Hip Kinematics During a Stop-Jump Task in Patients with Chronic Ankle Instability

Brown CN, Guskiewicz KM, Marhsall SW, Padua DA. J of Athl Training. 2011 September; 46(5): 461-471.

Lateral ankle sprains are common injuries sustained by both recreational and competitive athletes. After sustaining a lateral ankle sprain, individuals are at an increased risk of developing chronic ankle instability (CAI; subjective repeated episodes of giving away). Both mechanical ankle instability (MAI; ligament laxity) and functional ankle instability (FAI; proprioceptive deficits) are potential factors in the development of CAI. The authors report that there are a number of conflicting reports regarding kinematics differences in patients with and without CAI (“copers” = those with a history of a moderate to severe ankle sprain but no self-reported episodes of giving way in the past year). Therefore, Brown and colleagues completed a cross-sectional study to determine whether people with MAI or FAI exhibited different hip biomechanics during a stop-jump task compared with “copers”. A total of 63 recreational athletes (1.5 hrs/week) were divided into 3 groups (MAI, FAI, copers; 11 males, 10 females per group). Subjects reported a history of acute ankle sprains within the past 5 years. All subjects were evaluated through an orthopedic examination (performed by an experienced athletic trainer) and completed self-reported questionnaires (demographic, ankle injury history, Foot and Ankle Disability Index, and Foot and Ankle Disability Index Sport Subscale). All volunteers then performed a jump-stop task “similar to motions used in basketball and soccer.” Kinematics were measured using an electromagnetic tracking device and piezoelectric nonconductive force plate. Each subject was allowed to practice the maneuver 3 times, followed by 8 successful trials with 30 seconds of rest between each trial. For each trial, the subject “took a 3- or 4-step approach run at 2.5 to 3.5 m/s, took off on 1 foot, landed with both feet at the same time (test foot on the force plate and the other foot off the force plate), and then performed a maximal vertical jump and landed in approximately the same position.” Measured variables included hip flexion, abduction, and rotation at initial contact, at maximum ground reaction force, and displacement (total range of motion from minimum to maximum joint angle). Results revealed that the MAI group displayed greater hip flexion displacement than both “copers” and the FAI group. Although, these variations between groups were observed no differences existed with respect to hip abduction variable or any ground reaction force variables.

This study presents an interesting look at a need for clinicians to assess landing strategies in patients with CAI to ensure no compensations are occurring. The authors also call on clinicians to address issues of hip range of motion and strength during ankle rehabilitation. The results of this study serve as a good reminder that after injury, changes in the kinetic chain may exist.. If these kinematic changes in landing remain, it is reasonable to think that this could increase the risk of the athlete experiencing another injury in the kinetic chain, as we understand that landing kinematics are crucial to the proper absorption of shock through the kinetic chain. Have you seen athletes with CAI sustain other injuries after returning to play? Do you perform whole kinetic chain evaluations of your athletes in conjunction with ankle rehabilitation?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

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Brown CN, Guskiewicz KM, Marhsall SW, & Padua DA (2011). Hip Kinematics During a Stop-Jump Task in Patients with Chronic Ankle Instability Journal of Athletic Training, 46 (5), 461-471.