Following an ankle sprain only 70% of people struggle to return to their previous level of function. In many cases this is related to their development of a condition called chronic ankle instability (CAI). This condition has significant impact on well-being with approximately 85% of people diagnosed with chronic ankle instability also developing problems in the opposite leg. CAI is one of the related problems after an ankle sprain injury, specifically Lateral Ankle Sprains. CAI is defined as the continuation of the post-injury symptoms such as swelling, impaired strength, instability (occasional giving way), and impaired balance responses for more than 6 months following the initial injury 1.
Development of CAI: Meeuwiss et al 2 described a musculoskeletal injury as a focal point that when it occurs a series of subsequent events will be triggered. This injury is influenced by a combination of intrinsic and extrinsic risk factors. Intrinsic factors such as advanced age, poor neuromuscular control, previous history of trauma, etc. may interact with extrinsic factors in a sports event or a simple daily activity to cause a person or an athlete to sustain an injury. The presence of enough neuromuscular control, flexibility, and strength will protect this person from sustaining an injury. On the other hand, if these factors are not present, the person may be more likely to be injured and in turn develop CAI.
Deficits Associated with CAI: Postural Control: reduced ankle, knee, hip control and balance on one side or sometimes both sides, Gait Deficits: adjusting walking pattern to cope with pain, stiffness or weakness of the ankle, and Deficits in Jumping and Landing: such as favouring one side 3.
These deficits were evident at both early and middle phases of an ankle sprain and were then reported in those diagnosed with CAI. This refers to the hypothesis that these deficits are contributing to the development of CAI.
Treatment/Prevention: CAI prevention is important because this condition is common among athletes and less active people and could lead to major limitations and affect their performance. To prevent consequent CAI, joint stability strategies should be adopted in rehab with a skilled physiotherapist as well as normalized joint mechanics followed by gradual increase of load. A rehabilitation program designed to tackle the effects of injury on the ankle joint complex may offer promising results in regards to preventing CAI.
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- Fernández-de-las-Peñas C, editor. Manual therapy for musculoskeletal pain syndromes: An evidence-and clinical-informed approach. Elsevier Health Sciences; 2015 Jun 17
- Meeuwisse WH, Tyreman H, Hagel B, Emery C. A dynamic model of etiology in sport injury: the recursive nature of risk and causation. Clinical Journal of Sport Medicine. 2007 May 1;17(3):215-9.
- Chronic Ankle Instability Risk Identification [Internet]. Physiopedia. 2020 [cited 11 March 2020]. Available from: https://www.physio-pedia.com/Chronic_Ankle_ Instability_ Risk_Identification