The Mechanisms, Diagnosis and Rehabilitation of CAI Following ATFL Injury

Anterior talofibular ligament injury is one of the most common injuries associated with lateral ankle sprains,which may contribute to chronic ankle instability (CAI). This review summarizes recent evidence on the mechanisms, diagnosis, treatment, and rehabilitation of CAI following ATFL injury. ATFL injury will not only result in ligamentous laxity, but also cause altered ankle mechanics, proprioceptive deficits, muscle weakness, and impaired postural control. Diagnosis should combine clinical history, physical examination, functional assessment, and appropriate imaging. Conservative treatment remains the first-line approach, while surgical may be considered for persistent symptomatic instability. Rehabilitation should be individualized and include range-of-motion exercises, progressive loading, strength training, balance training and proprioceptive, neuromuscular control. Emerging technologies, including biofeedback and some virtual reality methods can further enhance rehabilitation. Overall, ankle function and reducing recurrent instability can be restored by comprehensive assessment and impairment-driven rehabilitation, while the emerging technologies may provide additional rehabilitation strategies.