PTCohortJournal of neuroengineering and rehabilitation2025

Association between lower extremity movement patterns and ACL loading in CAI patients across varied ankle sprain frequencies within a year.

Zeyi Zhang, Shengmeng Wei, Hanlin Shi and 1 others

PMID 40186238

WHAT IT FOUND

Male athletes with chronic ankle instability who suffered four or more sprains in a year showed significantly higher ACL loads during single-leg landing.

They landed with stiffer ankles and weaker calf muscles, forcing the knee to absorb more shock. Focus rehab on ankle dorsiflexion and calf strength for this group.

Key findings

01Participants with four or more ankle sprains within a year exhibited markedly elevated peak ACL loads during single-leg landing compared to those with two or three sprains.

02Higher ACL loading was associated with limited ankle dorsiflexion, increased ankle inversion, greater vertical ground reaction force, and reduced gastrocnemius and soleus muscle strength.

03Patients with five or more sprains showed significantly lower ankle dorsiflexion angles and greater knee varus angles during landing than those with fewer sprains.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study included only male participants, so results may not apply to female athletes. The number of ankle sprains was self-reported, which introduces potential recall bias. The sample size was relatively small (74 participants), and the '6 or more' group was not subdivided. ACL loading was estimated using OpenSim modeling, which is a simulation and not a direct measurement of tissue stress.

Declared interests

The authors declared no competing interests.

The easy way to misread this

Do not assume this applies to all patients with chronic ankle instability. The significant increase in ACL load was specifically observed in those with four or more sprains in the past year. Patients with fewer sprains did not show this same pattern of knee compensation. Also, this was a cross-sectional observation, so it does not prove that these movement patterns caused previous injuries.

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