Is There a Link Between Chronic Ankle Instability and Postural Instability?

OBJECTIVE: To provide clinicians and researchers with an expanded perspective on the association between functional ankle instability and postural control. DATA SOURCES: I searched MEDLINE and SPORT Discus for the years 1966-2001 using the key words ankle, instability, and balance. Additional information was obtained from cross-referencing pertinent articles. DATA SYNTHESIS: Conflicting reports have been published about whether postural control is disrupted in people with chronic ankle instability. The variety of testing methods and operational definitions used by various investigators make drawing a consensus difficult. In contrast, the results of investigations considering postural-control strategy disruptions in persons with chronic ankle instability have been compatible. Depending upon the effectiveness of an altered strategy, postural-control deficiencies may fail to be revealed in the absence of challenging tasks and environmental conditions. CONCLUSIONS/RECOMMENDATIONS: If we accept the idea that postural control is disrupted after orthopaedic injury, the next step becomes identifying the causative factors within the postural-control system. Experimental evidence surrounding the role of lateral ankle-ligament mechanoreceptors in posture suggests that they cannot be the sole source of the alterations revealed. Consideration should be directed to other potential areas within the postural-control system, as outlined in the text, during ankle evaluations and rehabilitation.