Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr 1;56(4):408-417.
doi: 10.4085/1062-6050-391.19.

Identifying Range-of-Motion Deficits and Talocrural Joint Laxity After an Acute Lateral Ankle Sprain

Bethany A Wisthoff  1 , Carrie L Docherty  2 , Joseph Glutting  1 , Geoff Gustavsen  1 , Todd D Royer  1 , Charles Buz Swanik  1 , Thomas W Kaminski  1
Affiliations

Identifying Range-of-Motion Deficits and Talocrural Joint Laxity After an Acute Lateral Ankle Sprain

Bethany A Wisthoff et al. J Athl Train. .

Abstract

Context: Approximately 72% of patients with an ankle sprain report residual symptoms 6 to 18 months later. Although 44% of patients return to activity in less than 24 hours after experiencing a sprain, residual symptoms should be evaluated in the long term to determine if deficits exist. These residual symptoms may be due to the quality of ligament tissue and motion after injury.

Objective: To compare mechanical laxity of the talocrural joint and dorsiflexion range of motion (DFROM) over time (24 to 72 hours, 2 to 4 weeks, and 6 months) after an acute lateral ankle sprain (LAS).

Design: Cross-sectional study.

Setting: Athletic training research laboratory.

Patients or other participants: A total of 108 volunteers were recruited. Fifty-five participants had an acute LAS and 53 participants were control individuals without a history of LAS.

Main outcome measure(s): Mechanical laxity (talofibular interval and anterior talofibular ligament length) was measured in inversion (INV) and via the anterior drawer test. The weight-bearing lunge test was conducted and DFROM was measured. The data were analyzed using repeated-measures analysis of variance, independent-samples t tests, and 1-way analysis of variance.

Results: Of the 55 LASs, 21 (38%) were grade I, 27 (49%) were grade II, and 7 (13%) were grade III. Increases were noted in DFROM over time, between 24 and 72 hours, at 2 to 4 weeks, and at 6 months (P < .05). The DFROM was less in participants with grade III than grade I LASs (P = .004) at 24 to 72 hours; INV length was greater at 24 to 72 hours than at 2 to 4 weeks (P = .023) and at 6 months (P = .035) than at 24 to 72 hours. The anterior drawer length (P = .001) and INV talofibular interval (P = .004) were greater in the LAS group than in the control group at 6 months.

Conclusions: Differences in range of motion and laxity were evident among grades at various time points and may indicate different clinical responses after an LAS.

Keywords: anterior drawer test; inversion; talofibular interval; weight-bearing lunge test.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Experimental design. Abbreviations: AD, anterior drawer; INV, inversion; ROM, range of motion.
Figure 2
Figure 2
Inversion talofibular interval. A, Static position. B, Stressed position.
Figure 3
Figure 3
Musculoskeletal ultrasound. A, Talofibular interval.
Figure 4
Figure 4
Anterior drawer talofibular interval, static position.
See this image and copyright information in PMC

References

    1. Browne GJ, PLj Barnett. Common sports-related musculoskeletal injuries presenting to the emergency department. J Paediatr Child Health. 2016;52(2):231–236. doi: 10.1111/jpc.13101. - DOI - PubMed
    1. Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wickstrom EA. The epidemiology of lateral ligament complex ankle sprains in National Collegiate Athletic Association sports. Am J Sports Med. 2017;45(1):201–209. doi: 10.1177/0363546516660980. - DOI - PubMed
    1. Braun BL. Effects of ankle sprain in a general clinic population 6 to 18 months after medical evaluation. Arch Fam Med. 1999;8(2):143–148. doi: 10.1001/archfami.8.2.143. - DOI - PubMed
    1. van Rijn RM, van Os AG, Bernsen RM, Luijsterburg PA, Koes BW, Bierma-Zeinstra SM. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med. 2008;121(4):324–331.e6. doi: 10.1016/j.amjmed.2007.11.018. - DOI - PubMed
    1. Hiller CE, Kilbreath SL, Refshauge KM. Chronic ankle instability: evolution of the model. J Athl Train. 2011;46(2):133–141. doi: 10.4085/1062-6050-46.2.133. - DOI - PMC - PubMed