Letter to the Editor: Clinical impact of normative data in ankle strength evaluation

Core Tip

Core Tip: The work by da Fonseca et al provides a crucial, long-awaited normative dataset for isokinetic ankle strength. What’s particularly striking is their finding that healthy ankles naturally exhibit over 90% bilateral symmetry, as measured by both limb symmetry index and their new muscular deficiency index. This empirically grounds the > 90% threshold, a standard borrowed from knee rehabilitation, as a valid and achievable goal for the ankle. The clinical takeaway is clear: We now have objective, gender-specific benchmarks that allow us to move beyond the flawed assumption that the uninjured limb is a perfect ‘control’. This research equips clinicians with the tools to make more precise and defensible decisions about rehabilitation progress and safe return to activity.