Ankle Injuries Ankle Sprains Ankle Sprains Single most common injury in athletics caused by sudden...
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Transcript of Ankle Injuries Ankle Sprains Ankle Sprains Single most common injury in athletics caused by sudden...
Ankle InjuriesAnkle Injuries
Ankle SprainsAnkle Sprains
Single most common injury in athletics caused Single most common injury in athletics caused by sudden inversion or eversion momentsby sudden inversion or eversion moments
Medial AspectMedial Aspect
Bones Bones of of
Foot & AnkleFoot & Ankle
Head of TalusHead of Talus
Medial MalleolusMedial Malleolus
Foot & Ankle BonesFoot & Ankle Bones
CalcaneousCalcaneous
CuboidCuboid
TalusTalus
3rd - 5th 3rd - 5th MetatarsalsMetatarsals
Lateral ViewLateral ViewTarsal Tarsal sinussinus
Anterior Tibiofibular LigamentAnterior Tibiofibular Ligament PalpationPalpation
Locate area where tibia and Locate area where tibia and fibula meetfibula meet
Spring TestSpring Test
External Rotation TestExternal Rotation Test
Anterior Talofibular LigamentAnterior Talofibular Ligament Palpation Palpation
Superior to sinus tarsiSuperior to sinus tarsi Anterior Drawer TestAnterior Drawer Test
Anterior translation of talus under tibiaAnterior translation of talus under tibia May cause a clunking at end point May cause a clunking at end point Indicates laxityIndicates laxity
Posterior Talofibular LigamentPosterior Talofibular Ligament
Posterior Drawer Test Posterior Drawer Test Stabilize TibiaStabilize Tibia
Apply a posterior stress to the foot and ankleApply a posterior stress to the foot and ankle Posterior translation indicates ligament laxityPosterior translation indicates ligament laxity
Talar Tilt Test (Varus Stress)Talar Tilt Test (Varus Stress)
AssessmentAssessment Calcaneofibular ligamentCalcaneofibular ligament
Apply a varus stress to calcaneousApply a varus stress to calcaneous
Grade 1-3+Grade 1-3+
Feel for cluckFeel for cluck
Inversion SprainsInversion Sprains Injury to the lateral ligamentsInjury to the lateral ligaments
Anterior talofibular ligament Anterior talofibular ligament
InversionInversion
Plantar flexion Plantar flexion
Internal rotationInternal rotation
Calcaneofibular ligament Calcaneofibular ligament
InversionInversion
Symptoms Symptoms Pain Pain
Active motionActive motion Resistive motionResistive motion Loss of functionLoss of function
SignsSigns Tenderness Tenderness SwellingSwelling EcchymosisEcchymosis
Inversion SprainInversion Sprain
Symptoms Symptoms Pain: mild Pain: mild
Active motionActive motion Resistive motionResistive motion Loss of functionLoss of function Weight bearing minimally impairedWeight bearing minimally impaired
SignsSigns Point Tenderness Point Tenderness SwellingSwelling EcchymosisEcchymosis No laxityNo laxity
1º Inversion Sprain1º Inversion Sprain1º Inversion Sprain1º Inversion Sprain ManagementManagement
RICERICE Weight bearing to toleranceWeight bearing to tolerance Tape or braceTape or brace Modalities as neededModalities as needed StrengtheningStrengthening Return to activity when functionalReturn to activity when functional Average return 7-10 daysAverage return 7-10 days
EtiologyEtiology Moderate inversion forceModerate inversion force
PathologyPathology Partial tearing of ligamentsPartial tearing of ligaments
Anterior TalofibularAnterior Talofibular CalcaneofibularCalcaneofibular
Signs and SymptomsSigns and Symptoms Pop or snap heard or feltPop or snap heard or felt Moderate painModerate pain Moderate disabilityModerate disability
Difficulty bearing weightDifficulty bearing weight TendernessTenderness EdemaEdema
2º Inversion Sprain2º Inversion Sprain ManagementManagement
RICE up to 72 hoursRICE up to 72 hours
X-ray if unable to weight bearX-ray if unable to weight bear
Crutches 5-10 daysCrutches 5-10 days
Progress to weight bearing Progress to weight bearing
Protective immobilizationProtective immobilization
Tape or braceTape or brace
Modalities as neededModalities as needed
Early ROM exercisesEarly ROM exercises
Strength & proprioception Strength & proprioception exercisesexercises
Return to activity when functionalReturn to activity when functional
Average return 7-10 daysAverage return 7-10 days
EtiologyEtiology Relatively uncommonRelatively uncommon
Significant inversion forceSignificant inversion force
Subluxation and relocationSubluxation and relocation
PathologyPathology Anterior talofibular ligamentAnterior talofibular ligament
Calcaneofibular ligamentCalcaneofibular ligament
Anterior tibiofibular ligamentAnterior tibiofibular ligament
3º Inversion Sprain3º Inversion Sprain
Signs and SymptomsSigns and Symptoms Severe painSevere pain EdemaEdema Hemarthrosis (blood in joint)Hemarthrosis (blood in joint) EcchymosisEcchymosis Inability to bear weightInability to bear weight Positive TestsPositive Tests
Anterior drawerAnterior drawer Talar TiltTalar Tilt
ManagementManagement RICERICE Refer to MDRefer to MD
Eversion SprainEversion Sprain EtiologyEtiology
Indirect Indirect Direct force Direct force Eversion of ankleEversion of ankle Inversion of ankleInversion of ankle
Crush injuryCrush injury SymptomsSymptoms
Pain Pain Active motionActive motion Resistive motionResistive motion Loss of functionLoss of function Weight bearingWeight bearing
Collapse of archCollapse of arch
SignsSigns Tenderness Tenderness
Deltoid ligamentsDeltoid ligaments SwellingSwelling EcchymosisEcchymosis
Special TestsSpecial Tests Valgus stressValgus stress External rotation testExternal rotation test
ManagementManagement Arch and ankle tapingArch and ankle taping OrthoticsOrthotics