Skip to main content
British Journal of Sports Medicine logoLink to British Journal of Sports Medicine
. 2003 Dec;37(6):495–497. doi: 10.1136/bjsm.37.6.495

Dynamic force distribution during level walking under the feet of patients with chronic ankle instability

M Nyska 1, S Shabat 1, A Simkin 1, M Neeb 1, Y Matan 1, G Mann 1
PMCID: PMC1724712  PMID: 14665586

Abstract

Objectives: To examine changes in the pattern of force transfer between the foot and the floor associated with chronically sprained ankles by measuring the peak forces and their timing under several regions of the feet during level walking.

Methods: Twelve young male subjects (mean (SD) age 21 (2) years) with recurrent ankle sprains were studied. Seven of them had unilateral and bilateral chronic instability and laxity, and five had bilateral instability. Twelve healthy men (without orthopaedic or medical disease) served as a control group. Subjects walked at their own pace along a 7 m walkway, which included a Mini-EMED pressure distribution measuring system. The variables measured were relative peak force (fraction of body weight) and relative timing (fraction of stance time). These variables were measured under six regions of interest in each foot print: heel, midfoot, medial, central, and lateral forefoot, and toes.

Results: (a) A significant delay to the time of peak force under the central and lateral forefoot and toes in subjects with chronic ankle instability. (b) A significant decrease in the relative forces under the heel and toes and an increase in the relative forces under the midfoot and lateral forefoot in subjects with chronic ankle instability. (c) In the patients with unilateral instability, there were no significant differences in any of the variables between the injured and non-injured foot.

Conclusions: In patients with chronic ankle instability, there is a slowing down of weight transfer from heel strike to toe off, a reduced impact at the beginning and end of the stance phase, and a lateral shift of body weight.

Full Text

The Full Text of this article is available as a PDF (197.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ashton-Miller J. A., Ottaviani R. A., Hutchinson C., Wojtys E. M. What best protects the inverted weightbearing ankle against further inversion? Evertor muscle strength compares favorably with shoe height, athletic tape, and three orthoses. Am J Sports Med. 1996 Nov-Dec;24(6):800–809. doi: 10.1177/036354659602400616. [DOI] [PubMed] [Google Scholar]
  2. BOSIEN W. R., STAPLES O. S., RUSSELL S. W. Residual disability following acute ankle sprains. J Bone Joint Surg Am. 1955 Dec;37-A(6):1237–1243. [PubMed] [Google Scholar]
  3. Becker H. P., Rosenbaum D., Claes L., Gerngross H. Dynamische Pedographie zur Abklärung der funktionellen Spranggelenkinstabilität. Unfallchirurg. 1997 Feb;100(2):133–139. doi: 10.1007/s001130050104. [DOI] [PubMed] [Google Scholar]
  4. Boruta P. M., Bishop J. O., Braly W. G., Tullos H. S. Acute lateral ankle ligament injuries: a literature review. Foot Ankle. 1990 Oct;11(2):107–113. doi: 10.1177/107110079001100210. [DOI] [PubMed] [Google Scholar]
  5. Clanton T. O. Instability of the subtalar joint. Orthop Clin North Am. 1989 Oct;20(4):583–592. [PubMed] [Google Scholar]
  6. Freeman M. A., Dean M. R., Hanham I. W. The etiology and prevention of functional instability of the foot. J Bone Joint Surg Br. 1965 Nov;47(4):678–685. [PubMed] [Google Scholar]
  7. Garrick J. G. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med. 1977 Nov-Dec;5(6):241–242. doi: 10.1177/036354657700500606. [DOI] [PubMed] [Google Scholar]
  8. Jackson D. W., Ashley R. L., Powell J. W. Ankle sprains in young athletes. Relation of severity and disability. Clin Orthop Relat Res. 1974 Jun;(101):201–215. [PubMed] [Google Scholar]
  9. Klenerman L. The management of sprained ankle. J Bone Joint Surg Br. 1998 Jan;80(1):11–12. doi: 10.1302/0301-620x.80b1.8037. [DOI] [PubMed] [Google Scholar]
  10. Konradsen L., Olesen S., Hansen H. M. Ankle sensorimotor control and eversion strength after acute ankle inversion injuries. Am J Sports Med. 1998 Jan-Feb;26(1):72–77. doi: 10.1177/03635465980260013001. [DOI] [PubMed] [Google Scholar]
  11. Louwerens J. W., van Linge B., de Klerk L. W., Mulder P. G., Snijders C. J. Peroneus longus and tibialis anterior muscle activity in the stance phase. A quantified electromyographic study of 10 controls and 25 patients with chronic ankle instability. Acta Orthop Scand. 1995 Dec;66(6):517–523. doi: 10.3109/17453679509002306. [DOI] [PubMed] [Google Scholar]
  12. Löfvenberg R., Kärrholm J., Sundelin G., Ahlgren O. Prolonged reaction time in patients with chronic lateral instability of the ankle. Am J Sports Med. 1995 Jul-Aug;23(4):414–417. doi: 10.1177/036354659502300407. [DOI] [PubMed] [Google Scholar]
  13. Milgrom C., Shlamkovitch N., Finestone A., Eldad A., Laor A., Danon Y. L., Lavie O., Wosk J., Simkin A. Risk factors for lateral ankle sprain: a prospective study among military recruits. Foot Ankle. 1991 Aug;12(1):26–30. doi: 10.1177/107110079101200105. [DOI] [PubMed] [Google Scholar]
  14. Nef W., Gerber N. J. Hypermotilitäts-Syndrom. Wenn zu viel Beweglichkeit Schmerzen auslöst. Schweiz Med Wochenschr. 1998 Feb 21;128(8):302–310. [PubMed] [Google Scholar]
  15. Nyska M., Amir H., Porath A., Dekel S. Radiological assessment of a modified anterior drawer test of the ankle. Foot Ankle. 1992 Sep;13(7):400–403. doi: 10.1177/107110079201300707. [DOI] [PubMed] [Google Scholar]
  16. Peters J. W., Trevino S. G., Renstrom P. A. Chronic lateral ankle instability. Foot Ankle. 1991 Dec;12(3):182–191. doi: 10.1177/107110079101200310. [DOI] [PubMed] [Google Scholar]
  17. Snyder R. B., Lipscomb A. B., Johnston R. K. The relationship of tarsal coalitions to ankle sprains in athletes. Am J Sports Med. 1981 Sep-Oct;9(5):313–317. doi: 10.1177/036354658100900505. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES