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

J Athl Train. 2021 Apr 1;56(4):408-417. doi: 10.4085/1062-6050-391.19.

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.

MeSH terms

  • Ankle Injuries / diagnosis
  • Ankle Injuries / physiopathology*
  • Ankle Joint / physiopathology*
  • Athletic Injuries / physiopathology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Joint Instability / diagnosis
  • Joint Instability / physiopathology*
  • Lateral Ligament, Ankle / injuries
  • Lateral Ligament, Ankle / physiopathology
  • Male
  • Physical Examination
  • Range of Motion, Articular*
  • Sprains and Strains / diagnosis
  • Sprains and Strains / physiopathology*
  • Weight-Bearing
  • Young Adult