{"id":1884,"date":"2016-02-21T13:02:25","date_gmt":"2016-02-21T13:02:25","guid":{"rendered":"https:\/\/andreasphysioblog.com\/?p=1884"},"modified":"2021-05-24T04:55:11","modified_gmt":"2021-05-24T04:55:11","slug":"what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues-2","status":"publish","type":"post","link":"https:\/\/andreasphysioblog.com\/?p=1884","title":{"rendered":"What happens when you sprain your ankle \u2013 three studies from Dr. Gehring and colleagues"},"content":{"rendered":"<header class=\"entry-header\">\n<h1 class=\"entry-title\">What happens when you sprain your ankle \u2013 three studies from Dr. Gehring and\u00a0colleagues<\/h1>\n<\/header>\n<div class=\"entry-body\">\n<div class=\"entry-content\">\n<p><strong><em><img fetchpriority=\"high\" decoding=\"async\" class=\" wp-image-6722 alignright\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-28-42.png?w=274&amp;h=183\" sizes=\"(max-width: 274px) 100vw, 274px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-28-42.png?w=274&amp;h=183 274w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-28-42.png?w=548&amp;h=366 548w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-28-42.png?w=150&amp;h=100 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-28-42.png?w=300&amp;h=200 300w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.28.42\" width=\"274\" height=\"183\" data-attachment-id=\"6722\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-28-42\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-28-42.png\" data-orig-size=\"1436,958\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.28.42\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-28-42.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-28-42.png?w=825\" \/><\/em><\/strong>Despite massive research efforts, it remains unclear how mechanical ankle instability (MAI) and functional ankle instability (FAI) affect joint control in the situation of ankle sprain.<\/p>\n<h2>Video of an acute ankle sprain \u2013\u00a0Djokovic<\/h2>\n<div class=\"jetpack-video-wrapper\"><span class=\"embed-youtube\"><iframe class=\"youtube-player\" src=\"https:\/\/www.youtube.com\/embed\/FQamEj7Jwu4?version=3&amp;rel=1&amp;showsearch=0&amp;showinfo=1&amp;iv_load_policy=1&amp;fs=1&amp;hl=en&amp;autohide=2&amp;wmode=transparent\" sandbox=\"allow-scripts allow-same-origin allow-popups allow-presentation\" allowfullscreen=\"allowfullscreen\" data-ratio=\"0.5636363636363636\" data-width=\"825\" data-height=\"465\" data-mce-fragment=\"1\"><\/iframe><\/span><\/div>\n<div class=\"title\"><\/div>\n<figure id=\"attachment_6730\" class=\"wp-caption alignnone\" data-shortcode=\"caption\" aria-describedby=\"caption-attachment-6730\"><a href=\"http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0021929012005611\"><img decoding=\"async\" class=\"alignnone size-full wp-image-6730\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png?w=825\" sizes=\"(max-width: 825px) 100vw, 825px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png?w=825 825w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png?w=150 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png?w=300 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png?w=768 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png?w=1024 1024w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png 1108w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.34.22\" data-attachment-id=\"6730\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-34-22\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png\" data-orig-size=\"1108,166\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.34.22\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-34-22.png?w=825\" \/><\/a><figcaption id=\"caption-attachment-6730\" class=\"wp-caption-text\">Journal of Biomechanics Volume 46, Issue 1, 4 januar 2014, page 175-178<\/figcaption><\/figure>\n<p>This\u00a0case report from D. Gehring et al., describ when one athlete sprained his ankle while performing 3 different run-and-cut movement (45 degree turn, 180 degree turn and a -20 degrees turn).<img decoding=\"async\" class=\" wp-image-6723 aligncenter\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-30-22.png?w=372&amp;h=257\" sizes=\"(max-width: 372px) 100vw, 372px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-30-22.png?w=744&amp;h=511 744w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-30-22.png?w=150&amp;h=103 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-30-22.png?w=300&amp;h=206 300w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.30.22\" width=\"372\" height=\"257\" data-attachment-id=\"6723\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-30-22\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-30-22.png\" data-orig-size=\"1424,978\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.30.22\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-30-22.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-30-22.png?w=825\" \/><br \/>\nA 3D kinematics, and muscle activity of the lower limb were recorded and compared to 16 previously performed trials.<\/p>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\" size-medium wp-image-6721 alignright\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-29-28.png?w=291&amp;h=300\" sizes=\"(max-width: 291px) 100vw, 291px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-29-28.png?w=291&amp;h=300 291w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-29-28.png?w=146&amp;h=150 146w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-29-28.png 474w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.29.28\" width=\"291\" height=\"300\" data-attachment-id=\"6721\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-29-28\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-29-28.png\" data-orig-size=\"474,488\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.29.28\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-29-28.png?w=291\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-29-28.png?w=474\" \/>Motion patterns of global pelvis orientation, hip flexion, and knee flexion in the sprain trail deviated from the reference trials already early in the preparatory phase before ground contact.<\/p>\n<p>During ground contact, the ankle was rapidly plantar flexed (up to 1240\u00b0\/s), inverted (up to 1290\u00b0\/s) and internally rotated (up to 580\u00b0\/s) reaching its maximum displacement within the first 150\u00a0ms after heel strike.<\/p>\n<p>Rapid neuromuscular activation bursts of the m. tibialis anterior and the m. peroneus longus started 40\u201345\u00a0ms after ground contact and overshot the activation profile of the reference trials with peak activation at 62\u00a0ms and 74\u00a0ms respectively.<\/p>\n<p>Therefore, it may be suggested that neuromuscular reflexes played an important role in joint control during the critical phase of excessive ankle displacement.<\/p>\n<p><a href=\"http:\/\/bjsm.bmj.com\/content\/48\/5\/377.abstract\"><img decoding=\"async\" class=\"alignnone size-full wp-image-6770\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png?w=825\" sizes=\"(max-width: 825px) 100vw, 825px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png?w=825 825w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png?w=150 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png?w=300 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png?w=768 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png?w=1024 1024w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png 1092w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.54.03\" data-attachment-id=\"6770\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-54-03\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png\" data-orig-size=\"1092,356\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.54.03\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-54-03.png?w=825\" \/><\/a><\/p>\n<p>The purpose of this study was to evaluate whether individuals with MAI have deficits in stabilising their ankle joint in a close-to-injury situation compared with those with FAI and healthy controls.<\/p>\n<div id=\"sec-2\" class=\"subsection\">\n<p id=\"p-2\"><strong>Methods<\/strong><br \/>\nAnkle-joint control was assessed by means of three-dimensional motion analysis and electromyography in participants with FAI and MAI (n=19), in participants with pure FAI (n=9) and in healthy controls (n=18). Close-to-injury situations were simulated during standing, walking and jumping by means of a custom-made tilt platform.<\/p>\n<p><img decoding=\"async\" class=\"aligncenter size-large wp-image-6781\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png?w=825&amp;h=618\" sizes=\"(max-width: 825px) 100vw, 825px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png?w=825&amp;h=618 825w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png?w=150&amp;h=112 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png?w=300&amp;h=225 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png?w=768&amp;h=575 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png?w=1024&amp;h=767 1024w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png 1392w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.59.06\" data-attachment-id=\"6781\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-59-06\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png\" data-orig-size=\"1392,1042\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.59.06\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-59-06.png?w=825\" \/><\/p>\n<p><strong>Results<\/strong><\/p>\n<div class=\"page\" title=\"Page 16\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p><em>with MAI:<\/em><br \/>\n<em>\u2013 increased ankle inversion in the injury mechanism <\/em><br \/>\n<em>\u2013 increased risk for subsequent ankle sprains<\/em><br \/>\n<em>\u2013 specific countermeasures are needed<\/em><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>Individuals with FAI and MAI displayed significantly greater maximum ankle inversion angles (+5\u00b0) and inversion velocities (+50\u00b0\/s) in the walking and jumping conditions compared to those with pure FAI and controls. Furthermore, individuals in the FAI and MAI group showed a significantly decreased pre-activation of the peroneus longus muscle during jumping compared to those with FAI. No differences between groups were found for plantar flexion and internal rotation, or for muscle activities following tilting of the platform.<\/p>\n<p><img decoding=\"async\" class=\"alignnone size-full wp-image-6785\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-01-10.png?w=825\" sizes=\"(max-width: 714px) 100vw, 714px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-01-10.png 714w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-01-10.png?w=150 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-01-10.png?w=300 300w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 18.01.10\" data-attachment-id=\"6785\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-18-01-10\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-01-10.png\" data-orig-size=\"714,690\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 18.01.10\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-01-10.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-01-10.png?w=714\" \/><\/p>\n<\/div>\n<div id=\"sec-3\" class=\"subsection\">\n<p id=\"p-3\"><strong>\u00a0<\/strong><\/p>\n<\/div>\n<div id=\"sec-4\" class=\"subsection\">\n<p id=\"p-4\"><strong>Conclusions<\/strong> The present study demonstrates that MAI is characterised by impairments of ankle-joint control in close-to-injury situations. This could make these individuals more prone to recurrent ankle sprains, and suggests the need for additional mechanical support such as braces or even surgery. In addition, the study highlights the fact that dynamic experimental test conditions in the acting participant are needed to further unravel the mystery of chronic ankle instability.<\/p>\n<p><a href=\"http:\/\/www.gaitposture.com\/article\/S0966-6362(13)00688-7\/pdf\"><img decoding=\"async\" class=\"alignnone size-full wp-image-6792\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png?w=825\" sizes=\"(max-width: 825px) 100vw, 825px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png?w=825 825w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png?w=150 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png?w=300 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png?w=768 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png?w=1024 1024w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png 1272w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 18.04.11\" data-attachment-id=\"6792\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-18-04-11\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png\" data-orig-size=\"1272,288\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 18.04.11\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-18-04-11.png?w=825\" \/><\/a><\/p>\n<div class=\"page\" title=\"Page 19\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<h2 class=\"sectionTitle\">Abstract<\/h2>\n<p>It is of special interest to understand how neuromuscular control mechanisms and mechanical constraints stabilize the ankle joint. Therefore, the aim of the present study was to determine how expecting ankle tilts and the application of an ankle brace influence ankle joint control when imitating the ankle sprain mechanism during walking.<\/p>\n<p>Ankle kinematics and muscle activity were assessed in 17 healthy men. During gait rapid perturbations were applied using a trapdoor (tilting with 24\u00b0 inversion and 15\u00b0 plantarflexion). The subjects either knew that a perturbation would definitely occur (expected tilts) or there was only the possibility that a perturbation would occur (potential tilts). Both conditions were conducted with and without a semi-rigid ankle brace.<img decoding=\"async\" class=\"aligncenter size-large wp-image-6719\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=825&amp;h=543\" sizes=\"(max-width: 825px) 100vw, 825px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=825&amp;h=543 825w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=1650&amp;h=1086 1650w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=150&amp;h=99 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=300&amp;h=197 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=768&amp;h=505 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=1024&amp;h=674 1024w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.27.48\" data-attachment-id=\"6719\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-27-48\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png\" data-orig-size=\"1866,1228\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.27.48\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-27-48.png?w=825\" \/><\/p>\n<p>Expecting perturbations led to an increased ankle eversion at foot contact, which was mediated by an altered muscle preactivation pattern. Moreover, the maximal inversion angle (\u22127%) and velocity (\u22124%), as well as the reactive muscle response were significantly reduced when the perturbation was expected. While wearing an ankle brace did not influence muscle preactivation nor the ankle kinematics before ground contact, it significantly reduced the maximal ankle inversion angle (\u221214%) and velocity (\u221211%) as well as reactive neuromuscular responses.<img decoding=\"async\" class=\"aligncenter size-full wp-image-6711\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-57.png?w=825\" sizes=\"(max-width: 786px) 100vw, 786px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-57.png 786w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-57.png?w=150 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-57.png?w=298 298w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-57.png?w=768 768w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.23.57\" data-attachment-id=\"6711\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-23-57\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-57.png\" data-orig-size=\"786,790\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.23.57\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-57.png?w=298\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-57.png?w=786\" \/><\/p>\n<p>The present findings reveal that expecting ankle inversion modifies neuromuscular joint control prior to landing.<\/p>\n<p>Although such motor control strategies are weaker in their magnitude compared with braces, they seem to assist ankle joint stabilization in a close-to-injury situation.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>Brace application &amp; knowledge about upcoming ankle tilts can assist in reduction in injury-related ankle inversion.<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"aligncenter size-large wp-image-6712\" src=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=825&amp;h=606\" sizes=\"(max-width: 825px) 100vw, 825px\" srcset=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=825&amp;h=606 825w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=1650&amp;h=1212 1650w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=150&amp;h=110 150w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=300&amp;h=220 300w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=768&amp;h=564 768w, https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=1024&amp;h=752 1024w\" alt=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.23.45\" data-attachment-id=\"6712\" data-permalink=\"https:\/\/physioblogandreasbjerregaard.com\/2016\/02\/21\/what-happens-when-you-sprain-your-ankle-three-studies-from-dr-gehring-and-colleagues\/skaermbillede-2016-02-21-kl-17-23-45\/\" data-orig-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png\" data-orig-size=\"1692,1242\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Sk\u00e6rmbillede 2016-02-21 kl. 17.23.45\" data-image-description=\"\" data-medium-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=300\" data-large-file=\"https:\/\/andreasbjerregaard.files.wordpress.com\/2016\/02\/skc3a6rmbillede-2016-02-21-kl-17-23-45.png?w=825\" \/><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>What happens when you sprain your ankle \u2013 three studies from Dr. Gehring and\u00a0colleagues Despite massive research efforts, it remains unclear how mechanical ankle instability (MAI) and functional ankle instability (FAI) affect joint control in the situation of ankle sprain. Video of an acute ankle sprain \u2013\u00a0Djokovic Journal of Biomechanics Volume 46, Issue 1, 4 januar 2014, page 175-178 This\u00a0case report from D. Gehring et al., describ when one athlete sprained his ankle while performing 3 different run-and-cut movement (45 degree turn, 180 degree turn and a -20 degrees turn). A 3D kinematics, and muscle activity of the lower limb were recorded and compared to 16 previously performed trials. &nbsp; Motion patterns of global pelvis orientation, hip flexion, and knee flexion in the sprain trail deviated from the reference trials already early in the preparatory phase before ground contact. During ground contact, the ankle was rapidly plantar flexed (up to 1240\u00b0\/s), inverted (up to 1290\u00b0\/s) and internally rotated (up to 580\u00b0\/s) reaching its maximum displacement within the first 150\u00a0ms after heel strike. Rapid neuromuscular activation bursts of the m. tibialis anterior and the m. peroneus longus started 40\u201345\u00a0ms after ground contact and overshot the activation profile of the reference trials with peak activation at 62\u00a0ms and 74\u00a0ms respectively. Therefore, it may be suggested that neuromuscular reflexes played an important role in joint control during the critical phase of excessive ankle displacement. The purpose of this study was to evaluate whether individuals with MAI have deficits in stabilising their ankle joint in a close-to-injury situation compared with those with FAI and healthy controls. Methods Ankle-joint control was assessed by means of three-dimensional motion analysis and electromyography in participants with FAI and MAI (n=19), in participants with pure FAI (n=9) and in healthy controls (n=18). Close-to-injury situations were simulated during standing, walking and jumping by means of a custom-made tilt platform. Results with MAI: \u2013 increased ankle inversion in the injury mechanism \u2013 increased risk for subsequent ankle sprains \u2013 specific countermeasures are needed Individuals with FAI and MAI displayed significantly greater maximum ankle inversion angles (+5\u00b0) and inversion velocities (+50\u00b0\/s) in the walking and jumping conditions compared to those with pure FAI and controls. Furthermore, individuals in the FAI and MAI group showed a significantly decreased pre-activation of the peroneus longus muscle during jumping compared to those with FAI. No differences between groups were found for plantar flexion and internal rotation, or for muscle activities following tilting of the platform. \u00a0 Conclusions The present study demonstrates that MAI is characterised by impairments of ankle-joint control in close-to-injury situations. This could make these individuals more prone to recurrent ankle sprains, and suggests the need for additional mechanical support such as braces or even surgery. In addition, the study highlights the fact that dynamic experimental test conditions in the acting participant are needed to further unravel the mystery of chronic ankle instability. Abstract It is of special interest to understand how neuromuscular control mechanisms and mechanical constraints stabilize the ankle joint. Therefore, the aim of the present study was to determine how expecting ankle tilts and the application of an ankle brace influence ankle joint control when imitating the ankle sprain mechanism during walking. Ankle kinematics and muscle activity were assessed in 17 healthy men. During gait rapid perturbations were applied using a trapdoor (tilting with 24\u00b0 inversion and 15\u00b0 plantarflexion). The subjects either knew that a perturbation would definitely occur (expected tilts) or there was only the possibility that a perturbation would occur (potential tilts). Both conditions were conducted with and without a semi-rigid ankle brace. Expecting perturbations led to an increased ankle eversion at foot contact, which was mediated by an altered muscle preactivation pattern. Moreover, the maximal inversion angle (\u22127%) and velocity (\u22124%), as well as the reactive muscle response were significantly reduced when the perturbation was expected. While wearing an ankle brace did not influence muscle preactivation nor the ankle kinematics before ground contact, it significantly reduced the maximal ankle inversion angle (\u221214%) and velocity (\u221211%) as well as reactive neuromuscular responses. The present findings reveal that expecting ankle inversion modifies neuromuscular joint control prior to landing. Although such motor control strategies are weaker in their magnitude compared with braces, they seem to assist ankle joint stabilization in a close-to-injury situation. Brace application &amp; knowledge about upcoming ankle tilts can assist in reduction in injury-related ankle inversion. &nbsp; &nbsp;<\/p>\n","protected":false},"author":1,"featured_media":1886,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"postBodyCss":"","postBodyMargin":[],"postBodyPadding":[],"postBodyBackground":{"backgroundType":"classic","gradient":""},"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[227,2,190],"tags":[17],"class_list":["post-1884","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ankel-sprains","category-ankle-injuries","category-publications","tag-ankle"],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":7}},"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.1.1 - aioseo.com -->\n\t<meta name=\"description\" content=\"What happens when you sprain your ankle \u2013 three studies from Dr. Gehring and colleagues Despite massive research efforts, it remains unclear how mechanical ankle instability (MAI) and functional ankle instability (FAI) affect joint control in the situation of ankle sprain. 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Bjerregaard","author_link":"https:\/\/andreasphysioblog.com\/?author=1"},"rttpg_comment":0,"rttpg_category":"<a href=\"https:\/\/andreasphysioblog.com\/?cat=227\" rel=\"category\">ankel sprains<\/a> <a href=\"https:\/\/andreasphysioblog.com\/?cat=2\" rel=\"category\">Ankle injuries<\/a> <a href=\"https:\/\/andreasphysioblog.com\/?cat=190\" rel=\"category\">Publications<\/a>","rttpg_excerpt":"What happens when you sprain your ankle \u2013 three studies from Dr. Gehring and\u00a0colleagues Despite massive research efforts, it remains unclear how mechanical ankle instability (MAI) and functional ankle instability (FAI) affect joint control in the situation of ankle sprain. Video of an acute ankle sprain \u2013\u00a0Djokovic Journal of Biomechanics Volume 46, Issue 1, 4&hellip;","_links":{"self":[{"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/posts\/1884","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1884"}],"version-history":[{"count":3,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/posts\/1884\/revisions"}],"predecessor-version":[{"id":1950,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/posts\/1884\/revisions\/1950"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=\/wp\/v2\/media\/1886"}],"wp:attachment":[{"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1884"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1884"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/andreasphysioblog.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1884"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}