Lateral Ligament Injuries Research Articles

Collateral ligament injury of the knee in sports

Athletes are particularly susceptible to medial or lateral collateral ligament injuries of the knee while playing sports. Sports are responsible for nearly half of all collateral ligament injuries, many of which are mild to moderate in severity. Frequently, the collateral ligaments are injured in association with other ligaments of the knee, necessitating surgical intervention and other measures to treat these injuries and restore full range of motion and function in the knee. In this review, we first discuss the stabilizing and supportive role of the collateral ligament and address why it is particularly susceptible to injuries in a sports setting. We then address the types of sports most frequently associated with damage to these ligaments, and note the role of gender and contact versus noncontact sports in the varying incidence rates of sports-related injuries observed in the literature. While conservative measures are typically used to treat collateral ligament injuries, more severe cases (particularly injuries that involve multiple ligaments) do require surgical intervention, with outcomes depending on the affected structures. We conclude by discussing a number of preventive strategies that can be employed to protect these ligaments – and the knee – from new or recurrent damage, with the hope that these preventive measures will be incorporated into future practice. Ultimately, athletes and clinicians should be informed on how to prevent debilitating injuries to preserve athletic performance and enhance or maintain an athlete's current quality of life.

Clinical characteristics of lateral epicondylitis of the humerus with lateral collateral ligament injury

Clinical characteristics of lateral epicondylitis of the humerus with lateral collateral ligament injury

Knee Trauma.

Knee Trauma.

Clinical Outcomes of Arthroscopic Debridement for Lateral Epicondylitis with Partial Injury of the Lateral Collateral Ligament Complex.

BackgroundLateral collateral ligament injuries may occur in patients with chronic lateral epicondylitis. The present study aimed to compare the clinical outcomes of arthroscopic debridement between patients with chronic lateral epicondylitis combined with a partial ligament injury and those without a ligament injury.MethodsBetween 2016 and 2018, patients who underwent arthroscopic debridement for lateral epicondylitis were evaluated. Partial injury to the lateral collateral ligament was defined as discontinuity or thinning with increased signal of the lateral ligament on magnetic resonance imaging and laxity with a firm endpoint in the varus or posterolateral rotatory stress test. Arthroscopic debridement was performed when there was no apparent instability in the stress test under fluoroscopic guidance after anesthesia. Patients with a ligament injury were compared with those without a ligament injury in terms of physical examination (varus stress test and posterolateral rotatory drawer test), pain visual analog scale, Mayo elbow performance score, and quick disabilities of the arm, shoulder and hand score.ResultsThere were 38 patients in the intact ligament group and 15 patients in the partial ligament injury group. There were 23 men and 30 women, and the mean patient age was 50 years (range, 27–77 years). The mean follow-up period was 30 months (range, 24–49 months). Instability was not observed in both groups at the last follow-up, and clinical scores improved significantly after surgery. Postoperative results did not show significant difference between the two groups. One patient in the partial injury group underwent revision open debridement owing to persistent pain.ConclusionsThe clinical outcomes of arthroscopic debridement for lateral epicondylitis did not show significant differences between patients with a partial ligament injury and those without a ligament injury.

Evaluation of role of MRI in knee joint injuries in correlation with arthroscopy

Introduction: Trauma to the knee joint is a major source of morbidity in young active people. An accurate diagnosis concerning the injury is important for early operative as well as non-operative treatment. The most extensively utilised diagnostic techniques to assess knee joint damage are arthroscopy and MRI. Objective: To detect various types of traumatic knee lesions using MRI and to compare the diagnostic accuracy of MRI with arthroscopy in the evaluations of ligamentous and meniscal injuries of the knee joint. Methods: A prospective study was done at the department of orthopaedic. A total of 50 patients (50 knees) were investigated, with 42 males and 11 females ranging in age from 16 to 61 years and presenting with various knee joint injuries. Results: Our comparison of these two methods in knee injuries comes to specific conclusions that are consistent with earlier research. Anterior and medial meniscal injuries are more common than posterior and lateral meniscal injuries. The description of the nature of ACL and PCL injuries by MRI assists the orthopaedic surgeon in deciding whether to proceed with conservative or final reconstruction by arthroscopy. Conclusion: Meniscal and ligamentous injuries are common in people who have had knee trauma. When compared to PCL and LM, the ACL and MM are more usually torn. While ACL and medial collateral ligament tears are associated with MM tears, lateral collateral ligament injuries are strongly associated with LM tears.

Couse of the prolonged pain after ankle sprain: Differential diagnosis of the Lateral ligament injury

Couse of the prolonged pain after ankle sprain: Differential diagnosis of the Lateral ligament injury

Characterization of Motor Performance in 200 Normal Ankles Through Isokinetic Evaluation

Category:Ankle; SportsIntroduction/Purpose:The isokinetic test has been used diffusely as a way to evaluate the functional results after the rehabilitation of musculoskeletal injuries. In the ankle, in particular, most studies are related to lateral ligament injuries and Achilles tendon's injuries. However, different protocols are used and a lack of normative values is observed in the literature. The aim of this work is to perform a global isokinetic evaluation on healthy ankles in order to propose reference values for future patients.Methods:We evaluated 100 participants (200 ankles) using the Biodex 3 System for the eversion, inversion, dorsiflexion and plantar flexion movements of the ankle. The sample consisted of individuals aged 20-60 years, with an active life and practice of recreational physical activity (non-athlete) and without previous injuries. Five repetitions for strength (N / m) and work (J) at a speed of 30° / sec and 10 repetitions for power (W) at a speed of 120° / sec were performed in our protocol. Agonist / antagonist ratio and the Muscle Deficiency Index, which globally assesses the balance between the sides for each movement, were also evaluated, as well as the demographic variables. Different statistical analyzes were performed for each parameter.Results:The mean age was 38.5 years and BMI 25.8 (CI 2.7 and 0.8 respectively). The non-dominant side was consistently stronger (higher peak torque) in all movements (p <0.001 -). The mean values obtained for force in each movement were 29.9N / m (CI 1.4) for eversion, 34.8N / m (CI 1.6) for inversion, 48.6N / m (2.0) for dorsiflexion and 140.2 N / m (CI 6.1) for plantar flexion. There was no correlation between age or BMI with the maximum torque (N / m). The ratio of eversors / inverters was 88.8% (CI 3.1) and that of dorsiflexors / plantar flexors was 36.1% (1.3). The Muscle Deficiency Index showed a balance between the sides for each movement (p 0.062), with an average global difference of less than 10% between them (eversion 8.66 [CI 3.17], inversion 4.2 [3, 48], dorsiflexion 3.41 [3.04] and plantar flexion 5.18 [2.51].Conclusion:As far as we know, this is the largest isokinetic assessment of normal ankles ever performed. The sample, although not stratified, was considered homogeneous (coefficient of variation <50%), which allows to propose several normative values for a non-athlete population in the isokinetic evaluation. It would be interesting to compare these data in the future with the functional results in patients after the treatment of certain injuries.

The development of a local clinical pathway for the management of high-grade lateral ankle ligament injuries

Purpose: High-grade lateral ankle ligament injuries cause significant functional impact with the potential for pathological sequelae and a known socio-economic burden. Clinical guidelines exist but are limited in their translation into local frameworks. The purpose of this clinical pathway was to standardise care for this specific group using current evidence and guidelines. This pathway also formed the main project for service development as part of the lead author's involvement in the Royal College of Nursing Clinical Leadership Programme for multi-professional staff at Mid Yorkshire Hospitals NHS Trust.

Ultrasonographic Measurement of Elbow Varus Laxity With a Sequential Injury Model of the Lateral Collateral Ligament-Capsular Complex.

Background:There is no consensus how to determine the varus laxity due to the LCL injury using the ultrasonography. There is a risk of lateral collateral ligament injury during or after arthroscopic extensor carpi radialis brevis release for tennis elbow. The equator of the radial head has been suggested as a landmark for the safe zone to not increase this risk; however, the safe zone from the intra-articular space has not been established.Hypothesis:Increased elbow varus laxity due to lateral collateral ligament–capsular complex (LCL-cc) injury could be assessed reliably via ultrasound.Study Design:Descriptive laboratory study.Methods:Eight cadaveric elbows were evaluated using a custom-made machine allowing passive elbow flexion under gravity varus stress. The radiocapitellar joint (RCJ) space was measured via ultrasound at 30° and 90° of flexion during 4 stages: intact elbow (stage 0), release of the anterior one-third of the LCL-cc (stage 1), release of the anterior two-thirds (stage 2), and release of the entire LCL-cc (stage 3). Two observers conducted the measurements separately, and the mean RCJ space in the 3 LCL-cc injury models (stages 1-3) at both flexion angles was compared with that of the intact elbow (stage 0). We also compared the measurements at 30° versus 90° of flexion.Results:At 30° of elbow flexion, the RCJ space increased 2 mm between stages 0 and 2 (95% confidence interval [CI], 1-3 mm; P < .01) and 4 mm between stages 0 and 3 (95% CI, 2-5 mm; P < .01). At 90° of elbow flexion, the RCJ space increased 1 mm between stages 0 and 2 (95% CI, 1-2 mm; P < .01) and 2 mm between stages 0 and 3 (95% CI, 2-3 mm; P < .01).Conclusion:Elbow varus laxity under gravity stress can be reliably assessed via ultrasound by measuring the RCJ space.Clinical Relevance:Because ultrasonographic measurement of the RCJ space can distinguish the increasing varus laxity seen with release of two-thirds or more of the LCL-cc, the anterior one-third of the LCL-cc, based on the diameter of the radial head, can be considered the safe zone in arthroscopic extensor carpi radialis brevis release for tennis elbow.

Recognition of ankle sprain: not only lateral collateral ligament injury

Ankle sprains are a common cause of morbidity in the general and athletic population. The majority of sprains involve the lateral aspect of the ankle, affecting the anterior talofibular ligament. However, the extent and categories of injury will depend upon the mechanism of injury. The ankle injury caused by ankle sprain is not only the injury of lateral collateral ligaments, but also chondral or osteochondral lesions of the talus, anterior ankle impingement, posterior ankle impingement and so on. In addition to the involvement of ankle joint, ankle sprain often leads to the injury of subtalar joint and transverse tarsal joint, even stress fracture, special part fracture or tendon soft tissue injury; multiple injuries often coexist. In clinical work, we should pay more attention to it.

Outcomes and Return to Sports Following the Ankle Lateral Ligament Reconstruction in Professional Athletes: A Systematic Review of the Literature.

The literature on the early reconstruction of severe acute lateral ligament injuries in professional athletes suggests earlier rehabilitation and reduced incidence of recurrent instability. Predicted time to return to training and sports is important to both the athlete and the club and has not previously been reported. The primary aim was to establish the best treatment options available for lateral ligament injury in professional athletes and assess the average time to return to physical training and return to play (RTP). Secondary aims were to find out the rate of return to the pre-injury level of competitive sports and the reasons for delayed recovery. We performed a systematic review according to PRISMA guidelines to evaluate the demographics, clinical profile, management, and treatment outcomes. Electronic searches of the MEDLINE, EMBASE, and Cochrane databases were performed. Studies conducted between Jan 2000 and Dec 2020 with articles reporting the ankle lateral ligament reconstruction in professional athletes were included. After initial screening, 982 articles were identified, of which, 10 articles evaluating 343 athletes met the criteria and were included for final review. The combined mean age was 23years with an average follow-up of 58.4months. After surgery 308 (89%) returned to their pre-injury level of sports, 7 (2%) patients returned to a lower-level sport while the remaining 28 (9%) never returned to play. Our results provide a guide to predict the expected time to return to play (RTP) after surgical repair of lateral ligament injuries along with associated injuries leading to delayed rehabilitation. Lateral ligament reconstruction is a safe and effective treatment for severe ruptures providing a stable ankle with a mean time of 16weeks to return to sports. The available studies vary considerably in their metrics used for measuring patient-reported outcomes. The online version contains supplementary material available at 10.1007/s43465-021-00532-0.

Ultimate Load Measuring System for Fixation of Soft Tissue to Bone.

The initial ultimate load for graft fixation is one of the essential factors in the reconstruction of lateral ankle ligaments. Several anchoring devices have been developed to fix the substitute ligament into the bone. A fair comparison of these fixation methods warrant a reproducible examination system. The purpose of this study was to make an experimental animal model and to compare the initial ultimate loads of 3 graft fixation methods, including the use of EndoButton (EB), interference screw (IFS), and a novel socket anchoring (SA) technique. Porcine calcaneus bones and 5-mm-wide split bovine Achilles tendons were used as fixation bases and graft materials, respectively. Both ends were firmly sutured side-by-side, using the circumferential ligation technique as a double-strand substitute that was 45 mm in length. Porcine calcanei with similar characteristics to adult human calcanei were mounted on a tensile testing machine, and substitutes were fixed into bones using the 3 fixation methods. A polyester tape was passed through the tendon loop and connected to a crosshead jig of the testing machine. The initial ultimate loads were measured in 15 specimens for each fixation method to simulate a lateral ankle ligament (LAL) injury. The ultimate loads (ULs) were 223.6 ± 52.7 N for EB, 229.7 ± 39.7 N for SA, and 208.8 ± 65.3 N for IFS. No statistically significant difference was observed among the 3 groups (P = .571). All failures occurred at the bone-ligament substitute interface. The initial ULs in all 3 fixation methods were sufficient for clinical usage. These values were larger than the UL of the anterior talofibular ligament; however, these were smaller than the UL of the calcaneofibular ligament. In an experimental animal model, ULs for SA, EB, and IFS techniques showed no significant difference. All failures were observed in the fixation site of the calcaneus and were overwhelmingly related to suture fixation failure.

Straight Form of Calcaneofibular Ligament as a Three-Dimensional Magnetic Resonance Imaging Sign in Diagnosis of Calcaneofibular Ligament and Anterior Talofibular Ligament Inferior Fascicle Injury

The present study was performed to investigate the morphological characteristics of the calcaneofibular ligament (CFL) and evaluate its relationship to the anterior talofibular ligament (ATFL) in patients with lateral ankle ligament injury using 3-dimensional magnetic resonance imaging (3D-MRI). This retrospective study involved 35 patients with lateral ankle ligament injury and 24 patients without a history of ankle trauma and a bone abnormality as controls. Reconstructed 3D-MRI was used to classify the form of the CFL as curved, wavy, or straight. The presence/absence of continuity between the fibula and CFL was evaluated in the 35 patients with injury, who were divided into 2 groups (continuity and discontinuity groups). The number of fascicles in the ATFL and the continuity between the distal end of the fibula and the proximal end of the ATFL were then evaluated. Among the patients with injury, 54.3% had the curve type of CFL, 34.3% had the wave type, and 11.4% had the straight type. In the control group, 62.5% had the curve type, 37.5% had the wave type, and none had the straight type. Continuity between the fibula and CFL was seen in 88.6%, and discontinuity was seen in 11.4%. Additionally, 85.7% had double fascicles in the ATFL. Inferior fascicle discontinuity between the ATFL and fibula was found in 13.3% with a double-fascicle ATFL; in all of these patients, the form of the CFL was straight and exhibited inferior fascicle discontinuity. The straight form of CFL could be a 3D-MRI sign in the diagnosis of CFL and ATFL inferior fascicle injury.

The radiological findings in complex elbow fracture-dislocation injuries.

Elbow fracture-dislocation is a complex injury which can lead to significant bony and soft tissue damage. Surgical intervention is guided towards restoring joint stability, allowing early mobilization and preventing long-term joint stiffness. The most common types are posterolateral, posteromedial, Monteggia type (and variants), and anterior trans-olecranon fracture-dislocations. Posterolateral fracture-dislocation is characterized by a radial head fracture (± anterolateral coronoid fracture) and typically capsuloligamentous disruption (lateral collateral ligaments injury is the most common). A posterolateral fracture-dislocation with radial head and coronoid anterolateral facet fractures is termed a terrible triad injury. In posteromedial fracture-dislocation, there is a fracture of the anteromedial facet of the coronoid, typically with proximal avulsion of the lateral collateral ligaments (± injury to the posterior bundle of the ulnar collateral ligament). Monteggia fracture-dislocation injuries demonstrate proximal ulnar fracture (with possible involvement of the olecranon and the coronoid) and radial head dislocation. These can be divided into apex anterior or apex posterior variants. The latter are commonly associated with radial head fractures and lateral ligamentous injury, and have a worse prognosis. In trans-olecranon fracture-dislocation, there is significant disruption of the greater sigmoid notch and the olecranon, with various involvement of the coronoid and the proximal ulna. The article describes the radiological findings and outlines the management principles in complex elbow fracture-dislocation injuries.

Lateral femoral notch sign and posterolateral tibial plateau fractures and their associated injuries in the setting of an anterior cruciate ligament rupture

IntroductionACL injury is one of the most common injuries of the knee joint in sports. As accompanying osseous injuries of the ACL rupture a femoral impression the so-called lateral femoral notch sign and a posterolateral fracture of the tibial plateau are described. However, frequency, concomitant ligament injuries and when and how to treat these combined injuries are not clear. There is still a lack of understanding with which ligamentous concomitant injuries besides the anterior cruciate ligament injury these bony injuries are associated.Materials and methodsOne hundred fifteen MRI scans with proven anterior cruciate ligament rupture performed at our center were retrospectively evaluated for the presence of a meniscus, collateral ligament injury, a femoral impression, or a posterolateral impression fracture. Femoral impressions were described according to their local appearance and posterolateral tibial plateau fractures were described using the classification of Menzdorf et al.ResultsIn 29 cases a significant impression in the lateral femoral condyle was detected. There was a significantly increased number of lateral meniscal (41.4% vs. 18.6% p = 0.023) and medial ligament (41.4% vs. 22.1%; p = 0.040) injuries in the group with a lateral femoral notch sign. 104 patients showed a posterolateral bone bruise or fracture of the tibial plateau. Seven of these required an intervention according to Menzdorf et al. In the group of anterior cruciate ligament injuries with posterolateral tibial plateau fracture significantly more lateral meniscus injuries were seen (p = 0.039).ConclusionIn the preoperative planning of ACL rupture accompanied with a positive femoral notch sign, attention should be paid to possible medial collateral ligament and lateral meniscus injuries. As these are more likely to occur together. A posterolateral impression fracture of the tibial plateau is associated with an increased likelihood of the presence of a lateral meniscal injury. This must be considered in surgical therapy and planning and may be the indication for necessary early surgical treatment.

Fracture of the capitellum with an associated fracture of the lateral humeral condyle: A case report

Isolated fractures of the capitellum humeri are rare and can be difficult to diagnose. Associated bone and soft tissue injuries are common. Mostly, a concomitant lateral collateral ligament injury or a radial head fracture is reported. Open reduction and internal fixation are accepted as the favored treatment to facilitate anatomic reduction. Missed diagnosis or inadequate treatment of capitellar fractures can led to the development of advanced degenerative changes, limitation of motion and pain. We present the case of an eighteen-year-old male with a Bryan and Morrey type I capitellar fracture in association with a fracture of the lateral humeral condyle. Fractures were treated with open reduction and internal fixation, using a headless compression screw and cannulated screws. To our knowledge this is the first case report to describe the treatment of a capitellar fracture with an associated fracture of the lateral humeral condyle.

Pullout Strength of All-Suture and Metallic Anchors in Repair of Lateral Collateral Ligament Injuries of the Elbow

To compare the biomechanical properties of metallic anchor (MA) and all-suture anchor (ASA) constructs in the anatomic reattachment of the lateral ulnar collateral ligament complex to its humeral insertion. Twenty paired male human cadaveric elbows with a mean age of 46.3 years (range: 33-58 years) were used in this study. Each pair was randomly allocated across 2 groups of either MA or ASA. A single 3.5-mm MA or 2.6-mm ASA was then inserted flush into the lateral epicondyle. A dynamic tensile testing machine was used to perform cyclic loading followed by a load to failure test. During the cyclic loading phase, the anchors were sinusoidally tensioned from 10 N to 100 N for 1,000 cycles at a frequency of 0.5 Hz. In the load to failure test, the anchors were pulled at a rate of 3 mm/s. Load at 1-mm and 2-mm displacement, as well as load to ultimate failure were assessed. Clinical failure was defined as displacement of more than 2 mm. Normality of data was assessed with the Shapiro-Wilk test. Continuous data are presented as medians and compared with the Mann-Whitney U test and categorical data was compared with the χ2 test or Fisher exact test. Displacement was significantly greater for the ASA group during cyclic loading starting from the tenth cycle (P < .05). Displacement of more than 5 mm within the first 100 cycles was observed in 2 anchors in the ASA group. No difference was observed in loads required to displace 1 mm (MA: 146 N [6-169] vs ASA: 144 N [2-153]; P= .53) and 2 mm (MA: 171 N [13-202] vs ASA: 161 N [9-191]; P= .97), but there was a statistically significant difference between ultimate loads in favor of ASA in the load to failure test (MA: 297 N [84-343] vs 463 N [176-620]; P < .01). In the cyclic test, no difference in clinical failure defined as pull-out of more than 2 mm was observed between 3.5 mm MAs and 2.6 mm ASAs. In the ultimate load to failure analysis, no difference was observed between groups in force causing 1 and 2 mm of displacement, but there was a significant difference in favor of ASA in the pull to ultimate failure test. Potential benefits of all-suture anchors include preservation of bone stock, reduced radiographic artifacts, and easier revisions. Although their use has been investigated thoroughly in the shoulder, there remains a paucity of literature regarding displacement and pull-out strength in the elbow.

Injuries of Kaplan fibers in ACL deficient and reconstructed knees – redefining the structure and risk assessment on MRI using injury patterns

Objectives:To determine an injury pattern of knee structures along torn Kaplan fibers in ACL deficient knees and to observe the healing process of Kaplan fibers in ACL reconstructed knees.Methods:A total of 101 knee MRIs obtained between January 2004 and April 2020 with full-thickness ACL tears were retrospectively assessed for visibility and impairment of three Kaplan bundles (proximal, distal and epicondylar band) and for associated injuries by two fellowship-trained independent musculoskeletal radiologists. A subgroup of 33 follow-up knee MRIs after ACL reconstruction was assessed to observe the natural evolution of Kaplan fibers injury. Descriptive statistics and Spearman correlation coefficients (P<.05) were used to determine injury patterns.Results:Kaplan fibers were injured in 43 of 101 (43%) acute ACL deficient knees. Proximal Kaplan fibers were visible in less than 48 of 101 (50%) knees as opposed to the distal Kaplan fibers and epicondylar Kaplan band which were both visible in 98 of 101 (97%) knees. Injury to the Kaplan complex was significantly associated with anterolateral (rho, 0.36; P<.001) and lateral collateral ligament impairment (rho, 0.21;P<.05) and medial femoral bone marrow edema (rho, 0.21;P<.05). After ACL reconstruction, only two of 33 (6%) patients showed torn Kaplan and 13 of 33 (39%) distal Kaplan fibers were scarred.Conclusion:Torn Kaplan fibers are associated with anterolateral and lateral collateral ligament injuries in ACL deficiency, indicating a more severe anterolateral and rotatory instability. Injury patterns in ACL deficient knees can eliminate the uncertainty of proximal Kaplan fibers identification. Kaplan fiber tears tend to heal following ACL reconstruction.

Peroneus brevis tendon injury in chronic ankle instability.

Objective: To compare the surgical outcome of patients with chronic lateral ligament injury of the ankle, with and without an associated peroneus brevis tendon injury. Methods: This retrospective comparative study was based on epidemiological analysis and the American Orthopedic Foot and Ankle Society (AOFAS) scores of patients diagnosed with chronic ankle instability who were treated surgically with the Broström-Gould technique. The medical records of 50 patients treated in an orthopedics service between January 2012 and January 2020 were analyzed. The patients were divided into two groups: those with and without a peroneus brevis tendon injury. The following data were also collected: sex, age, comorbidities, and AOFAS score in the pre- and postoperative period (between 90-120 days), as well as other epidemiological data. Results: Sixteen patients (32%), whose mean age was 43 years and 76% of whom were female, presented with a peroneus brevis tendon injury. The right side (54%) was more commonly affected. The main comorbidities were obesity (14%), slight pes cavus (12%), diabetes mellitus (4%) and depression (4%). The mean improvement in AOFAS score was 41 points. There was a marginal difference in final AOFAS score (p=0.03) between the groups. Conclusion: The Broström-Gould Technique proved effective for treating chronic lateral ligament injury regardless of an associated peroneus brevis tendon injury. However, the final postoperative results were significantly worse in patients with a peroneus brevis tendon injury than in those without one. Level of Evidence III; Therapeutic Studies; Comparative Retrospective Study.

The Role of Strength and Conditioning in the Prevention and Treatment of Chronic Lateral Ankle Instability

ABSTRACT Lateral ankle sprains are one of the most common injuries sustained during sport or physical activity. Up to 40% of individuals can develop chronic lateral ankle instability (CLAI) after a lateral ankle sprain. CLAI occurs when functional or mechanical insufficiencies of the lateral ankle ligamentous complex persist. The purpose of this article is to identify characteristics of CLAI and describe strength and conditioning strategies that can be used to treat lateral ankle ligamentous injuries, preventing them from progressing on to CLAI (See Video, Supplemental Digital Content 1, http://links.lww.com/SCJ/A306).