver S, Saliba S, Hertel J. Anterior talocruraljoint laxity: diagnostic accuracy of the anterior drawer test of theankle. J Orthop Sports Phys Ther. 2013;43(12):911-919. doi:10.2519/jospt.2013.4679
22. van Dijk CN, Mol BW, Lim LS, Marti RK, Bossuyt PM. Diagnosisof ligament rupture of the ankle joint. Physical examination,arthrography, stress radiography and sonography compared in 160patients after inversion trauma. Acta Orthop Scand. 1996;67(6):566-570.doi:10.3109/17453679608997757
23. Lähde S, Putkonen M, Puranen J, Raatikainen T. Examination of thesprained ankle: anterior drawer test or arthrography?. Eur J Radiol.1988;8(4):255-257.
24. Phisitkul P, Chaichankul C, Sripongsai R, Prasitdamrong I,Tengtrakulcharoen P, Suarchawaratana S. Accuracy of anterolateraldrawer test in lateral ankle instability: a cadaveric study. Foot Ankle Int.2009;30(7):690-695. doi:10.3113/FAI.2009.0690
25. Li Q, Tu Y, Chen J, et al. Reverse anterolateral drawer test is moresensitive and accurate for diagnosing chronic anterior talofibularligament injury. Knee Surg Sports Traumatol Arthrosc. 2020;28(1):55-62. doi:10.1007/s00167-019-05705-x
26. Gribble PA, Hertel J, Denegar CR, Buckley WE. The Effects of Fatigueand Chronic Ankle Instability on Dynamic Postural Control. J AthlTrain. 2004;39(4):321-329.
27. Harris GF. Analysis of ankle and subtalar motion during humanlocomotion. Inman’s Joints of the Ankle. 1991;2:75-84.
28. Youdas JW, McLean TJ, Krause DA, Hollman JH. Changes in activeankle dorsiflexion range of motion after acute inversion ankle sprain. JSport Rehabil. 2009;18(3):358-374. doi:10.1123/jsr.18.3.358
29. Green T, Refshauge K, Crosbie J, Adams R. A randomized controlledtrial of a passive accessory joint mobilization on acute ankle inversionsprains. Phys Ther. 2001;81(4):984-994.
30. Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprainon dorsiflexion range of motion, posterior talar glide, and jointlaxity. J Orthop Sports Phys Ther. 2002;32(4):166-173. doi:10.2519/jospt.2002.32.4.166
31. Vicenzino B, Branjerdporn M, Teys P, Jordan K. Initial changes inposterior talar glide and dorsiflexion of the ankle after mobilizationwith movement in individuals with recurrent ankle sprain. J OrthopSports Phys Ther. 2006;36(7):464-471. doi:10.2519/jospt.2006.2265
32. Munn J, Beard DJ, Refshauge KM, Lee RY. Eccentric muscle strength infunctional ankle instability. Med Sci Sports Exerc. 2003;35(2):245-250. doi:10.1249/01.MSS.0000048724.74659.9F
33. Konradsen L, Olesen S, Hansen HM. Ankle sensorimotor control andeversion strength after acute ankle inversion injuries. Am J Sports Med.1998;26(1):72-77. doi:10.1177/03635465980260013001
34. Kobayashi T, Gamada K. Lateral ankle sprain and chronic ankleinstability: a critical review. Foot Ankle Spec. 2014;7(4):298-326.doi:10.1177/1938640014539813
35. Wilkerson GB, Pinerola JJ, Caturano RW. Invertor vs. evertor peaktorque and power deficiencies associated with lateral ankle ligamentinjury. J Orthop Sports Phys Ther. 1997;26(2):78-86. doi:10.2519/jospt.1997.26.2.78
36. Miklovic TM, Donovan L, Protzuk OA, Kang MS, Feger MA.Acute lateral ankle sprain to chronic ankle instability: a pathway ofdysfunction. Phys Sportsmed. 2018;46(1):116-122. doi:10.1080/00913847.2018.1409604
37. McKeon PO, Hubbard TJ, Wikstrom EA. Consequences of AnkleInversion Trauma: A Novel Recognition and Treatment Paradigm.INTECH Open Access Publisher; 2012.
38. Nakagawa L, Hoffman M. Performance in static, dynamic, and clinicaltests of postural control in individuals with recurrent ankle sprains. JSport Rehabil. 2004;13(3):255-268. doi:10.1123/jsr.13.3.255
39. de Vries JS, Krips R, Sierevelt IN, Blankevoort L, van Dijk CN.Interventions for treating chronic ankle instability. Cochrane DatabaseSyst Rev. 2011;(8):CD004124. doi:10.1002/14651858.CD004124.pub3
40. Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E. Lowerextremity function during gait in participants with first time acutelateral ankle sprain compared to controls. J Electromyogr Kinesiol.2015;25(1):182-192. doi:10.1016/j.jelekin.2014.09.004
41. Delahunt E, Monaghan K, Caulfield B. Altered neuromuscular controland ankle joint kinematics during walking in subjects with functionalinstability of the ankle joint. Am J Sports Med. 2006;34(12):1970-1976.doi:10.1177/0363546506290989
42. Punt I, Ziltener JL, Laidet M, Armand S, Allet L. Functional deficitsin acute lateral ankle sprain patients. Gait Posture. 2014;(39):S19-S20. doi:10.1016/j.gaitpost.2014.04.029
43. Feger MA, Hart JM, Saliba S, Abel MF, Hertel J. Gait training forchronic ankle instability improves neuromechanics during walking. JOrthop Res. 2018;36(1):515-524. doi:10.1002/jor.23639
44. Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E.Single-leg drop landing motor control strategies following acute anklesprain injury. Scand J Med Sci Sports. 2015;25(4):525-533. doi:10.1111/sms.12282
45. Caulfield BM, Garrett M. Functional instability of the ankle:differences in patterns of ankle and knee movement prior to andpost landing in a single leg jump. Int J Sports Med. 2002;23(1):64-68.doi:10.1055/s-2002-19272
46. Hertel J, Corbett RO. An updated model of chronic ankle instability. JAthl Train. 2019;54(6):572-588. doi:10.4085/1062-6050-344-18
47. Engel GL. The need for a new medical model: a challenge forbiomedicine. Science. 1977;196(4286):129-136. doi:10.1126/science.847460
48. Bleakley CM, Glasgow P, MacAuley DC. PRICE needs updating, shouldwe call the POLICE?. Br J Sports Med. 2012;46(4):220-221. doi:10.1136/bjsports-2011-090297
49. Chen ET, Borg-Stein J, McInnis KC. Ankle Sprains: Evaluation,Rehabilitation, and Prevention [published correction appears inCurr Sports Med Rep. 2019 Aug;18(8):310]. Curr Sports Med Rep.2019;18(6):217-223. doi:10.1249/JSR.0000000000000603
50. Hudson R, Baker RT, May J, Reordan D, Nasypany A. Novel treatmentof lateral ankle sprains using the Mulligan concept: an exploratory caseseries analysis. J Man Manip Ther. 2017;25(5):251-259. doi:10.1080/10669817.2017.1332557
51. Weerasekara I, Deam H, Bamborough N, et al. Effect of Mobilisationwith Movement (MWM) on clinical outcomes in lateral ankle sprains:A systematic review and meta-analysis. Foot (Edinb). 2020;43:101657.doi:10.1016/j.foot.2019.101657
52. Chinn L, Hertel J. Rehabilitation of ankle and foot injuries in athletes.Clin Sports Med. 2010;29(1):157-167. doi:10.1016/j.csm.2009.09.006
53. Alahmari KA, Silvian P, Ahmad I, et al. Effectiveness of low-frequency stimulation in proprioceptive neuromuscular facilitationtechniques for post ankle sprain balance and proprioception in adults:a randomized controlled trial. Biomed Res Int. 2020;2020:9012930.doi:10.1155/2020/9012930
54. Dastmanesh S, Shojaedin SS, Eskandari E. The effects of corestabilization training on postural control of subjects with chronic ankleinstability. Ann Biol Res. 2012;3(8):3926-3930.
55. Rivera MJ, Winkelmann ZK, Powden CJ, Games KE. Proprioceptivetraining for the prevention of ankle sprains: an evidence-based review.J Athl Train. 2017;52(11):1065-1067. doi:10.4085/1062-6050-52.11.16
56. Ismail MM, Ibrahim MM, Youssef EF, El Shorbagy KM. Plyometrictraining versus resistive exercises after acute lateral ankle sprain. FootAnkle Int. 2010;31(6):523-530. doi:10.3113/FAI.2010.0523
57. Tassignon B, Verschueren J, Delahunt E, et al. Criteria-Based Returnto Sport Decision-Making Following Lateral Ankle Sprain Injury: aSystematic Review and Narrative Synthesis. Sports Med. 2019;49(4):601-619. doi:10.1007/s40279-019-01071-3
58. Wikstrom EA, Mueller C, Cain MS. Lack of Consensus on Return-to-Sport Criteria Following Lateral Ankle Sprain: A Systematic Reviewof Expert Opinions. J Sport Rehabil. 2020;29(2):231-237. doi:10.1123/jsr.2019-0038
59. Smith MD, Vicenzino B, Bahr R, et al. Return to sport decisions after anacute lateral ankle sprain injury: introducing the PAASS framework-an international multidisciplinary consensus. Br J Sports Med.2021;55(22):1270-1276. doi:10.1136/bjsports-2021-104087
60. Cross KM, Worrell TW, Leslie JE, Van Veld KR. The relationshipbetween self-reported and clinical measures and the number of daysto return to sport following acute lateral ankle sprains. J Orthop SportsPhys Ther. 2002;32(1):16-23. doi:10.2519/jospt.2002.32.1.16
Article available in :
Volume 1, Issue 2, 2023
Page : 37-43
https://doi.org/10.51271/JORR-0009
Article Information
Received : 30 Oca 2023
Accepted : 07 Mar 2023
Published : 29 Nis 2023
Corresponding Author :

Caner Karartı: Kırşehir Ahi Evran University

[email protected]
Citation : Karartı C, Özyurt F, Basat HÇ. Biomechanics, pathomechanics, diagnosis, treatment, and return to play criterias of lateral ankle sprains: an evidence-based clinical guideline. J Orthop Res Rehabil. 2023;1(2):37-43

Read: 1044
Cited: 0
Download : 557
_Footer