Deep Tissue Hypersensitivity to Pressure Pain in Individuals with Unilateral Acute Inversion Ankle Sprain

Ramiro-González, María D.; Cano‐de‐la‐Cuerda, Roberto; de-la-Llave-Rincón, Ana I; Miangolarra‐Page, Juan Carlos; Zarzoso-Sánchez, Rafael; Fernández‐de‐las‐Peñas, César

doi:10.1111/j.1526-4637.2011.01302.x

Cited by 17 publications

(11 citation statements)

References 31 publications

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“…32 It has also recently been demonstrated that localized mechanical pain hypersensitivity over ankle ligaments and the lateral malleolus exists in individuals with lateral ankle sprains. 26 This suggests that the peripheral sensitization secondary to the acuteness of the injury postlateral ankle sprain may be positively affected by myofascial techniques. 26 We also found significantly greater increases in PPTs over the affected leg in the experimental group.…”

Section: Discussionmentioning

confidence: 99%

“…26 This suggests that the peripheral sensitization secondary to the acuteness of the injury postlateral ankle sprain may be positively affected by myofascial techniques. 26 We also found significantly greater increases in PPTs over the affected leg in the experimental group. Again, effect sizes were large, supporting a clinical effect of the intervention over mechanical sensitivity in those points previously found to be hypersensitive.…”

Section: Discussionmentioning

confidence: 99%

“…To investigate the hypoalgesic effects of both treatment protocols, consistent with a previous study, 26 PPT was assessed at 4 predetermined locations on the affected leg: anterior to the lateral malleolus over the anterior talofibular ligament, distal to the lateral malleolus over the calcaneofibular ligament, over the lateral malleolus, and over the medial malleolus.…”

Section: Outcome Measuresmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of Thrust and Nonthrust Manipulation and Exercise With or Without the Addition of Myofascial Therapy for the Management of Acute Inversion Ankle Sprain: A Randomized Clinical Trial

Truyols-Domínguez¹,

Salom‐Moreno²,

Abián-Vicén³

et al. 2013

J Orthop Sports Phys Ther

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of Thrust and Nonthrust Manipulation and Exercise With or Without the Addition of Myofascial Therapy for the Management of Acute Inversion Ankle Sprain: A Randomized Clinical Trial

Truyols-Domínguez¹,

Salom‐Moreno²,

Abián-Vicén³

et al. 2013

J Orthop Sports Phys Ther

Self Cite

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“…While there is evidence of contralateral sensory perception changes in people with tendinopathy,55 this can equally reflect persistent nociceptive drive from the local tissue. Acute pain conditions, such as acute inversion ankle sprain, also caused secondary hyperalgesia;56 however, this can be reversed instantaneously with an anaesthetic. This suggests that the nociceptive input from the periphery maintains sensitisation 57.…”

Section: Where Does Tendon Pain Fit In the Continuum Model?mentioning

confidence: 99%

Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?

et al. 2016

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The pathogenesis of tendinopathy and the primary biological change in the tendon that precipitates pathology have generated several pathoaetiological models in the literature. The continuum model of tendon pathology, proposed in 2009, synthesised clinical and laboratory-based research to guide treatment choices for the clinical presentations of tendinopathy. While the continuum has been cited extensively in the literature, its clinical utility has yet to be fully elucidated. The continuum model proposed a model for staging tendinopathy based on the changes and distribution of disorganisation within the tendon. However, classifying tendinopathy based on structure in what is primarily a pain condition has been challenged. The interplay between structure, pain and function is not yet fully understood, which has partly contributed to the complex clinical picture of tendinopathy. Here we revisit and assess the merit of the continuum model in the context of new evidence. We (1) summarise new evidence in tendinopathy research in the context of the continuum, (2) discuss tendon pain and the relevance of a model based on structure and (3) describe relevant clinical elements (pain, function and structure) to begin to build a better understanding of the condition. Our goal is that the continuum model may help guide targeted treatments and improved patient outcomes.

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“…In addition, the present study will assess the effects of MWM on pressure pain threshold in CAI. The presence of localized peripheral sensitization has been previously identified in acute inversion ankle sprains [24] and in subacute ankle sprains [25]. Balance impairments in CAI are frequently reported in the literature and MWM has been found to be effective immediately after application, but there is presently insufficient research to determine the short term benefits of MWM for balance impairments [6].…”

Section: Introductionmentioning

confidence: 99%

Effects of mobilisation with movement (MWM) on anatomical and clinical characteristics of chronic ankle instability: a randomised controlled trial protocol

Weerasekara

Osmotherly

Snodgrass

et al. 2019

BMC Musculoskelet Disord

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Background Up to 40% of individuals who sprain their ankle develop chronic ankle instability (CAI). One treatment option for this debilitating condition is joint mobilisation. There is preliminary evidence that Mulligan’s Mobilisation With Movement (MWM) is effective for treating patients with CAI, but the mechanisms by which it works are unclear, with Mulligan suggesting a repositioning of the fibula. This randomised controlled trial aims to determine the effects of MWM on anatomical and clinical characteristics of CAI. Methods Participants 18 years or over with CAI will be accepted into the study if they satisfy the inclusion and exclusion criteria endorsed by the International Ankle Consortium. They will be randomised into the experimental group (MWM) or the placebo group (detuned laser) and will receive the assigned intervention over 4 weeks. General joint hypermobility and the presence of mechanical instability of the ankle will be recorded during the first visit. Further, position of the fibula, self-reported function, ankle dorsiflexion range, pressure pain threshold, pain intensity, and static and dynamic balance will be assessed at baseline, and at the conclusion of course of intervention. Follow-up data will be collected at the twelfth week and at the twelfth month following intervention. Discussion Effectiveness of MWM on clinically relevant outcomes, including long term benefits will be evaluated. The capacity of MWM to reverse any positional fault of the fibula and the association of any positional fault with other clinically important outcomes for CAI will be explored. Proposed biomechanical mechanisms of fibular positional fault and other neurophysiological mechanisms that may explain the treatment effects of MWM will be further explored. The long term effectiveness of MWM in CAI will also be assessed. Trial registration Australian New Zealand Clinical Trials Registry; ACTRN12617001467325 (17/10/2017).

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Deep Tissue Hypersensitivity to Pressure Pain in Individuals with Unilateral Acute Inversion Ankle Sprain

Abstract: This study showed the presence of localized pressure pain hypersensitivity over ankle ligaments in patients with unilateral acute inversion ankle sprain, confirming the presence of localized peripheral sensitization.

Cited by 17 publications

References 31 publications

Efficacy of Thrust and Nonthrust Manipulation and Exercise With or Without the Addition of Myofascial Therapy for the Management of Acute Inversion Ankle Sprain: A Randomized Clinical Trial

Efficacy of Thrust and Nonthrust Manipulation and Exercise With or Without the Addition of Myofascial Therapy for the Management of Acute Inversion Ankle Sprain: A Randomized Clinical Trial

Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?

Effects of mobilisation with movement (MWM) on anatomical and clinical characteristics of chronic ankle instability: a randomised controlled trial protocol

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