Versus Arthritis Centre for Sport, Exercise and Osteoarthritis
University of Nottingham

The Muscle Study: The impact of immobilisation and inflammation on muscle metabolic health and adaption in ageing, obesity and ankle fracture 


Ankle fractures are very common and are often treated in hospitals, making up 10% of all fractures. Muscle loss is often associated with an ankle fracture (especially in the calf muscle) and limits the patients’ long-term recovery. 

There are two major factors resulting in muscle loss. Firstly, immobilising the leg in a cast limits muscle use and leads to muscle loss. Secondly, inflammation which occurs through the fracture and surgery, also leads to muscle loss. 

A leg cast is applied to ankle fracture patients for 6 weeks following surgery. A shorter leg cast period with earlier physiotherapy may help reduce muscle loss and speed up recovery. 

What the research hopes to achieve

This study aims to understand why muscle loss occurs in patients and what the response is to two different rehabilitations.

  1. To measure what happens to muscle mass, muscle protein synthesis and insulin sensitivity, over 2-5 days of bed rest, in patients following ankle fracture. 
  2. To evaluate the response of muscle protein synthesis and insulin sensitivity, in the two days after surgical repair, in patients.
  3. To compare muscle mass, muscle protein synthesis and insulin sensitivity during standard treatment and during the EMADE intervention in patients.
Work Packages

Epidemiology (WP1) 
Biomarkers (WP2)

Principal Investigators Prof Brigitte Scammell & Prof Paul Greenhaff (University of Nottingham)
Investigator Arfan Ali

two young men running