Frontal plane ankle stiffness increases with weight-bearing.

Ankle sprains are among the most common musculoskeletal injuries. They are not isolated innocuous injuries as 30-40% of people who sprain their ankles develop chronic ankle instability. Ankle instability is typically assessed under passive unloaded conditions, ignoring any potential contribution of joint loading or muscle activation to the maintenance of ankle stability. Thus, the relevance of unloaded ankle stability assessments to the evaluation of impairments in chronic ankle instability or the prediction of future ankle sprains is questionable. Ankle impedance, which quantifies the resistance to an imposed rotation, has often been used to quantify ankle stability. However, few studies have investigated impedance in the frontal plane where sprains occur, and none have systematically investigated the effect of weight-bearing on ankle impedance. The objective of this study was to determine whether weight-bearing affects frontal plane ankle impedance. We had subjects systematically alter the weight on the tested ankle, while imposed frontal plane rotations were applied to estimate the impedance. We found that ankle stiffness, the static component of impedance, increased proportionally with the weight on the ankle. This increase in stiffness was due to a combination of the increase loading on the joint and the increase in muscle activation that occurs during weight-bearing. Finally, we found that men had a greater stiffness than women over the majority of the weight-bearing range. These results highlight the importance of clinically assessing ankle stability during weight-bearing conditions to better determine the impairments in chronic ankle instability and identify those at risk for ankle sprains.