Associations between ankle strength and physical performance in healthy individuals: a systematic review

This systematic review aimed to assess the association between ankle muscle (i.e., plantarflexor, dorsiflexor, invertor and evertor muscles) strength and measures of physical performance in healthy individuals.

A systematic search was conducted across three electronic databases (PubMed, Scopus, and Web of Science) up to 30th April 2025. Studies investigating the relationship between ankle strength and physical performance outcomes were included. Study eligibility was determined using the PECOS framework and methodological quality was assessed using a modified Downs and Black checklist.

Thirty-four studies with a total of 2,275 participants met the eligibility criteria. 11 studies examined the relationship between ankle strength and static balance, 5 studies focused on dynamic balance, 8 on jump performance, 6 on sprint performance, and 4 on reactive strength index (RSI). Additionally, individual studies explored associations with deceleration, reaction time, muscular endurance, and change of direction speed. Statistically significant associations indicated that ankle plantarflexor and dorsiflexor strength showed positive associations with jump height (r = 0.32-0.85), sprint speed (r = 0.36 - 0.86), and RSI (r = 0.35-0.526), and significant negative correlations with static (r = -0.28 to -0.925) and dynamic balance measures (r = -0.24 to -0.91). The strength of associations ranged from small to very strong (r = 0.32-0.95).

Ankle muscle strength is significantly associated with a wide range of physical performance outcomes in healthy individuals. These findings suggest that ankle muscle strength may be an important characteristic to consider in physical training programs.