The SHIFT Project 12- Lateral Ankle Instability: A Kinetic View
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This podcast presents a kinetic paradigm for understanding lateral ankle instability (LAI), arguing that the condition is fundamentally a force-moment timing problem rather than an issue of alignment, ligament laxity, or primary muscle weakness. Instability occurs because the a high magnitude inversion moment from ground reaction forces (GRF) rises much faster than the internal eversion moment generated by the peroneal-ligament complex can oppose it, usually within the first 40 milliseconds of stance. The presenters emphasizes that neuromuscular timing, specifically impaired feed-forward readiness (anticipatory pre-activation), is a central deficit, as reflexive responses are too slow to prevent injury. Effective management strategies involve modulating GRF using material stiffness (stiffer lateral heel/softer medial heel) and addressing factors like internal supination loads from a tight gastrocnemius–soleus complex to restore the crucial kinetic balance. Finally, the source cautions against relying on wedging to change GRF, which forces motion, in favor of methods that directly modify forces and improve timing.