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Welcome to this Special Issue of the Journal of Athletic Training dedicated to the topic of ankle instability. This issue follows 3 previous special issues that have provided positive domestic and international exposure to the profession of athletic training with regard to contemporary clinical practice and research into important topics in sports medicine. We are confident this issue on ankle instability will reach the same high level of quality set by previous special issues dedicated to anterior cruciate ligament injuries in female athletes, shoulder injuries, and mild brain injuries.
Ankle sprains are a frequent occurrence in the physically active population, accounting for a significant amount of lost time from work and play on a daily basis. What is often frustrating is the patient or athlete who, despite your best efforts at rehabilitation, continues to suffer repetitive bouts of ankle instability. Although hundreds of articles have been published on this topic, suggesting a wide array of treatment options over the past few decades, the incidence of initial and recurrent ankle sprains remains a substantial clinical problem. The goal of this issue on ankle instability is to elucidate many aspects of this complex phenomenon and provide insight for broadening your clinical expertise.
As researchers, we are delighted to have this forum to discuss the most contemporary views on chronic ankle disability. You will notice that we have chosen to use the term chronic ankle instability throughout the special issue as a means of adding consistency and lessening confusion on the part of the reader. Furthermore, we feel that because there is still so much about this enigmatic phenomenon that we do not know, this terminology may be more appropriate in many cases than more specific terms such as functional ankle instability or mechanical ankle instability.
One of the most exciting features about this special issue is that we have assembled an internationally renowned group of experts on ankle instability, representing such disciplines as athletic training, physical therapy, and orthopaedics. Our intent is to frame the scope of the clinical entity with a series of in-depth literature reviews, then provide the reader with the current state of both the art and science of ankle-injury evaluation and treatment, and lastly, highlight contemporary research reports related to ankle instability. Equally exciting is the special commentary by Hans Tropp, MD, PhD, considered by many to be a pioneer in the area of ankle-instability research. We have purposely attempted to push the boundaries of traditional methods of managing ankle injuries and offer evidence for alternative ways of evaluating and treating these injuries. For example, we hope that you will find articles such as Denegar and Miller's illustration of manual therapy approaches to the injured ankle and Kovaleski et al's research report of ankle-joint arthrometry both intriguing and thought provoking.
Perhaps the most helpful thing to come about from our experience as Guest Editors is the fact that we have developed camaraderie with a group of clinicians and researchers sharing a common interest, the end result being a mechanism for future collaboration. Although we have made considerable advances in our understanding of ankle instability in the last 30 years, many unanswered questions remain. Leading the way is the need to establish a uniform set of criteria to define individuals who truly do and do not have ankle instability. Uniform criteria will allow for a better means of comparing research reports across various dependent measures and populations. Additionally, we see the area of prevention as one beckoning future research. Can initial ankle sprains and subsequent ankle instability be prevented? These questions, along with many others, remain unanswered.
We thank our distinguished group of authors for their hard work and dedication to making this special issue a reality. Additionally, we thank the manuscript reviewers and Associate Editors for their contributions to the special issue. Special thanks must go to David Perrin, PhD, ATC, Editor-in-Chief, and Leslie Neistadt, Managing Editor, for their careful guidance and help along the way. Whether you are a clinician, educator, or researcher, or any combination of these, we believe this issue will improve your understanding of ankle instability in athletes and serve as a contemporary reference and resource on this topic.
Editor's Note: Jay Hertel, PhD, ATC, is an Assistant Professor of Kinesiology and Director of the Athletic Training Research Laboratory at Pennsylvania State University, University Park, PA. Thomas W. Kaminski, PhD, ATC/R, is Department Head and Associate Professor, Department of Sports Medicine and Athletic Training, Southwest Missouri State University, Springfield, MO. Doctors Hertel and Kaminski are Guest Editors for this Special Issue of the Journal of Athletic Training.