Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 24, Issue 4, pp 1049–1059 | Cite as

Single-leg drop landing movement strategies in participants with chronic ankle instability compared with lateral ankle sprain ‘copers’

  • Cailbhe DohertyEmail author
  • Chris Bleakley
  • Jay Hertel
  • Brian Caulfield
  • John Ryan
  • Eamonn Delahunt



To compare the movement patterns and underlying energetics of individuals with chronic ankle instability (CAI) to ankle sprain ‘copers’ during a landing task.


Twenty-eight (age 23.2 ± 4.9 years; body mass 75.5 ± 13.9 kg; height 1.7 ± 0.1 m) participants with CAI and 42 (age 22.7 ± 1.7 years; body mass 73.4 ± 11.3 kg; height 1.7 ± 0.1 m) ankle sprain ‘copers’ were evaluated 1 year after incurring a first-time lateral ankle sprain injury. Kinematics and kinetics of the hip, knee and ankle joints from 200 ms pre-initial contact (IC) to 200 ms post-IC, in addition to the vertical component of the landing ground reaction force, were acquired during performance of a drop land task.


The CAI group adopted a position of increased hip flexion during the landing descent on their involved limb. This coincided with a reduced post-IC flexor pattern at the hip and increased overall hip joint stiffness compared to copers (−0.01 ± 0.05 vs 0.02 ± 0.05°/Nm kg−1, p = 0.03).


Individuals with CAI display alterations in hip joint kinematics and energetics during a unipodal landing task compared to LAS ‘copers’. These alterations may be responsible for the increased risk of injury experienced by individuals with CAI during landing manoeuvres. Thus, clinicians must recognise the potential for joints proximal to the affected ankle to contribute to impaired function following an acute lateral ankle sprain injury and to develop rehabilitation protocols accordingly.

Level of evidence

Level III.


Ankle joint Biomechanics Kinematics Kinetics Task performance and analysis Joint instability 



This study was supported by the Health Research Board (HRA_POR/2011/46). There were no conflicts of interest to report.


  1. 1.
    Anandacoomarasamy A, Barnsley L (2005) Long term outcomes of inversion ankle injuries. Br J Sports Med 39:e14 (discussion e14) CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Attenborough A, Hiller C, Smith R, Stuelcken M, Greene A, Sinclair P (2014) Chronic ankle instability in sporting populations. Sports Med 44:1545–1556CrossRefPubMedGoogle Scholar
  3. 3.
    Brown C, Padua C, Marshall D, Guskiewicz K (2008) Individuals with mechanical ankle instability exhibit different motion patterns than those with functional ankle instability and ankle sprain copers. Clin Biomech 23:822–831CrossRefGoogle Scholar
  4. 4.
    Brown CN, Padua DA, Marshall SW, Guskiewicz KM (2011) Hip kinematics during a stop-jump task in patients with chronic ankle instability. J Athl Train 46:461–467PubMedPubMedCentralGoogle Scholar
  5. 5.
    Brown CN, Padua DA, Marshall SW, Guskiewicz KM (2009) Variability of motion in individuals with mechanical or functional ankle instability during a stop jump maneuver. Clin Biomech 24:762–768CrossRefGoogle Scholar
  6. 6.
    Bullock-Saxton JE (1994) Local sensation changes and altered hip muscle function following severe ankle sprain. Phys Ther 74:17–28PubMedGoogle Scholar
  7. 7.
    Carcia C, Martin R, Drouin J (2008) Validity of the Foot and Ankle Ability Measure in athletes with chronic ankle instability. J Athl Train 43:179–183CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Caulfield B, Garrett M (2002) Functional instability of the ankle: differences in patterns of ankle and knee movement prior to and post landing in a single leg jump. Int J Sports Med 23:64–68CrossRefPubMedGoogle Scholar
  9. 9.
    Delahunt E, Monaghan K, Caulfield B (2006) Changes in lower limb kinematics, kinetics, and muscle activity in subjects with functional instability of the ankle joint during a single leg drop jump. J Orthop Res 24:1991–2000CrossRefPubMedGoogle Scholar
  10. 10.
    DeVita P, Skelly W (1992) Effect of landing stiffness on joint kinetics and energetics in the lower extremity. Med Sci Sports Exerc 24:108–115PubMedGoogle Scholar
  11. 11.
    Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E (2014) Postural control strategies during single limb stance following acute lateral ankle sprain. Clin Biomech 29:643–649CrossRefGoogle Scholar
  12. 12.
    Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E (2014) Single-leg drop landing motor control strategies following acute ankle sprain injury. Scand J Med Sci Sports. doi: 10.1111/sms.12282 Google Scholar
  13. 13.
    Doherty C, Bleakley C, Hertel J, Caulfield B, Ryan J, Delahunt E (2014) Single-leg drop landing movement strategies 6 months following first-time acute lateral ankle sprain injury. Scand J Med Sci Sports. doi: 10.1111/sms.12390 Google Scholar
  14. 14.
    Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C (2014) The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies. Sports Med 44(1):123–140CrossRefPubMedGoogle Scholar
  15. 15.
    Dufek J, Bates B (1990) Regression models for predicting impact forces and knee joint moments and power during landings. In: Proc CSB, pp 55–56Google Scholar
  16. 16.
    Farley C, Morgenroth D (1999) Leg stiffness primarily depends on ankle stiffness during human hopping. J Biomech 32:267–273CrossRefPubMedGoogle Scholar
  17. 17.
    Friel K, McLean N, Myers C, Caceres M (2006) Ipsilateral hip abductor weakness after inversion ankle sprain. J Athl Train 41:74–78PubMedPubMedCentralGoogle Scholar
  18. 18.
    Gribble P (2011) Commentary. J Athl Train 46:468–470PubMedPubMedCentralGoogle Scholar
  19. 19.
    Gribble P, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F et al (2013) Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. J Orthop Sports Phys Ther 43:585–591CrossRefPubMedGoogle Scholar
  20. 20.
    Gribble P, Robinson R (2009) Alterations in knee kinematics and dynamic stability associated with chronic ankle instability. J Athl Train 44:350–355CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F et al (2014) Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. Br J Sports Med 48:1014–1018CrossRefPubMedGoogle Scholar
  22. 22.
    Gribble PA, Delahunt E, Bleakley CM, Caulfield B, Docherty CL, Fong DTP et al (2014) Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the international ankle consortium. J Athl Train 49:121–127CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Hertel J (2008) Sensorimotor deficits with ankle sprains and chronic ankle instability. Clin Sports Med 27:353–370CrossRefPubMedGoogle Scholar
  24. 24.
    Hiller C, Refshauge K, Bundy A, Herbert R, Kilbreath S (2006) The Cumberland ankle instability tool: a report of validity and reliability testing. Arch Phys Med Rehabil 87:1235–1241CrossRefPubMedGoogle Scholar
  25. 25.
    Hopkins W, Marshall S, Batterham A, Hanin J (2009) Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc 41:3–13CrossRefPubMedGoogle Scholar
  26. 26.
    Lees A (1981) Methods of impact absorption when landing from a jump. Eng Med 10:204–211CrossRefGoogle Scholar
  27. 27.
    MacKinnon C, Winter D (1993) Control of whole body balance in the frontal plane during human walking. J Biomech 26:633–644CrossRefPubMedGoogle Scholar
  28. 28.
    Norcross MF, Blackburn JT, Goerger BM, Padua DA (2010) The association between lower extremity energy absorption and biomechanical factors related to anterior cruciate ligament injury. Clin Biomech 25:1031–1036CrossRefGoogle Scholar
  29. 29.
    Schmitz RJ, Shultz SJ (2010) Contribution of knee flexor and extensor strength on sex-specific energy absorption and torsional joint stiffness during drop jumping. J Athl Train 45:445–452CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Wikstrom EA, Brown C (2014) Minimum reporting standards for copers in chronic ankle instability research. Sports Med 44:251–268CrossRefPubMedGoogle Scholar
  31. 31.
    Winter D (1980) Overall principle of lower limb support during stance phase of gait. J Biomech 13:923–927CrossRefPubMedGoogle Scholar
  32. 32.
    Winter D (2009) Biomechanics and motor control of human movement, 4th edn. Wiley, Hoboken, pp 180–183CrossRefGoogle Scholar

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015

Authors and Affiliations

  1. 1.A101, School of Public Health, Physiotherapy and Sport Science, Health Sciences CentreUniversity College DublinBelfield, Dublin 4Ireland
  2. 2.Institute for Sport and HealthUniversity College DublinDublin 4Ireland
  3. 3.Sport and Exercise Sciences Research Institute, Ulster Sports AcademyUniversity of UlsterNewtownabbey, Co. AntrimNorthern Ireland, UK
  4. 4.Department of KinesiologyUniversity of VirginiaCharlottesvilleUSA
  5. 5.St. Vincent’s University HospitalDublin 4Ireland

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