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19th Aug, 2026 12:00 AM
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Ankle Strength Not Linked to Joint Hypermobility in Children

TOPLINE

In healthy children aged 5 to 10 years, ankle muscle strength was not associated with ankle dorsiflexion or general joint hypermobility. Foot posture was also not linked to ankle muscle strength in most comparisons.

METHODOLOGY

  • A cross-sectional study assessed the relationships between foot posture, joint hypermobility, ankle dorsiflexion, and isometric ankle strength in 196 children aged 5-10 years (mean age, 7.6 years; 59.2% girls) at a Spanish school between January and June 2022.
  • Participants underwent bilateral assessments of foot posture using the foot posture index, generalized joint hypermobility using the Beighton score, and lower-limb hypermobility using the lower limb assessment score (LLAS) and foot and ankle flexibility index (FAFI). Ankle dorsiflexion range of motion was measured using the weight-bearing lunge test.
  • Isometric ankle strength including inversion, eversion, plantar flexion, and dorsiflexion was measured using handheld dynamometry.

TAKEAWAY

  • Researchers found no significant association between ankle dorsiflexion or generalized hypermobility and ankle muscle strength; foot posture also showed no significant association in most comparisons.
  • Region-specific hypermobility showed weak correlations with some ankle strength measures (all correlations ≤ 0.24; P < .05 for significant correlations).
  • Only a few small associations remained after adjusting for age, sex, and BMI for age.

IN PRACTICE

"[The] findings suggest that ankle muscle strength alone has limited clinical utility as an indicator of lower limb hypermobility in healthy children," the authors wrote.

SOURCE

The study was led by Carlos Martinez-Sebastian, University of Malaga, Spain. It was published online on August 15 in the European Journal of Pediatrics.

LIMITATIONS

The study was cross-sectional; thus, it prevented establishing causal relationships. Most participants were asymptomatic White children aged 5 to 10 years. Non-participants and children excluded for discomfort were not characterized.

DISCLOSURES

The study did not receive any funding. The authors reported no relevant conflicts of interest.

SUGGESTED FOR YOU

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

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