November 2014

ATFL data suggest ligament thickening after sprain does not cause instability

In the moment: Sports medicine

By Jordana Bieze Foster

Both ankle sprain copers and patients with chronic ankle instability have thickened anterior talofibular ligaments (ATFL), suggesting that these structural changes are not the cause of chronic instability, according to research from the University of Evansville in Indiana.

Investigators used musculoskeletal ultrasound to assess ATFL thickness in 80 collegiate athletes. Based on history of ankle sprain and scores on the Cumberland Ankle Instability Tool, 46 athletes were categorized as healthy, 24 as copers, and 10 as unstable.

The ATFL was significantly thicker in the injured ankles of the copers and the athletes with chronic ankle instability than in the healthy group, but thickness did not differ significantly between the two ankle sprain groups. ATFL thickness in the uninjured ankles of the copers and athletes with instability also was not significantly different from ATFL thickness in the uninjured group.

The findings, which were epublished on November 10 by the Journal of Athletic Training, suggest that, although a previous injury may cause lasting structural changes in the ligament, those structural changes are not what cause chronic ankle instability.


Liu K, Gustavsen G, Royer T, et al. Increased ligament thickness in previously sprained ankles as measured by musculoskeletal ultrasound. J Athl Train 2014 Nov 10. [Epub ahead of print]

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