The Relationship Between Joint Stiffness and Muscle Activity in Unstable Ankles and Copers.

ABSTRACT

CONTEXT Rolling sensations at the ankle are common after injury and represent failure in neural regulation of joint stiffness. However, deficits after ankle injury are variable and strategies for optimizing stiffness may differ across patients. OBJECTIVE: To determine if ankle stiffness and muscle activation differ between patients with varying history of ankle injury. PATIENTS Fifty-nine individuals were stratified into healthy (CON, n = 20), functionally unstable (UNS, n = 19), and coper (COP, n = 20) groups. MAIN OUTCOME MEASURES: A 20° supination perturbation was applied to the ankle as position and torque were synchronized with activity of tibialis anterior, peroneus longus, and soleus. Subjects were tested with muscles relaxed, while maintaining 30% muscle activation, and while directed to react and resist the perturbation. RESULTS: No group differences existed for joint stiffness (F = 0.07, P = .993); however, the UNS group had higher soleus and less tibialis anterior activation than the CON group during passive trials (P < .05). In addition, greater early tibialis anterior activation generally predicted higher stiffness in the CON group (P ≤ .03), but greater soleus activity improved stiffness in the UNS group (P = .03). CONCLUSION: Although previous injury does not affect the ability to stiffen the joint under laboratory conditions, strategies appear to differ. Generally, the COP has decreased muscle activation, whereas the UNS uses greater plantar-flexor activity. The results of this study suggest that clinicians should emphasize correct preparatory muscle activation to improve joint stiffness in injury-rehabilitation efforts.