Biomechanics of ankle instability. Part 1: Reaction time to simulated ankle sprain.
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Mitchell A, Dyson R, Hale T, Abraham C.
Med Sci Sports Exerc. 2008 Aug;40(8):1515-21.
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Compression fatigue of midsoles of running shoes
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Repeatability in the assessment of multi-segment foot kinematics
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Biomechanics of Ankle Instability. Part 2: Postural Sway-Reaction Time Relationship.
Mitchell A, Dyson R, Hale T, Abraham C.
Med Sci Sports Exerc. 2008 Aug;40(8):1522-1528.
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Subtalar instability: a biomechanical cadaver study.
Weindel S, Schmidt R, Rammelt S, Claes L, Campe AV, Rein S.
Arch Orthop Trauma Surg. 2008 Oct 7. [Epub ahead of print]
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Effect of Foot Orthotics on Single- and Double-Limb Dynamic Balance Tasks in Patients With Chronic Ankle Instability
Amelia R. Sesma, Carl G. Mattacola, Tim L. Uhl, Arthur J. Nitz, Patrick O. McKeon
Foot & Ankle Specialist, Vol. 1, No. 6, 390-397 (2008)
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Lateral ankle sprain alters postural control in bipedal stance: Part 2 sensorial and mechanical effects induced by wearing an ankle orthosis.
Genthon N, Bouvat E, Banihachemi JJ, Bergeau J, Abdellaoui A, Rougier PR.
Scand J Med Sci Sports. 2009 Apr 20. [Epub ahead of print]
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Effects of Taping and Exercise on Ankle Joint Movement in Subjects With Chronic Ankle Instability: A Preliminary Investigation.
Delahunt E, O'Driscoll J, Moran K.
Arch Phys Med Rehabil. 2009 Aug;90(8):1418-1422
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Altered ankle kinematics and shank-rear-foot coupling in those with chronic ankle instability.
Drewes LK, McKeon PO, Paolini G, Riley P, Kerrigan DC, Ingersoll CD, Hertel J.
J Sport Rehabil. 2009 Aug;18(3):375-88.
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Modified Evans technique improves plantar pressure distribution in lateral ankle instability.
Ateşalp S, Demiralp B, Ozkal UB, Uğurlu M, Bozkurt M, Başbozkurt M.
Eklem Hastalik Cerrahisi. 2009;20(1):41-6.
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The influence of Mulligan ankle taping during balance performance in subjects with unilateral chronic ankle instability.
Hopper D, Samsson K, Hulenik T, Ng C, Hall T, Robinson K.
Phys Ther Sport. 2009 Nov;10(4):125-30
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Chronic ankle instability. Which tests to assess the lesions? Which therapeutic options?
Orthop Traumatol Surg Res. 2010 May 19. [Epub ahead of print]
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Chronic ankle instability: Biomechanics and pathomechanics of ligaments injury and associated lesions.
Bonnel F, Toullec E, Mabit C, Tourné Y; et la Sofcot.
Orthop Traumatol Surg Res. 2010 May 19. [Epub ahead of print]
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Chronic ankle instability alters central organization of movement.
Hass CJ, Bishop MD, Doidge D, Wikstrom EA.
Am J Sports Med. 2010 Apr;38(4):829-34
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Characteristics of people with recurrent ankle sprains: a systematic review with meta-analysis.
Hiller CE, Nightingale EJ, Christine Lin CW, Coughlan GF, Caulfield B, Delahunt E.
Br J Sports Med. 2011 Jan 21. [Epub ahead of print]
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Press Release:
Foot positioning during walking and running may influence ankle sprains
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A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types.
Kemler E, van de Port I, Backx F, van Dijk CN.
Sports Med. 2011 Mar 1;41(3):185-97.
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Eric -
Is there much evidence to support valgus forefoot posting to increase lateral ankle stability?
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Some studies of sinus tarsi syndrome and lateal ankle instability have demonstrated increased latency to activation of peroneal muscles in response to a sudden inversion movement, and this could explain why they have an increased number of ankle sprains. An increased latency probably would not be helped by a forefoot valgus wedge. On the other hand, peroneal weakness might be helped by a forefoot valgus wedge because there would be increased pronation moment from the ground when there was decreased pronation moment from muscles.
Eric -
I guess it would depend on the forefoot plantar pressures too, as to whether it could be approp. treated with ff valgus wedging. An excessively supinated gait ( that predisposes patient to lateral landing and lat ankle sprains) with ++ px under the 5 th would not respond well to extra valgus wedging.
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Eric -
Foot pressure and center of pressure in athletes with ankle instability during lateral shuffling and running gait.
Huang PY, Lin CF, Kuo LC, Liao JC.
Scand J Med Sci Sports. 2011 Aug 18.
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Eric -
Functional Ankle Instability and Health-Related Quality of Life
Arnold, Brent L.; Wright, Cynthia J.; Ross, Scott E.
Journal of Athletic Training, Volume 47, Number 1, November/December 2011 , pp. 634-641(8)Last edited: Jan 4, 2012 -
Altered plantar-receptor stimulation impairs postural control in those with chronic ankle instability.
McKeon PO, Stein AJ, Ingersoll CD, Hertel J.
J Sport Rehabil. 2012 Feb;21(1):1-6.
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Associated intra-articular ankle pathologies in patients with chronic lateral ankle instability: arthroscopic findings at the time of lateral ankle reconstruction.
Lee J, Hamilton G, Ford L.
Foot Ankle Spec. 2011 Oct;4(5):284-9
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Increased in-shoe lateral plantar pressures with chronic ankle instability.
Schmidt H, Sauer LD, Lee SY, Saliba S, Hertel J.
Foot Ankle Int. 2011 Nov;32(11):1075-80.
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Orthotic intervention and postural stability in participants with functional ankle instability after an accommodation period.
Hamlyn C, Docherty CL, Klossner J.
J Athl Train. 2012;47(2):130-5.
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Discriminating between copers and people with chronic ankle instability.
Wikstrom EA, Tillman MD, Chmielewski TL, Cauraugh JH, Naugle KE, Borsa PA.
J Athl Train. 2012;47(2):136-42.
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"Intrinsic STJ-Instability (STJ-I) is eval'd by putting the STJ thru a ROM, and then one will feel either a smooth arc (normal), little to no motion (suspect coalition, either caritilaginous or ossseous), or as though there is a sharp "dell of the arc of ROM" and the ankle 'gives way laterally' (=STJ-I)...
Now, this is the rearfoot (ankle) that rolls/inverts/sprains--EVEN when sub 5th MT head is loaded and one places their other index finger sub proximal medial heel!! Yes, in heel contact to rearfoot loading phase of gait, one should [needs] to place a medial wedge in to ALL shoe gear and/or onto their Functional Foot Orthotics.
Any questions. Do this and your patients will luv you.
Also, place your patients into a Bioskin Biolok (low profile, ultra-breathable) ankle brace, with the straps reefed up/locked in place while the ankle/rearfoot is dorsiflexed & everted into the position of maximal stability. This is for work, play, exercise, and uneven terrain such as for military et al.
How do you like it know. The total package. Stability from the ground up and all around the ankle. -
What do you think causes the sharp sensation? Why do you think the sharp sensation would correlate with ankle instability?
Of course, as you mentioned you can work use an ankle brace to apply moments to the STJ from something other than changing the location of ground reaction force.
Eric -
This is a very interesting thread that I have monitored until now.
There seems to be agreement that there is a laterally deviated STJ Axis in play.
I am not sure if the forefoot position that is being discussed here is equally in agreement. Is it pronated or supinated?
I read that it is everted but I'm looking more for the sagittal plane component, as I'm not so sure that inversion forefoot moments are the real culprit.
In addition, there seems to be a greater supinatory moment produced in the UA compared to the its mate with the same injurious force. Perhaps this is indicative of an assymetry of the limbs where the short side is more inverted and therefore is more apt to sprain when challenged with supinatory moments.
Perhaps a lift on the UA might help or LLD should be considered as culpatory? After all, a 1/2" valgus wedge in the rearfoot with have a 1/4" lift effect.
Dennis -
Two-week joint mobilization intervention improves self-reported function, range of motion, and dynamic balance in those with chronic ankle instability.
Hoch MC, Andreatta RD, Mullineaux DR, English RA, Medina McKeon JM, Mattacola CG, McKeon PO.
J Orthop Res. 2012 May 18. doi: 10.1002/jor.22150.
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Effects of Joint Mobilization on Ankle Dorsiflexion Range of Motion, Dynamic Postural Control and Self-Reported Patient Outcomes in Individuals with Chronic Ankle Instability
Master of Science in Exercise Science, University of Toledo, College of Health Science and Human Service, 2012.
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In Vivo Kinematics of the Talocrural and Subtalar Joints With Functional Ankle Instability During Weight-Bearing Ankle Internal Rotation: A Pilot Study.
Kobayashi T, No Y, Yoneta K, Sadakiyo M, Gamada K.
Foot Ankle Spec. 2013 Feb 25.
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Effects of Chronic Ankle Instability on Energy Dissipation in the Lower Extremity
Terada, Masafumi; Pfile, Kate R.; Pietrosimone, Brian G.; Gribble, Phillip A.
Medicine & Science in Sports & Exercise: 8 May 2013
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Aquatic Training for Ankle Instability
Gioftsidou Asimenia, et al
Foot Ankle Spec June 27, 2013 1938640013493461
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Selection Criteria for Patients With Chronic Ankle Instability in Controlled Research: A Position Statement of the International Ankle Consortium
Phillip A. Gribble, Eamonn Delahunt, Chris Bleakley, Brian Caulfield, Carrie L. Docherty, François Fourchet, Daniel Fong, Jay Hertel, Claire Hiller, Thomas W. Kaminski, Patrick O. McKeon, Kathryn M. Refshauge, Philip van der Wees, Bill Vicenzino, Erik A. Wikstrom
J Orthop Sports Phys Ther 2013;43(8):585-591. doi:10.2519/jospt.2013.0303
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The Effectiveness of Foot Orthotics on Improving Postural Control in Individuals With Chronic Ankle Instability: A Critically Appraised Topic
Michael L. Gabriner, Brittany A. Braun, Megan N. Houston, and Matthew C. Hoch
Journal of Sports Rehabilitation (in press)
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Compression fatigue of midsoles of running shoes
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Repeatability in the assessment of multi-segment foot kinematics
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