Kinematic analysis of a televised medial ankle sprain

Ankle sprains are one of the most prevalent athletic injuries. Prior work has investigated lateral ankle sprains, but research on generally more severe medial sprains is lacking. This case report performs a kinematic analysis using novel motion analysis methods on a non-contact medial ankle sprain. Peak eversion (50°) occurred 0.2 seconds following ground contact, maximum velocity of 426°/s, while peak dorsiflexion (64°) occurred with a greater maximum velocity (573°/s). The combination of dorsiflexion at ground contact and rapid eversion is associated with a non-contact eversion sprain. This study provides a quantitative analysis of the eversion ankle sprain injury mechanism

Kinematics analysis of ankle inversion ligamentous sprain injuries in sports: five cases from televised tennis competitions

Background: Ankle ligamentous sprain is common in sports. The most direct way to study the mechanism quantitatively is to study real injury cases; however, it is unethical and impractical to produce an injury in the laboratory. A recently developed, model-based image-matching motion analysis technique allows quantitative analysis of real injury incidents captured in televised events and gives important knowledge for the development of injury prevention protocols and equipment. To date, there have been only 4 reported cases, and there is a need to conduct more studies for a better understanding of the mechanism of ankle ligamentous sprain injury. Purpose: This study presents 5 cases in tennis and a comparison with 4 previous cases for a better understanding of the mechanism of ankle ligamentous sprain injury. Study Design: Case series; level of evidence, 4. Methods: Five sets of videos showing ankle sprain injuries in televised tennis competition with 2 camera views were collected. The videos were transformed, synchronized, and rendered to a 3-dimensional animation software. The dimensions of the tennis court in each case were obtained to build a virtual environment, and a skeleton model scaled to the injured athletes height was used for the skeleton matching. Foot strike was determined visually, and the profiles of the ankle joint kinematics were individually presented. Results: There was a pattern of sudden inversion and internal rotation at the ankle joint, with the peak values ranging from 48°- 126° and 35°-99°, respectively. In the sagittal plane, the ankle joint fluctuated between plantar flexion and dorsiflexion within the first 0.50 seconds after foot strike. The peak inversion velocity ranged from 509 to 1488 deg/sec. Conclusion: Internal rotation at the ankle joint could be one of the causes of ankle inversion sprain injury, with a slightly inverted ankle joint orientation at landing as the inciting event. To prevent the foot from rolling over the edge to cause a sprain injury, tennis players who do lots of sideward cutting motions should try to land with a neutral ankle orientation and keep the center of pressure from shifting laterally

Delayed ankle muscle reaction time in female amateur footballers after the first 15 minutes of a simulated prolonged football protocol

Purpose: Ankle sprain injury rate is reported to be higher towards the end of a football match. Muscle fatigue may contribute to the delayed muscle reaction and subsequent injury. This study investigated the ankle muscle reaction time during a simulated, prolonged football protocol.Methods: Seven amateur female football players participated in a 105-minute simulated, prolonged football protocol. An ankle muscle reaction test was conducted with a pair of ankle sprain simulators at a scheduled interval every 15-minutes. The reaction times of peroneus longus, tibialis anterior, and lateral gastrocnemius were collected using an electromyography system sampling at 1000 Hz. Repeated measures one-way multivariate analysis of variance with post-hoc paired t-tests were conducted to evaluate if the reaction time at each time point significantly differed from baseline. Statistical significance was set at p Results: Reaction times started from 40.5-47.7 ms at baseline and increased to 48.6-55.7 ms at the end. Reaction times significantly increased in all muscles after the first 15 minutes except for the dominant lateral gastrocnemius. Increased reaction times were seen in the non-dominant limb after 60 minutes for tibialis anterior, after 75 minutes for peroneus longus, and after 90 minutes for the lateral gastrocnemius. Conclusions: Delayed reaction time of the ankle muscles were found after the first 15 minutes and in the final 45 minutes of a simulated prolonged football protocol. Strategies for injury prevention should also focus on tackling the delayed ankle muscle reaction time in the acute phase (the first 15 minutes), in addition to the latter minutes in the second half.Level of evidence: Controlled laboratory study, Level V.</div

An inverted ankle joint orientation at foot strike could incite ankle inversion sprain: Comparison between injury and non-injured cutting motions of a tennis player

Ankle sprain is very common in sports. Research on its prevention is as important as on its treatment as recommended in the 2016 consensus statement of the International Ankle Consortium. Successful prevention depends on the understanding of its mechanism, which has been presented with quantities in some recent case reports. Inciting event was suggested to be an inverted ankle joint at foot strike, however, is still lacking evidence from comparison with non-injury trials. This study investigated the ankle joint orientation at foot strike in successful non-injury cases and compared them with a previously analysed ankle sprain injury case. Two injury-free cutting motions with similar movement approach to a previously analysed ankle sprain injury performed by the same athlete were collected from an online search and were trimmed from 0.05 second before until 0.30 second after the foot strike. The video sequences were then processed by video editing software and then analysed by a model-based image-matching motion analysis technique. Ankle joint orientation at foot strike and the profiles were presented in inversion, plantarflexion and rotation planes, for both the previously analysed injury case and the two non-injury cases. The ankle joint orientation at foot strike was 0-1 degree inverted and 10-21 degree dorsiflexed in the two non-injury cases, compared to 14-degree inverted and 16-degree plantarflexed in the previously analysed injury case. From the case comparison, it can be observed that an inverted ankle joint orientation at foot strike in an inciting event of ankle inversion sprain

A lateral ankle sprain during a lateral backward step in badminton: a case report of a televised injury incident

Background: This study presents a kinematic analysis of an acute lateral ankle sprain incurred during a televised badminton match. The kinematics of this injury were compared to those of 19 previously reported cases in the published literature.Methods: Four camera views of an acute lateral ankle sprain incurred during a televised badminton match were synchronised and rendered in 3-dimensional animation software. A badminton court with known dimensions was built in a virtual environment, and a skeletal model scaled to the injured athlete’s height was used for skeletal matching. The ankle joint angle and angular velocity profiles of this acute injury were compared to the summarised findings from 19 previously reported cases in the published literature.Results: At foot strike, the ankle joint was 2 degrees everted, 33 degrees plantarflexed, and 18 degrees internally rotated. Maximum inversion of 114 degrees and internal rotation of 69 degrees was achieved at 0.24 and 0.20 seconds after foot strike, respectively. After the foot strike, the ankle joint moved from an initial position of plantarflexion to dorsiflexion – from 33 degrees plantarflexion to 53 degrees dorsiflexion (range = 86 degrees). Maximum inversion, dorsiflexion, and internal rotation velocity were 1262, 961, and 677 degree/s at 0.12 second after foot strike.Conclusion: A forefoot landing posture with a plantarflexed and internally rotated ankle joint configuration could incite an acute lateral ankle sprain injury in badminton. Prevention of lateral ankle sprains in badminton should focus on the control and stability of the ankle joint angle during forefoot landings, especially when the athletes perform a combined lateral and backward step. </div

Knee wobbling during the single-leg-squat-and-hold test reflects dynamic knee instability in patients with anterior cruciate ligament injury

We propose using the single-leg squat-and-hold (SLSH) task with kinematic analysis to objectively measure dynamic knee stability after anterior cruciate ligament (ACL) injury. There are three objectives of this study: to compare the knee kinematics of ACL-deficient patients and healthy controls by capturing knee wobbling during the SLSH task, to detect kinematic changes after ACL reconstruction, and to correlate the kinematic variables with self-reported knee function. Twenty-five ACL-deficient participants and 18 healthy matched participants were recruited. The knee kinematics involving both the magnitudes and frequency of motion fluctuation was captured during SLSH by 3D motion analysis system (Vicon). Compared to the limbs of the control participants, the ACL involved limbs exhibited a greater range of flexion-extension (4.33±1.96 vs. 2.73±1.15; p=0.005) and varus-valgus (2.52±0.99 vs. 1.36±0.42; p<0.001). It also inhibited higher frequency of flexion-extension (4.87±2.55 vs. 2.68±1.23; p=0.003) and varus-valgus (3.83±2.59 vs. 1.42±0.55; p<0.001). The range of flexion-extension (4.50±2.24 vs. 2.90± 1.01; p=0.018), frequency of flexion-extension (4.58±2.53 vs. 3.05± 1.80; p=0.038) and varus-valgus (3.46±2.11 vs. 1.80± 1.23; p=0.022) was reduced after ACL reconstruction. Increased frequency of knee varus-valgus was correlated with lower IKDC score (r=-0.328; p=0.034). Knee wobbling was more prominent in ACL-deficient patients, which was associated with poor knee function. SLSH task with kinematic analysis appears to be a potential assessment method for monitoring dynamic knee stability after ACL injury.</p

Supplementary information files for What have we learnt from quantitative case reports of acute lateral ankle sprains injuries and episodes of ‘giving-way’ of the ankle joint, and what shall we further investigate?

Supplementary information files for article What have we learnt from quantitative case reports of acute lateral ankle sprains injuries and episodes of ‘giving-way’ of the ankle joint, and what shall we further investigate? Lateral ankle sprains are a commonly incurred injury in sports. They have a high recurrence rate and can lead to the development of persistent injury associated symptoms. We performed a quantitative synthesis of published case reports documenting the kinematics of acute lateral ankle sprains and episodes of “giving-way” of the ankle joint to provide a comprehensive description of the mechanisms. A systematic literature search was conducted to screen records within MEDLINE® and EMBASE® . Additional strategies included manual search of specific journals as well as contacting researchers in relevant communities to retrieve unpublished data. Twenty-four cases were included in the quantitative synthesis; 11 from individual case reports and 13 from four separate case series. Two authors independently reviewed all articles and extracted ankle joint kinematic data. Excessive ankle inversion was the most pronounced kinematic pattern observed across all included cases, with a mean peak inversion angle of 67.5° (range 2.0 to 142) and a mean peak inversion velocity of 974°/s (range 468 to 1752). This was followed by internal rotation and plantar flexion, respectively. A homogeneous linear function revealed a mean inversion velocity across all cases of 337°/s (range 117 to 1400; R2 =0.78; p<0.0001). </p

What have we learnt from quantitative case reports of acute lateral ankle sprains injuries and episodes of ‘giving-way’ of the ankle joint, and what shall we further investigate?

Lateral ankle sprains are a commonly incurred injury in sports. They have a high recurrence rate and can lead to the development of persistent injury associated symptoms. We performed a quantitative synthesis of published case reports documenting the kinematics of acute lateral ankle sprains and episodes of “giving-way” of the ankle joint to provide a comprehensive description of the mechanisms. A systematic literature search was conducted to screen records within MEDLINE® and EMBASE® . Additional strategies included manual search of specific journals as well as contacting researchers in relevant communities to retrieve unpublished data. Twenty-four cases were included in the quantitative synthesis; 11 from individual case reports and 13 from four separate case series. Two authors independently reviewed all articles and extracted ankle joint kinematic data. Excessive ankle inversion was the most pronounced kinematic pattern observed across all included cases, with a mean peak inversion angle of 67.5° (range 2.0 to 142) and a mean peak inversion velocity of 974°/s (range 468 to 1752). This was followed by internal rotation and plantar flexion, respectively. A homogeneous linear function revealed a mean inversion velocity across all cases of 337°/s (range 117 to 1400; R2 = 0.78; p < 0.0001).</p