THE ANKLE

CHAPTER 18The Ankle and Lower Leg

Introduction

“Have you ever sprained your ankle, or do you know anyone who has?”

What did you do for it? How long did the pain last? Do you have any problems

with that ankle?

Anatomy of the Ankle What bone make up the

Ankle joint?

Tibia Fibula Talus Calcaneus

Online Ankle Quiz

Access the following link and take the online bones of the Ankle quiz.

http://www.csuchico.edu/~sbarker/shock/Anklequiz.html

Anatomy of the Ankle What type of joint is

the Ankle?

The Ankle joint is a HINGE JOINT

The TALOCRURAL Joint

Major Ligaments of the Ankle LATERAL ASPECT

Anterior Tibiofibular

Anterior Talofibular- 3

Calcaneofibular- 6

Posterior Talofibular- 9

Major Ligaments of the Ankle

MEDIAL ASPECT

Posterior Talotibial Posterior

Talocalcaneal Deltoid

Muscles and Tendons around the Ankle

Achilles Tendon

Peroneal Tendinitis

Anterior Tibialis Tendinitis

Posterior Tibialis Tendinitis

Common Ankle Injuries

Inverted Ankle Sprain

Everted Ankle Sprain

Ankle Dislocation

Muscle and Tendon Strains

Inverted Ankle Sprain Inversion Ankle Sprain-

the foot turns inward rolling over the lateral aspect of the ankle.

Most common ankle sprain- about 85% of all ankle sprains

Everted Ankle Sprain

Eversion Ankle Sprain- the turns inward. The ankle rolls in medially.

Uncommon sprain due to bone support.

Occurs in about 10-15% of ankle sprains.

Ankle Dislocation/Fracture Ankle Dislocation -

Fracture Medical Emergency Usually the foot is

inverted. Frequently both the

Tibia and Fibula are fractured.

Ankle Dislocation/Fracture - Medical Emergency

Muscle and Tendon Strains

Most common is the Achilles Tendon Strain.

THOMPSON Test the Achilles.

Peroneal tendon sometimes damaged with inversion ankle sprain.

Video on Ankle Injuries

NOTES on VIDEO:

Grading Scales for Sprained Ankles

GRADE I

GRADE II

GRADE III

Most common ankle sprain. Mild pain, still weight baring.

More painful, report popping sound. Can not bear weight. Stretching of lateral ligaments of the ankle.

Extreme pain. Usually complete tear of one of the ankle ligaments.

Sometimes fracture occurs also.

Rehab/Treatment Plan for Sprained Ankles

RICE

Modalities

Exercises

RICE Rest- stay off the Ankle,

crutches may be needed Ice- 15 minutes a 4 to 5 times a

day Compression- ace wrap with

horseshoe keeps the swelling down

Elevation- keep ankle above heart level when possible, allows gravity to pump out swelling

Goals of RICE Limit Swelling

Reduce pain

Return to sport/activity quicker

Modalities Used COLD WHIRLPOOL- 15 minutes a couple times

a day Vasoconstrictors vessels

around ankle Stimulates pain killing

receptors Slows cell metabolism Aids in reducing swelling

Modalities Used HIGH VOLTAGE- Assists in activating pain killing

receptors. Assists in muscle stimulation

around ankle joint to aid in edema removal.

ULTRASOUND- Assists in edema removal. Assists in bringing digestive

enzymes to clean debris cells of the injured ankle.

Rehab Exercises Range of Motion ABC’s One leg Stands BAPS Board Towel Curls Toe Pickups Toe Rises Theraband

Taping Vs. Wrapping

TAPING- Psychologically better

feeling to the athlete Tight fitting at first Tape looses a large

percentage of its support within the first 15-20 minutes of competition

Taping Vs. Wrapping

WRAPPING- Purpose in wrapping is

injury prevention. Wrapping will not

eliminate sprained ankle, but it does minimize the severity of the sprain.

Ankle Braces

ANKLE BRACES- Many varieties and types. Lace Up Hinged Air Casts All offer different levels of

support. Large and competitive

business market for ankle braces.

Ankle Braces

Ankle Braces

Ankle Braces

Video on Cramer Ankle Brace Notes on Video:

Questions Over Ankle

Notes: