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Comparison of the Strength of the Ankle Evertor, Invertor, and Ratio at Different Ankle and Toe Positions Between Sides With and Without Chronic Ankle Instability in Taekwondo Athletes

  • Beom-jun Kim (Department of Physical Therapy, The Graduate School, Yonsei University) ;
  • Ui-jae Hwang (Kinetic Ergocise Based on Movement Analysis Laboratory, Yonsei University) ;
  • Oh-yun Kwon (Kinetic Ergocise Based on Movement Analysis Laboratory, Yonsei University)
  • Received : 2024.06.26
  • Accepted : 2024.07.18
  • Published : 2024.08.20

Abstract

Background: In Taekwondo athletes, ankle sprain is the most common risk factor for injury. Repeated ankle injuries lead to weakness and imbalance of the ankle muscles, resulting in chronic ankle instability (CAI). Both the ankle and toe muscles contribute to the inversion and eversion of the foot at the subtalar joint. Therefore, it is necessary to consider the ankle and toe joint positions when measuring ankle invertor and evertor strength. Objects: This study aimed to compare the muscle strength and ratio differences of the ankle invertor and evertor muscles in both the toe and ankle positions between the CAI and uninjured sides in Taekwondo athletes. Methods: Fifteen Taekwondo athletes participated in this study. The isometric strengths of both the ankle invertor and evertor were determined in different ankle and toe positions (dorsiflexion with toe extension, dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion). Paired t-tests were used to determine the differences between the ankle invertor and evertor in strength and ratio according to toe and ankle positions between the ankle CAI side and the uninjured side. Results: The results demonstrated that ankle evertor strength significantly decreased in all ankle and toe positions on the CAI side (p < 0.05). In addition, significant differences were observed in the ratios of the ankle invertor and evertor strengths in the dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion positions (p < 0.05). Conclusion: The findings of this study suggest that athletes, trainers, and clinicians should consider ankle and toe positions when measuring invertor and evertor strength and develop ankle rehabilitation protocols for Taekwondo athletes with CAI.

Keywords

References

  1. Jeong HS, O'Sullivan DM, Lee SC, Lee SY. Safety evaluation of protective equipment for the forearm, shin, hand and foot in Taekwondo. J Sports Sci Med 2019;18(2):376-83.
  2. Slimani M, Chaabene H, Miarka B, Chamari K. The activity profile of elite low-kick kickboxing competition. Int J Sports Physiol Perform 2017;12(2):182-9. https://doi.org/10.1123/ijspp.2015-0659
  3. Park JH, Rhyu HS, Rhi SY. The effects of instrument-assisted soft tissue mobilization rehabilitation exercise on range of motion, isokinetic strength, and balance in chronic ankle instability Taekwondo players. J Exerc Rehabil 2020;16(6):516-21. https://doi.org/10.12965/jer.2040752.376
  4. Son M, Youm C, Woo J, Lee M, Kim Y, Kim J. Postural stability for Taekwondo athletes with repetitive ankle sprains during a single-leg stance. J Phys Ther Sci 2018;30(3):405-10. https://doi.org/10.1589/jpts.30.405
  5. Bayraktar Y, Erkmen N, Kocaoglu Y, unuvar BS. The effects of ankle Kinesiotaping on postural control in healthy Taekwondo athletes. Phys Educ Stud 2021;25(6):345-52. https://doi.org/10.15561/20755279.2021.0602
  6. Lystad RP, Pollard H, Graham PL. Epidemiology of injuries in competition Taekwondo: a meta-analysis of observational studies. J Sci Med Sport 2009;12(6):614-21. https://doi.org/10.1016/j.jsams.2008.09.013
  7. Michael JW, Schluter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Dtsch Arztebl Int 2010;107(9):152-62. https://doi.org/10.3238/arztebl.2010.0152
  8. Ji M. Analysis of injuries in Taekwondo athletes. J Phys Ther Sci 2016;28(1):231-4. https://doi.org/10.1589/jpts.28.231
  9. Lambert C, Pfeiffer T, Lambert M, Brozat B, Lachmann D, Shafizadeh S, et al. Side differences regarding the limb symmetry index in healthy professional athletes. Int J Sports Med 2020;41(11):729-35. https://doi.org/10.1055/a-1171-2548
  10. Pieter W, Fife GP, O'Sullivan DM. Competition injuries in Taekwondo: a literature review and suggestions for prevention and surveillance. Br J Sports Med 2012;46(7):485-91. https://doi.org/10.1136/bjsports-2012-091011
  11. Fong SS, Ng GY. Does Taekwondo training improve physical fitness? Phys Ther Sport 2011;12(2):100-6. https://doi.org/10.1016/j.ptsp.2010.07.001
  12. Kobayashi T, Gamada K. Lateral ankle sprain and chronic ankle instability: a critical review. Foot Ankle Spec 2014;7(4):298-326. https://doi.org/10.1177/1938640014539813
  13. Gerber JP, Williams GN, Scoville CR, Arciero RA, Taylor DC. Persistent disability associated with ankle sprains: a prospective examination of an athletic population. Foot Ankle Int 1998;19(10):653-60. https://doi.org/10.1177/107110079801901002
  14. Woods C, Hawkins R, Hulse M, Hodson A. The Football Association Medical Research Programme: an audit of injuries in professional football: an analysis of ankle sprains. Br J Sports Med 2003;37(3):233-8. https://doi.org/10.1136/bjsm.37.3.233
  15. Willauschus M, Ruther J, Millrose M, Walcher M, Lambert C, Bail HJ, et al. Foot and ankle injuries in elite Taekwondo athletes: a 4-year descriptive analysis. Orthop J Sports Med 2021;9(12):23259671211061112.
  16. Bridge CA, Jones MA, Drust B. Physiological responses and perceived exertion during international Taekwondo competition. Int J Sports Physiol Perform 2009;4(4):485-93. https://doi.org/10.1123/ijspp.4.4.485
  17. de Noronha M, Franca LC, Haupenthal A, Nunes GS. Intrinsic predictive factors for ankle sprain in active university students: a prospective study. Scand J Med Sci Sports 2013;23(5):541-7. https://doi.org/10.1111/j.1600-0838.2011.01434.x
  18. Fousekis K, Tsepis E, Vagenas G. Intrinsic risk factors of noncontact ankle sprains in soccer: a prospective study on 100 professional players. Am J Sports Med 2012;40(8):1842-50. https://doi.org/10.1177/0363546512449602
  19. Kang M, Lee JS, Ahn S, Yang H, Yoon SJ. Comparison of ankle flexibility, iso-kinetic strength and static.dynamic balance in high school judo player depending on chronic ankle sprain. J Korean Acad Kinesiol 2015;17(2):75-82. https://doi.org/10.15758/jkak.2015.17.2.75
  20. Willems T, Witvrouw E, Verstuyft J, Vaes P, De Clercq D. Proprioception and muscle strength in subjects with a history of ankle sprains and chronic instability. J Athl Train 2002;37(4):487-93.
  21. Donnelly L, Donovan L, Hart JM, Hertel J. Eversion strength and surface electromyography measures with and without chronic ankle instability measured in 2 positions. Foot Ankle Int 2017;38(7):769-78. https://doi.org/10.1177/1071100717701231
  22. Ahn SH, Hwang UJ, Gwak GT, Yoo HI, Kwon OY. Comparison of the strength and electromyography of the evertor muscles with and without toe flexion in patients with chronic ankle instability. Foot Ankle Int 2020;41(4):479-85. https://doi.org/10.1177/1071100719898464
  23. Leem MY, Park MS, Lim SK. Strength of hip and ankle muscles in Taekwondo athletes with chronic ankle instability. Exerc Sci 2010;19(4):371-80. https://doi.org/10.15857/ksep.2010.19.4.371
  24. Juneja P, Hubbard JB. Anatomy, bony pelvis and lower limb: tibialis anterior muscles. StatPearls; 2018.
  25. Otis JC, Deland JT, Lee S, Gordon J. Peroneus brevis is a more effective evertor than peroneus longus. Foot Ankle Int 2004;25(4):242-6. https://doi.org/10.1177/107110070402500408
  26. Ahn S, Kim H, Kim J, Kwak K, Kwon O. Ankle evertor strength of healthy subjects in different ankle and toe positions. Phys Ther Korea 2019;26(3):84-90. https://doi.org/10.12674/ptk.2019.26.3.084
  27. Kim HA, Hwang UJ, Jung SH, Ahn SH, Kim JH, Kwon OY. Comparison of shoulder strength in males with and without myofascial trigger points in the upper trapezius. Clin Biomech (Bristol, Avon) 2017;49:134-8. https://doi.org/10.1016/j.clinbiomech.2017.09.001
  28. Ahn SH, Hwang UJ, Jung SH, Kim HA, Kim JH, Kwon OY. Hip external rotator strength and compensatory movement in three different positions. Health 2018;10(1):132.
  29. Muscolino JE. The muscular system manual: the skeletal muscles of the human body. Elsevier Health Sciences; 2016.
  30. Milanezi FC, Marques NR, Cardozo AC, Goncalves M. Comparison of strength and proprioception parameters between subjects with and without functional ankle instability. Fisioter Pesq 2015;22(1):23-8.
  31. Pontaga I. Ankle joint evertor-invertor muscle torque ratio decrease due to recurrent lateral ligament sprains. Clin Biomech (Bristol, Avon) 2004;19(7):760-2. https://doi.org/10.1016/j.clinbiomech.2004.05.003
  32. Utsahachant N, Sakulsriprasert P, Vongsirinavarat M. Comparisons of foot posture and ankle and knee strength between athletes with and without chronic ankle instability. J Sports Sci Technol 2012;12(2):107-16.