{"id":2582,"date":"2025-02-08T21:09:10","date_gmt":"2025-02-08T20:09:10","guid":{"rendered":"https:\/\/kineaphp.fr\/?p=2582"},"modified":"2025-02-16T09:57:51","modified_gmt":"2025-02-16T08:57:51","slug":"instabilite-chronique-de-la-cheville","status":"publish","type":"post","link":"https:\/\/kineaphp.fr\/?p=2582","title":{"rendered":"Instabilit\u00e9 chronique de la cheville"},"content":{"rendered":"\n<p><strong>D\u00e9finition<\/strong><br>Condition caract\u00e9ris\u00e9e par une sensation r\u00e9currente de \u00ab\u00a0cheville qui part\u00a0\u00bb et une instabilit\u00e9 per\u00e7ue au niveau de la cheville.<br><strong>Facteurs de risque<\/strong><br>Intrins\u00e8ques : ant\u00e9c\u00e9dents d&rsquo;entorse, IMC \u00e9lev\u00e9, condition physique g\u00e9n\u00e9rale (d\u00e9ficit hanche, fibulaire)<br>Extrins\u00e8ques : sport (sauts et changements de direction rapides), chaussage, surface de jeux<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Physiopathologie<\/strong><\/p>\n\n\n\n<div class=\"wp-block-media-text has-media-on-the-right is-stacked-on-mobile\" style=\"grid-template-columns:auto 40%\"><div class=\"wp-block-media-text__content\">\n<p>&#8211; <strong>Alt\u00e9ration m\u00e9canique de la cheville<\/strong> : une mauvaise gu\u00e9rison d&rsquo;une entorse de cheville peut entra\u00eener une laxit\u00e9 ligamentaire persistante et instabilit\u00e9 chronique.<br>&#8211; <strong>Alt\u00e9ration sensorimotrice<\/strong> : les m\u00e9canor\u00e9cepteurs au niveau des ligaments l\u00e9s\u00e9s ne transmettent plus efficacement les information n\u00e9cessaire \u00e0 la proprioception et au contr\u00f4le postural.<br>&#8211; <strong>Alt\u00e9ration neuromusculaire<\/strong> : d\u00e9conditionnement et faiblesse musculaire entra\u00eene un cercle vicieux de l&rsquo;instabilit\u00e9. <\/p>\n<\/div><figure class=\"wp-block-media-text__media\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/core\/lw\/2.0\/html\/tileshop_pmc\/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&amp;p=PMC3&amp;id=6602403_i1062-6050-54-6-572-f01.jpg\" target=\"_blank\" rel=\" noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"535\" height=\"366\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-31-png.avif\" alt=\"\" class=\"wp-image-2887 size-full\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-31-png.avif 535w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-31-300x205.avif 300w\" sizes=\"auto, (max-width: 535px) 100vw, 535px\" \/><\/a><\/figure><\/div>\n\n\n\n<p>Voir le <a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6602403\/figure\/i1062-6050-54-6-572-f01\/\" target=\"_blank\" rel=\"noreferrer noopener\">mod\u00e8le de Hertel<\/a> pour la mod\u00e9lisation de la physiopathologie.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p class=\"has-text-align-center\"><strong>Diagnostique clinique<\/strong><\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p><strong>Pour tester la laxit\u00e9 m\u00e9canique<\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"The Talar Tilt Test | Lateral Ankle Sprain\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/UHNbm6Z3XK4?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Anterior Drawer Test of the Ankle | Chronic Ankle Laxity &amp; Anterior Talofibular Ligament Rupture\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/vAcBEYZKcto?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<p><strong>Score fonctionnel <\/strong>: <em>Cumberland Ankle Instability Tool <\/em>(CAIT)<\/p>\n\n\n\n<figure class=\"wp-block-image is-resized\"><a href=\"https:\/\/fiche-bilan-kine.fr\/wp-content\/uploads\/2021\/01\/Cumberland-Ankle-Instability-Tool.pdf\" target=\"_blank\" rel=\" noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"685\" height=\"1024\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/Cumberland-Ankle-Instability-Tool-685x1024.avif\" alt=\"\" class=\"wp-image-2883\" style=\"width:386px;height:auto\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/Cumberland-Ankle-Instability-Tool-685x1024.avif 685w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/Cumberland-Ankle-Instability-Tool-201x300.avif 201w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/Cumberland-Ankle-Instability-Tool-768x1148.avif 768w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/Cumberland-Ankle-Instability-Tool-1028x1536.avif 1028w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/Cumberland-Ankle-Instability-Tool-1371x2048.avif 1371w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/Cumberland-Ankle-Instability-Tool.png 1926w\" sizes=\"auto, (max-width: 685px) 100vw, 685px\" \/><\/a><\/figure>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Examen paraclinique<\/strong><br>&#8211; IRM : pour les structures ligamentaires et les changements du cartilage<br>&#8211; Radio de stress en inversion : si l&rsquo;inclinaison talienne est sup\u00e9rieur \u00e0 7\u00b0 par rapport au c\u00f4t\u00e9 controlat\u00e9ral, cela indique une instabilit\u00e9 chronique.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full is-resized\"><a href=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-32-png.avif\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"633\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-32-png.avif\" alt=\"\" class=\"wp-image-2896\" style=\"width:180px;height:auto\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-32-png.avif 768w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-32-300x247.avif 300w\" sizes=\"auto, (max-width: 768px) 100vw, 768px\" \/><\/a><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Th\u00e9rapeutique<\/strong><br>1\u00e8re intention : conservateur<br>R\u00e9\u00e9ducation sur la force, la stabilit\u00e9, l&rsquo;\u00e9quilibre, avec l&rsquo;utilisation de strap si n\u00e9cessaire. <br>2\u00e8me intention : chirurgie<br>Reconstruction ligamentaire par greffe pour les cas s\u00e9v\u00e8re ou r\u00e9fractaire au traitement conservateur.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>D\u00e9celer un cas r\u00e9fractaire<\/strong><br>&#8211; <strong>Ankle Go Score <\/strong>: risque de r\u00e9cidive sur 1 an si le score est inf\u00e9rieur \u00e0 11\/25 (<a href=\"https:\/\/www.youtube.com\/watch?v=vA9aKCbLcs0\" target=\"_blank\" rel=\"noreferrer noopener\">voir vid\u00e9o<\/a>)<br>Liste des tests et questionnaires utilis\u00e9s pour la construction du Ankle-GO score<\/p>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"791\" height=\"1024\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-33-791x1024.avif\" alt=\"\" class=\"wp-image-2900 size-full\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-33-791x1024.avif 791w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-33-232x300.avif 232w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-33-768x995.avif 768w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-33-png.avif 1064w\" sizes=\"auto, (max-width: 791px) 100vw, 791px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p>&#8211; <strong><a href=\"https:\/\/fiche-bilan-kine.fr\/wp-content\/uploads\/2021\/01\/Foot-and-Ankle-Ability-Measure.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">FAAM <\/a><\/strong>(Foot Ankle Ability Measurement) : \u00e9valuation fonctionnelle du pied et de la cheville dans les AVQ et le sport. Instabilit\u00e9 chronique de la cheville si AVQ&lt;80% \/ sport&lt;90%<br>&#8211; <strong><a href=\"https:\/\/cdn.prod.website-files.com\/5efdebdeb7b3547cff001ad5\/64a55a90b33a84e3730b3928_ALR%20RSI%20.png\" target=\"_blank\" rel=\"noreferrer noopener\">ALR-RSI <\/a><\/strong>(ankle ligament reconstruction-return to sport injury&nbsp;) : \u00e9valuation psychologique avant la reprise du sport <br>&#8211; <strong>SLS <\/strong>: single leg stance<br>&#8211; <strong>YBT <\/strong>: Y Balance Test<br>&#8211;<strong> SHT : <\/strong>Side Hop Test <br>&#8211; <strong>F8T<\/strong> : figure of eight<\/p>\n<\/div><\/div>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"644\" height=\"249\" src=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-35-png.avif\" alt=\"\" class=\"wp-image-2912\" srcset=\"https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-35-png.avif 644w, https:\/\/kineaphp.fr\/wp-content\/uploads\/2025\/02\/image-35-300x116.avif 300w\" sizes=\"auto, (max-width: 644px) 100vw, 644px\" \/><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>Vid\u00e9o<\/strong><br><em>L\u2019INSTABILIT\u00c9 CHRONIQUE de la CHEVILLE, in\u00e9vitable ? &#8211; En th\u00e9orie<\/em> par NeuroXTrain<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"L\u2019INSTABILIT\u00c9 CHRONIQUE de la CHEVILLE, in\u00e9vitable ? - En th\u00e9orie\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/iFaqICPHFSc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p><em>Peut-on en FINIR avec l&rsquo;INSTABILITE de CHEVILLE ? <\/em>par NeuroXTrain<br>Plusieurs exercices :<br>&#8211; \u00c9quilibre unipodal dynamique<br>&#8211; \u00c9quilibre position m\u00e9canisme l\u00e9sionnel<br>&#8211; Proprioception dynamique<br>&#8211; Proprioception impr\u00e9visible<br>&#8211; Fente instable dynamique<br>&#8211; Fente bulgare m\u00e9canisme l\u00e9sionnel<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Peut-on en FINIR avec l&#039;INSTABILITE de CHEVILLE ? - Bulletproof\" width=\"925\" height=\"520\" src=\"https:\/\/www.youtube.com\/embed\/hnTL-ksbnmU?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>D\u00e9finitionCondition caract\u00e9ris\u00e9e par une sensation r\u00e9currente de \u00ab\u00a0cheville qui part\u00a0\u00bb et une instabilit\u00e9 per\u00e7ue au niveau de la cheville.Facteurs de risqueIntrins\u00e8ques : ant\u00e9c\u00e9dents d&rsquo;entorse, IMC \u00e9lev\u00e9, condition physique g\u00e9n\u00e9rale (d\u00e9ficit hanche, fibulaire)Extrins\u00e8ques : sport (sauts&hellip;<\/p>\n<p class=\"more-link-wrapper\"><a href=\"https:\/\/kineaphp.fr\/?p=2582\" class=\"more-link\">Continue Reading<span class=\"screen-reader-text\"> \u00ab\u00a0Instabilit\u00e9 chronique de la cheville\u00a0\u00bb<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[358],"tags":[],"class_list":["post-2582","post","type-post","status-publish","format-standard","hentry","category-pathologie-cheville-pied"],"_links":{"self":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2582","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2582"}],"version-history":[{"count":24,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2582\/revisions"}],"predecessor-version":[{"id":3025,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=\/wp\/v2\/posts\/2582\/revisions\/3025"}],"wp:attachment":[{"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2582"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2582"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kineaphp.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2582"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}