Functional Instability Following Lateral Ankle Sprain
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Sports Med 2000 May; 29 (5): 361-371 0112-1642/00/0005-0361/$20.00/0 © Adis International Limited. All rights reserved.
Functional Instability Following Lateral Ankle Sprain Jay Hertel Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Overview of Functional Instability . . . . . . . . . . . . . . . . . . . . . . . . 1.1 Historical Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 Relationship Between Functional Instability and Mechanical Instability 2. Evidence of Functional Instability After Ankle Sprain . . . . . . . . . . . . . 2.1 Balance Deficits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Joint Position Sense Deficits . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 Delayed Peroneal Muscle Reaction Time . . . . . . . . . . . . . . . . . 2.4 Altered Common Peroneal Nerve Function . . . . . . . . . . . . . . . . 2.5 Strength Deficits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 Decreased Dorsiflexion Range of Motion . . . . . . . . . . . . . . . . . 2.7 Sinus Tarsi Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.8 Anterolateral Impingement Syndrome . . . . . . . . . . . . . . . . . . 2.9 Miscellaneous Causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Clinical Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3 Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Abstract
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Lateral ankle sprain (LAS) is an extremely common athletic injury. Despite extensive clinical and basic science research, the recurrence rate remains high. Functional instability (FI) following LAS is hypothesised to predispose individuals to reinjury because of neuromuscular deficits which result following injury. This paper provides an overview of the potential causes of FI which may manifest themselves clinically. The theoretical explanations of FI are discussed, as are implications for assessment and treatment of FI following LAS. When LAS occurs, structural damage not only occurs to the ligamentous tissue,
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