Chronic ankle instability: overlooking a key player
Labor Day + social distancing = some form of outdoorsy event. And with more physical activity on uneven terrain, ankle sprains and instability have become another 2020 topic of interest. While ankle inversion sprains are so common that people have generally used the RICE protocol to self-treat (rest, ice, compress, elevate), it’s important to note that about 70% of people who sustain an ankle sprain will most likely have recurrent sprains, which can turn into the condition known as chronic ankle instability (CAI). While several factors can contribute to such a long-term condition, including changes in proprioception, loss of ligamentous integrity and balance deficits, the peroneal muscle and its role in ankle stability is the point of interest in this week’s powwow.
The study:
A recent systematic review with meta-analysis used an electronic search in PubMed Central and EBSCOhost to make correlations between ankle sprains and decrease in peroneal reaction time (PRT). Studies were included if three criteria were met: 1.) they measured PRT in subjects with ankle sprains using a mechanical platform; 2.) they were compared with a control group or with an uninvolved contralateral limb, and 3.) effect size calculations were provided.
The results:
All involved limbs versus both uninvolved side and control group showed a moderate-to-large PRT deficit (effect size = 0.67, p<0.0001, indicating significant difference in results between PRT of involved side versus uninvolved side or control group with low likelihood that results are muddled by chance). The greatest delay in PRT were seen amongst subjects with chronic ankle instability.
What it means:
If you had an ankle sprain in the past, chances are likely that your peroneal muscle, a key player that counters inversion sprains, may have a delayed reaction time when put to the test. Therefore, if you’re wondering why you keep rolling your ankle, it might be a good idea to do some reactive training for your peroneals.
The vid below shows examples of stability and reactive training to make sure ankle sprains stay a thing of the past.
REFERENCES:
Hoch MC, McKeon PO. Peroneal reaction time after ankle sprain: a systematic review and meta-analysis. Med Sci Sports Exerc. 2014 Mar;46(3):546-56. doi: 10.1249/MSS.0b013e3182a6a93b.