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Effect of Peripheral Afferent Alteration of the Lateral Ankle Ligaments on Dynamic Stability

Joseph B. Myers, PhD, ATC^,, Bryan L. Riemann, PhD, ATC, Ji-Hye Hwang, MD, PhD^||, Freddie H. Fu, MD and Scott M. Lephart, PhD, ATC

Neuromuscular Research Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
Graduate Athletic Training Program, Georgia Southern University, Statesboro, Georgia
^|| Department of Physical Medicine and Rehabilitation, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea

Presented at the interim meeting of the AOSSM, Dallas, Texas, February 2002.

Address correspondence and reprint requests to Joseph B. Myers, PhD, ATC, Neuromuscular Research Laboratory, UPMC Center for Sports Medicine, 3200 South Water Street, Pittsburgh, PA 15213

Background: The sensorimotor influence of the lateral ankle ligaments in muscle activation is unclear.

Hypothesis: The lateral ankle ligaments have significant sensorimotor influence on muscle activation.

Study Design: Controlled laboratory study.

Methods: Muscle-firing characteristics in response to a high-speed inversion perturbation and during gait were assessed in 13 normal subjects. Solutions (1.5% lidocaine or a placebo of saline) were injected bilaterally into the anterior talofibular and calcaneofibular ligaments (1.5 ml per ligament) to alter peripheral afferent influence. Subjects were again tested with the same protocol.

Results: The protective response of the anterior tibialis and peroneal muscles during inversion perturbation and mean muscle activation amplitude decreased during running after both injections. After injection, no significant differences were seen for muscle reflex latencies, maximum amplitude, time to maximum amplitude during inversion perturbation, or mean amplitude during walking.

Conclusion: The lateral ankle ligaments have a sensorimotor influence on muscle activation.

Clinical Relevance: Induced edema from the injected solutions may have altered the sensorimotor influence of the lateral ankle ligaments, thereby inhibiting the dynamic ankle stabilizers. This finding suggests that dynamic stability may be compromised because of swelling after joint injury.

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