Running gait adaptations among adolescent runners with soft tissue impairments following lateral ankle sprains

Abstract

Background: Lateral ankle sprains (LAS) frequently lead to residual soft tissue impairments, often attributed to biomechanical dysfunction during movement.

Objective: To compare running biomechanics between adolescent runners with soft tissue pathologies following LAS (injured) and healthy runners (control) and between limbs.

Design: Retrospective cohort study.

Setting: Hospital-affiliated sports injury prevention center.

Participants: Twenty-five adolescent runners with a history of LAS and current ankle impingement or tendinopathy (23 female, 2 male; age: 15 ± 2 years; body mass index [BMI]: 19.5 ± 2.5 kg/m² ; symptom duration: 1.1 ± 0.9 years), and 23 healthy controls without any LAS history (19 female, 4 male; age: 15 ± 1 years; BMI: 19.2 ± 2.7 kg/m² ) were included in this study.

Interventions: All participants completed a clinical gait assessment in which they ran at a self-selected speed on a force-plate instrumented treadmill, while two video cameras recorded two-dimensional sagittal and coronal views.

Main outcome measures: Foot rotation, step width, contact time, and cadence were compared between groups and limbs (involved, uninvolved [or "better" for bilateral cases]) using a multivariate analysis of variance (MANOVA). Rearfoot landing and foot strike type were compared between groups and limbs using a chi-square analysis.

Results: The injured group had significantly increased step width (F = 4.71, p = .04; mean difference [MD] with SE: 1.5 [0.7] cm) compared to controls. The injured groups' involved limb had longer contact time (F = 4.62, p = .03; MD_group : 12 [7] ms, MD_limb : 22 [11] ms) with more internal foot rotation (F = 14.60, p < .001; MD_group : 2.2 [1.2] degrees, MD_limb : 4.2 [1.3] degrees) compared to controls and their contralateral limb. There were no significant differences for cadence (F = 2.43, p = .13; MD: 4 [3] steps/min), foot landing (X² = 1.28, p = .53), or foot strike (X² = 1.24, p = .54).

Conclusions: Spatiotemporal and kinematic running adaptations may predispose young runners with initial LAS to secondary soft tissue dysfunction due to loss of stability from ligamentous structures and an overreliance on myotendinous control. Clinicians may consider targeting these maladaptations during gait-training interventions.