Understanding and treating lateral ankle sprains and their consequences: a constraints-based approach

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanics

Background:

• Lateral ankle sprains are common injuries with significant long-term consequences.
• Inadequate management can lead to chronic ankle instability (CAI) and post-traumatic osteoarthritis (OA).
• Current treatment paradigms have limited efficacy in preventing this continuum of disability.

Purpose of the Study:

• To review the consequences of lateral ankle sprains, CAI, and ankle OA.
• To introduce the patient-, clinician-, and laboratory- (PCL)-oriented model for understanding injury.
• To present dynamic systems theory as a framework for post-injury adaptations.

Main Methods:

• Review of literature on consequences of ankle sprains.
• Introduction of the PCL-oriented model.
• Application of dynamic systems theory to ankle injury.

Main Results:

• Ankle sprains cause structural and sensorimotor impairments, quantified by PCL outcomes.
• Dynamic systems theory explains how injury-related constraints lead to disability.
• Effective management requires immediate ligament protection and goal-oriented rehabilitation.

Conclusions:

• Ankle sprains are complex pathologies with far-reaching sensorimotor consequences.
• The PCL-oriented model and dynamic systems theory offer a comprehensive understanding.
• Shifting to goal-oriented rehabilitation is crucial for preventing chronic ankle issues.