Okamoto et al. studied two volunteers using DTI immediately, 24 h, 48 h, and one week after unilateral exercises of repeated flexion and extension of the ankle with loading.
According to literature review, the anterior opening angle of the distal tibial joint surface increases in ankle osteoarthritis, loading stress is concentrated on the front of the ankle, and the talus is translated anteriorly due to stretching of the anterior talofibular ligament [ 5, 6].
Physiologically, the foot and ankle are loaded joints during gait.
Clinically, the compression model provides a rationale for why patients with insertional tendinopathies may dislike compressive joint patterns such as loading in ankle dorsi flexion that is often observed in insertional Achilles tendinopathy populations (Cook and Purdam 2012).
However, some research has suggested that restricting the motion at the ankle may alter the loading at the knee joint.
Muscle gene/protein expression, post-translational contractile protein modifications, muscle membrane excitability and regulation of muscle contraction at the cellular level were explored after unilateral passive standardized mechanical loading of ankle joint flexors and extensors for 10 hours per day (2.5 hours, four times per day) for 9 ± 1 days (7 to 11 days).
With ankle in neutral position, load distribution to the fibula has been shown to average between 6%and7%7% of the total load transmitted through both the tibia and fibula [20, 21].
A mechanical testing apparatus, developed by the Medical Technical Development Department of our institution, loaded the ankle during testing.
This restriction can result in increased loading at the ankle, knee and hip as well as decreased energy absorption during certain parts of the stance phase [48, 49].
The talus loses its lateral support and valgus ankle instability occurs, with abnormal loading conditions inhibiting growth of the lateral part of the distal tibial epiphysis (Wiltse 1972, Hsu et al. 1974, Tompkins et al. 2012).
