Comparison of two manual therapy interventions applied to the ankle joint: a randomized control trial in collegiate athletes

Background Lateral ankle sprains (LAS) are among the most prevalent musculoskeletal injuries in athletics. Restricted closed kinetic chain dorsiflexion range of motion is a modifiable intrinsic risk factor, yet manual therapy as a preventive intervention remains understudied. Primary Aim: to compare the immediate effects of high-velocity low-amplitude thrust manipulation versus closed kinetic chain mobilization with movement on dorsiflexion mobility in uninjured pain free collegiate athletes. Secondary Aim: examine the association between posterior talar glide restriction and dorsiflexion deficits. Tertiary Aim: determine whether a single MT session can shift athletes to a lower LAS injury risk classification. Material and methods Seventy-three collegiate athletes were randomized to high velocity low amplitude thrust (n = 24), mobilization with movement (n = 27), or control (n = 22). Dorsiflexion mobility was measured pre and post-intervention using a standardized weight-bearing lunge test. Talocrural joint play was assessed via posterior talar glide testing. Descriptive and inferential statistical analysis were utilized in the study. Results Mobilization with movement produced significantly greater dorsiflexion gains than the high velocity thrust (+2.74° vs. +0.71°; p = 0.042, partial η 2 = 0.086). A restricted posterior talar glide was significantly associated with closed chain dorsiflexion mobility <35° (p = 0.028). McNemar's test revealed a statistically significant change in the proportion of athletes classified at elevated ankle sprain risk on the CKCDF ROM criteria from pre- to post-intervention within the manual therapy group ( χ 2 = 9.39, p = 0.002). Conclusion A single session of mobilization with movement significantly improved dorsiflexion mobility and reduced LAS injury risk classification in collegiate athletes. Talocrural joint mobilization warrants consideration as a proactive component of ankle injury prevention programs.