Chinese Journal of Tissue Engineering Research ›› 2025, Vol. 29 ›› Issue (24): 5109-5115.doi: 10.12307/2025.739

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Increasing foot toe-out angle reduces strain on the anterior talofibular ligament and calcaneofibular ligament during drop-landing with ankle inversion

Zhu Xiaoxue1, Zhang Teng1, Song Qingqing1, Luo Xin1, Zhang Hengshuo2, Wang Dan3, Qiu Jihong4, Wei Feng5, Song Qipeng1   

  1. 1School of Sport and Health, Shandong Sport University, Jinan 250102, Shandong Province, China; 2Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, LE113TU, UK; 3School of Athletic Performance, Shanghai University of Sport, Shanghai 200438, China; 4School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; 5Orthopaedic Biomechanics Laboratories, Michigan State University, East Lansing, MI 48824, USA
  • Received:2024-08-21 Accepted:2024-10-25 Online:2025-08-28 Published:2025-01-24
  • Contact: Song Qipeng, PhD, Professor, School of Sport and Health, Shandong Sport University, Jinan 250102, Shandong Province, China
  • About author:Zhu Xiaoxue, Master’s candidate, School of Sport and Health, Shandong Sport University, Jinan 250102, Shandong Province, China
  • Supported by:
    the National Natural Science Foundation of China, No. 12102235 (to SQP); the Youth Boosting Program of the National Team of the General Administration of Sport of China, No. 23QN009 (to SQP)

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Abstract: BACKGROUND: Ankle inversion injuries frequently occur during landing, injuring the anterior talofibular and calcaneofibular ligaments. Previous studies usually used indirect indicators, such as inversion angle, as an injury risk indicator, but epidemiological support is lacking. 
OBJECTIVE: To calculate anterior talofibular and calcaneofibular ligament strains using a three-dimensional multi-body foot model during a drop-landing and to investigate whether increasing the foot toe-out angle for landing would reduce the risk of inversion sprains.
METHODS: Thirty-five participants with high sports demands [15 males and 20 females, age: (21.0±0.9) years, height: (176.2±8.8) cm, body mass: (71.6±12.8) kg] were recruited to perform a drop-landing test using a trapdoor device to simulate ankle inversion sprains. Two landing conditions were tested, i.e., natural landing and toe-out landing. Kinematic data were collected using a 12-camera motion analysis system, the strains of the anterior talofibular and calcaneofibular ligaments were calculated using a three-dimensional rigid-body foot model. 
RESULTS AND CONCLUSION: From natural landing to toe-out landing conditions, the anterior talofibular ligament strain decreased [natural landing= (3.57±1.92)%, toe-out landing=(0.36±1.18)%, P < 0.001, Cohen’s d=2.01), as was the calcaneofibular ligament strain [natural landing=(1.38±1.80)%, toe-out landing=(0.28±2.29)%, P=0.003, Cohen’s d=0.81). It could be concluded that increasing foot toe-out angle reduces anterior talofibular and calcaneofibular ligament strains during drop-landing with ankle inversion, thereby reducing the potential of ankle inversion sprains.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: ankle injury, ankle inversion sprain, ligament injury, ligament tear, anterior talofibular ligament, calcaneofibular ligament, foot model, finite element analysis

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