Rotational Stiffness of Football Shoes Influences Talus Motion during External Rotation of the Foot

2012 ◽  
Vol 134 (4) ◽  
Author(s):  
Feng Wei ◽  
Eric G. Meyer ◽  
Jerrod E. Braman ◽  
John W. Powell ◽  
Roger C. Haut
Keyword(s):  
Ankle Joint ◽  
Joint Torque ◽  
Ankle Injuries ◽  
Design Parameters ◽  
Deltoid Ligament ◽  
Rotational Stiffness ◽  
Shoe Design ◽  
Tibiofibular Ligament ◽  
Ankle Ligament ◽  
Ligament Strain

Shoe-surface interface characteristics have been implicated in the high incidence of ankle injuries suffered by athletes. Yet, the differences in rotational stiffness among shoes may also influence injury risk. It was hypothesized that shoes with different rotational stiffness will generate different patterns of ankle ligament strain. Four football shoe designs were tested and compared in terms of rotational stiffness. Twelve (six pairs) male cadaveric lower extremity limbs were externally rotated 30 deg using two selected football shoe designs, i.e., a flexible shoe and a rigid shoe. Motion capture was performed to track the movement of the talus with a reflective marker array screwed into the bone. A computational ankle model was utilized to input talus motions for the estimation of ankle ligament strains. At 30 deg of rotation, the rigid shoe generated higher ankle joint torque at 46.2 ± 9.3 Nm than the flexible shoe at 35.4 ± 5.7 Nm. While talus rotation was greater in the rigid shoe (15.9 ± 1.6 deg versus 12.1 ± 1.0 deg), the flexible shoe generated more talus eversion (5.6 ± 1.5 deg versus 1.2± 0.8 deg). While these talus motions resulted in the same level of anterior deltoid ligament strain (approxiamtely 5%) between shoes, there was a significant increase of anterior tibiofibular ligament strain (4.5± 0.4% versus 2.3 ± 0.3%) for the flexible versus more rigid shoe design. The flexible shoe may provide less restraint to the subtalar and transverse tarsal joints, resulting in more eversion but less axial rotation of the talus during foot/shoe rotation. The increase of strain in the anterior tibiofibular ligament may have been largely due to the increased level of talus eversion documented for the flexible shoe. There may be a direct correlation of ankle joint torque with axial talus rotation, and an inverse relationship between torque and talus eversion. The study may provide some insight into relationships between shoe design and ankle ligament strain patterns. In future studies, these data may be useful in characterizing shoe design parameters and balancing potential ankle injury risks with player performance.

scholarly journals Magnetic resonance imaging in traumatic injuries of the ankle joint in children

2020 ◽  
Vol 24 (4) ◽  
pp. 266-271
Author(s):  
N. Yu. Serova ◽  
T. A. Akhadov ◽  
I. A. Melnikov ◽  
O. V. Bozhko ◽  
N. A. Semenova ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Soft Tissues ◽  
Diagnostic Value ◽  
Ankle Injuries ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Mri Findings ◽  
Traumatic Injuries ◽  
Sport Activities ◽  
Bone Fragments

Introduction. Sprain of the ankle joint is one of the most common injuries in children during sport activities. Purpose. To define MRI diagnostic value in ankle joint injuries. Material and methods. 30 patients , 18 boys and 12 girls aged 8-17 ( average age 14.6 years), were enrolled into the study. 20 of them (66.7%) were 12-14 years old, 3 (10%) - < 10 years old and 7 (23.3 %) - > 14 years old. A Philips AchievadStream 3.0 Tesla scanner was used for MRI examination. Results. MRI findings showed that 17 (56.7%) patients had damage of the anterior talofibular ligament; 8 patients had avulsion of bone fragments of the lateral ankle; 9 patients (30.0%) had partial deltoid ligament injuries. Complete rupture of ligaments was rare and was seen only in two patients (6.7%). Conclusion. MRI is a method of choice in assessing ankle injuries due to high contrast of soft tissues, high resolution and multi-planar potentials. MRI is especially useful in examining soft ankle tissue structures such as tendons, ligaments, nerves and fascia, as well as in revealing hidden / subtle bone damage.

The effect of rotational stiffness on ankle tibiocalcaneal motion and ligament strain during external rotation

2016 ◽  
Vol 230 (4) ◽  
pp. 264-274
Author(s):  
Keith D Button ◽  
Paige Thornton ◽  
Jerrod E Braman ◽  
Feng Wei ◽  
Roger C Haut
Keyword(s):  
Injury Risk ◽  
Model Simulation ◽  
External Rotation ◽  
Torsional Stiffness ◽  
Rotational Stiffness ◽  
Predictive Equations ◽  
Tibiofibular Ligament ◽  
Ankle Kinematics ◽  
Statistical Effect ◽  
Ligament Strain

The rotational stiffness of footwear has been previously shown to have an effect on ankle kinematics and injury risk, but this relationship has not yet been modeled. The aim of this study was to derive equations from experimental data that were able to predict ankle kinematics under various torsional stiffness constraints and use these equations to estimate ligament strains. Three athletic tapes were tested for their ability to constrain the ankle during external rotation. Six subjects then performed a voluntary external foot rotation using the selected tape designs to constrain the ankle, as well as with no constraints. The motion of the calcaneus with respect to the tibia (tibiocalcaneal motion) from 0° to 15° of tibia rotation and predictive equations were determined to establish tibiocalcaneal rotation, eversion, and flexion as a function of gross tibia motion and tape stiffness. These predictive equations were then used to drive a computational model in which ankle ligament strains were determined at 15° of tibia rotation and for ankle constraint stiffness ranging from 0 to 30 N m/deg. The three tapes provided significantly different constraint stiffnesses during external foot rotation. There was no statistical effect of ankle constraint on the dorsiflexion response of the ankle (p = 0.461). In contrast, there was an effect of constraint stiffness on tibiocalcaneal external rotation (p < 0.001) and tibiocalcaneal eversion (p < 0.001). Results of the model simulation revealed the highest ligament strains in the anterior tibiotalar ligament and anterior tibiofibular ligament. Anterior tibiotalar ligament strain increased with increasing constraint stiffness, while there was little effect of constraint stiffness on anterior tibiofibular ligament strain. Results from this study could aid in the design of footwear, as well as the analysis of clinical injuries.

Ankle Injuries During Excessive External Foot Rotation May Depend on Foot Constraint: Development of a Computational Model

2010 ◽  
Author(s):  
Feng Wei ◽  
John W. Powell ◽  
Roger C. Haut
Keyword(s):  
Computational Model ◽  
Bone Fracture ◽  
Clinical Studies ◽  
External Rotation ◽  
Ankle Injuries ◽  
Deltoid Ligament ◽  
Calcaneofibular Ligament ◽  
Tibiofibular Ligament ◽  
Posterior Talofibular Ligament

Numerous studies on the mechanisms of ankle injury deal with injuries to the syndesmosis and anterior ligamentous structures, but previous sectioning and clinical studies also describe the important role of the posterior talofibular ligament (PTaFL) in the ankle’s resistance to external rotation of the foot. Foot constraint may influence subtalar motion and the movement of the bones in the foot, thereby influencing the mode of injury during external rotation [1]. Stiehl et al. [2] constrain the foot with fiberglass cast tape, externally rotate the foot 90°, and produce injury to the deltoid ligament and anterior tibiofibular ligament (ATiFL) with bone fracture. In contrast, Stormont et al. [3] fix the foot in a potting alloy and conclude the primary ligamentous restraints to external rotation are the PTaFL and calcaneofibular ligament (CaFL).

scholarly journals The Benefits of the Plastination Techniques for the Anatomo Clinical Studies of Ankle Joint Ligaments Injuries

2017 ◽  
Vol 54 (3) ◽  
pp. 487-490
Author(s):  
Alina Maria Sisu ◽  
Gheorghe Noditi ◽  
Dan Grigorescu ◽  
Sorin Floresc ◽  
Jenel Marian Patrascu ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Ligament Injuries ◽  
Calcaneofibular Ligament ◽  
Conventional Mri ◽  
Ankle Ligament ◽  
Ct And Mri ◽  
Second Degree

The present research was made by following three directions: dissection and plastination, clinical ankle joint ligament injuries and MRI and CT examination of the cases.191 cases of ankle joint ligament injuries have been studied during two years. They were examined clinically and radiologically, using CT and MRI testing. The classification of ankle sprain was based on the number of injured ligaments. Out of the 191 cases diagnosed with ligament injuries, 92 involved the anterior talofibular ligament, 54 in the calcaneofibular ligament, 40 involved the posterior talofibular ligament and 5 involved the deltoid ligament. First degree sprain involves the injury of the anterior talofibular ligament, the second degree sprain involves the injury of the anterior talofibular ligament and of the calcaneofibular ligament, and the third degree sprain involves the damaging of anterior and posterior talofibular ligaments, as well as the calcaneofibular ligament. In this paper we have diagnosed a number of 39 first degree springs, 12 of second degree springs and 41 of third degree springs. The standard X- ray examinations have a low diagnostic rate of the ankle ligament injuries. Conventional MRI has a higher accuracy in diagnosing ankle joint collateral ligaments lesions.

Determination of In Situ Ankle Ligament Strains in Cases of High and Medial Ankle Sprains

2012 ◽  
Author(s):  
Keith D. Button ◽  
Feng Wei ◽  
Eric G. Meyer ◽  
Kathleen Fitzsimons ◽  
Roger C. Haut
Keyword(s):  
Ankle Sprain ◽  
Ankle Injury ◽  
Ankle Injuries ◽  
Deltoid Ligament ◽  
Generic Model ◽  
Ankle Sprains ◽  
Ligament Injuries ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Tibiofibular Ligament

Ankle sprain is a common occurrence in sports, accounting for 10–30% of injuries [1]. While approximately 85% of ankle sprains are lateral ankle injuries, syndesmotic (high) and medial injuries typically result in more time off the field. In order to help limit or mitigate ankle injuries, it is important to understand the mechanisms of injury. While numerous biomechanical studies have been conducted to investigate ankle injuries, most of them are designed to study ankle fractures rather than sprains. Ankle sprains have been graded in the clinical literature and associated with the degree of damage to a ligament resulting from excessive strains [2]. Recently, there have been studies of lateral ankle sprain in laboratory settings [3,4] and based on investigation of game films [5], providing considerable insight into the mechanism of lateral ankle sprain. On the other hand, few biomechanical studies have been conducted on high and medial ankle sprains. A more recent study from our laboratory used human cadaver limbs to investigate such injuries [6]. The study showed that the type of ankle injury, whether medial or high, under excessive levels of external foot rotation depends on the extent of foot eversion [6]. Everted limbs showed isolated anterior tibiofibular ligament injuries (high ankle sprain) only, while neutral limbs mostly demonstrated deltoid ligament failures (medial ankle sprain). Additionally, the study documented grade II (partial tears) and grade III (ruptures) ligament injuries. While a computational ankle model has also been developed and validated to help understand the mechanisms of injury [7], it is a generic model. The objective of the current study was to develop computational, subject-specific models from those cadaver limbs and determine the levels of ligament strain generated in the medial and high ankle injury cases, as well as correlate the grades of injury with ligament strains from the computational model.

Specimen-Specific Computational Models of Ankle Sprains Produced in a Laboratory Setting

2013 ◽  
Vol 135 (4) ◽  
Author(s):  
Keith D. Button ◽  
Feng Wei ◽  
Eric G. Meyer ◽  
Roger C. Haut
Keyword(s):  
Computational Models ◽  
External Rotation ◽  
Experimental Studies ◽  
Cadaver Study ◽  
Deltoid Ligament ◽  
Ankle Sprains ◽  
Tibiofibular Ligament ◽  
Maximum Angle ◽  
Injury Mechanisms ◽  
Ligament Strain

The use of computational modeling to predict injury mechanisms and severity has recently been investigated, but few models report failure level ligament strains. The hypothesis of the study was that models built off neutral ankle experimental studies would generate the highest ligament strain at failure in the anterior deltoid ligament, comprised of the anterior tibiotalar ligament (ATiTL) and tibionavicular ligament (TiNL). For models built off everted ankle experimental studies the highest strain at failure would be developed in the anterior tibiofibular ligament (ATiFL). An additional objective of the study was to show that in these computational models ligament strain would be lower when modeling a partial versus complete ligament rupture experiment. To simulate a prior cadaver study in which six pairs of cadaver ankles underwent external rotation until gross failure, six specimen-specific models were built based on computed tomography (CT) scans from each specimen. The models were initially positioned with 20 deg dorsiflexion and either everted 20 deg or maintained at neutral to simulate the cadaver experiments. Then each model underwent dynamic external rotation up to the maximum angle at failure in the experiments, at which point the peak strains in the ligaments were calculated. Neutral ankle models predicted the average of highest strain in the ATiTL (29.1 ± 5.3%), correlating with the medial ankle sprains in the neutral cadaver experiments. Everted ankle models predicted the average of highest strain in the ATiFL (31.2 ± 4.3%) correlating with the high ankle sprains documented in everted experiments. Strains predicted for ligaments that suffered gross injuries were significantly higher than the strains in ligaments suffering only a partial tear. The correlation between strain and ligament damage demonstrates the potential for modeling to provide important information for the study of injury mechanisms and for aiding in treatment procedure.

scholarly journals Arthroscopic Posterior Ankle Ligament Anatomy

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110006
Author(s):  
Richard D. Ferkel ◽  
Cory Kwong ◽  
Randall Farac ◽  
Mark Pinto ◽  
Nader Fahimi ◽  
...  
Keyword(s):  
Distal Tibia ◽  
Case Series ◽  
Ankle Arthroscopy ◽  
Flexor Hallucis Longus ◽  
Level Of Evidence ◽  
Tibiofibular Ligament ◽  
Ankle Ligament

Background: The purpose of this article is to document the normal arthroscopic appearance of the posterior ankle capsular and ligamentous structures, and variations in their anatomical relationships. Methods: 102 ankle arthroscopy videotapes were evaluated retrospectively for the configuration of the posterior capsuloligamentous structures. Based on these observations, the variations in the appearance and position of the posterior tibiofibular ligament (PTFL) and transverse (tibiofibular) ligament (TTFL) were documented. In addition, differences in the appearance of the flexor hallucis longus (FHL) were also noted. Results: All patients had evidence of both a PTFL and TTFL, which formed a labrum or meniscus-like addition to the posterior distal tibia. No patients demonstrated disruption of the PTFL; 3 had tears of the TTFL. We noted 4 distinct patterns of the PTFL and the TTFL. Thirty-four patients (33%) had a gap of ≥2 mm between the 2 ligamentous structures. Thirty-three (32.4%) had a gap <2 mm between the PTFL and TTFL. Twenty-six (25.5%) had a confluence of the 2 ligaments without a gap. Nine (9%) demonstrated a sizable gap between the 2 ligaments, and the TTFL appeared as a “cord-like” structure. Conclusion: To our knowledge, this is the first article to describe the variations in the arthroscopic normal posterior capsuloligamentous structures and FHL of the ankle. Level of Evidence: Level IV, case series.

Role of ultrasonography in assessment of painful ankle

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Amin Nassef ◽  
Shaimaa El Metwaly El Diasty ◽  
Marina Sameh Lamei
Keyword(s):  
Ankle Joint ◽  
Joint Pain ◽  
Pathological Condition ◽  
Ankle Injuries ◽  
Ankle Pain ◽  
Cross Sectional ◽  
Screening Study ◽  
Underlying Causes ◽  
Post Traumatic

Abstract Background Ankle disorders are a relatively common pathological condition, and ankle injuries account for approximately 14% of sports-related orthopedic emergency visits. Various imaging modalities can be used to make a diagnosis in cases of ankle pain; however, ultrasound (US) has several benefits for the evaluation of ankle pain, especially in the tendons, ligaments, and nerves of the ankle. Aim of the work to assess the role of high resolution US as a valuable tool in the depiction of causes of ankle joint pain. Patient & methods our study is a cross sectional descriptive screening study including 25 patients with ankle joint pain (acute or chronic), post traumatic or not with no age or sex predilection. Results The study included 15 (60%) males and 10 (40%) females. Their age ranged from 10 to 60 years with a mean age of 33.84±13.31years. Chronic ankle pain was the most common presenting symptom in 15 patients (60%) whereas 10 (40%) patients presented with acute ankle pain after trauma. The posterior ankle compartment was the most common affected compartment (24%) of cases. About 7 cases (28%) were presented by ankle swelling with or without pain. Conclusion In conclusion, MSK US is useful in detecting the underlying causes of ankle pain and still it has the potential to offer more valuable data if it is well mastered by the sonographers.

scholarly journals Predisposing factors to lateral ankle injury in male comrades marathon runners

2009 ◽  
Vol 65 (1) ◽  
Author(s):  
J. Hiemstra ◽  
N. Naidoo
Keyword(s):  
Correlation Coefficient ◽  
Undergraduate Research ◽  
The United States ◽  
Ankle Injury ◽  
Ankle Injuries ◽  
Distance Runners ◽  
Marathon Runners ◽  
Lateral Ankle ◽  
Ankle Ligament ◽  
Lateral Ankle Ligament

Introduction: More than two million people experience ankle ligament traumaeach year in the United States. Half of these are severe ligament sprains, however verylittle is known about the factors that predispose individuals to these injuries. The purpose of this study, (which was conducted as an undergraduate research project),was to find a correlation between the characteristics of height, weight and limbdominance and lateral ankle ligament injuries. Method: A  retrospective study was conducted on 114 ultra distance runners whoparticipated in the 2006 Comrades Marathon. During race registration, the runners’ height and weight were measuredafter answering a questionnaire regarding their training. Results: 114 runners responded to the questionnaire. From this cohort, 38 (33.3%) had sustained previous lateral ankle injuries. Of these 38 injuries, 47.4% of the injuries occurred on the runner’s dominant limb and 36.8% occurred on thenon-dominant side. 15.8% of the runners sustained previous ankle injuries to both ankles. There was a low negative correlation coefficient of 0.24 with regards to weight as a risk factor. This indicated that the power of the correlationwas 5.93%. The study demonstrates that there is no correlation between an increase in weight and an increase in theincidence of ankle injury. The correlation coefficient indicated a low correlation between an increase in height and the incidence of ankle injury. However, the power of the correlation at 18.37% makes inaccurate any attempt to predict the height at which a runner would be at most risk for lateral ankle injury. Conclusion: Height and weight are not risk factors predisposing subjects to lateral ankle injury. In addition, the studyillustrated that there was no effect of limb dominance on the incidence of lateral ankle injury.

scholarly journals A Custom-Made Lower Limb Dynamometer for Assessing Ankle Joint Torque in Humans: Calibration and Measurement Procedures

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 135
Author(s):  
Iulia Iovanca Drăgoi ◽  
Florina Georgeta Popescu ◽  
Teodor Petrița ◽  
Romulus Fabian Tatu ◽  
Cosmina Ioana Bondor ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Plantar Flexion ◽  
Calibration Procedure ◽  
Measurement Procedure ◽  
Joint Torque ◽  
Ankle Torque ◽  
Offset Voltage ◽  
Interclass Correlation ◽  
Custom Made ◽  
Measurement Protocol

Custom-made dynamometry was shown to objectively analyze human muscle strength around the ankle joint with accuracy, easy portability and low costs. This paper describes the full method of calibration and measurement setup and the measurement procedure when capturing ankle torque for establishing reliability of a portable custom-built electronic dynamometer. After considering the load cell offset voltage, the pivotal position was determined, and calibration with loads followed. Linear regression was used for calculating the proportionality constant between torque and measured voltage. Digital means were used for data collection and processing. Four healthy consenting participants were enrolled in the study. Three consecutive maximum voluntary isometric contractions of five seconds each were registered for both feet during plantar flexion/dorsiflexion, and ankle torque was then calculated for three ankle inclinations. A calibration procedure resulted, comprising determination of the pivotal axis and pedal constant. Using the obtained data, a measurement procedure was proposed. Obtained contraction time graphs led to easier filtering of the results. When calculating the interclass correlation, the portable apparatus demonstrated to be reliable when measuring ankle torque. When a custom-made dynamometer was used for capturing ankle torque, accuracy of the method was assured by a rigorous calibration and measurement protocol elaboration.

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