ANKLE INJURIES

UNIT 6

FOOT, ANKLE, AND, LOWER LEG

Sports Medicine

ANKLE INJURIES

Ankle Sprain Evaluation

Sports Medicine

SPRAINS 1ST, 2ND, 3RD DEGREE● STRETCH OR TEAR TO A LIGAMENT● LIGAMENTS CONNECT BONE TO

BONESTRAINS 1ST, 2ND, 3RD DEGREE

● STRETCH OR TEAR TO A MUSCLE OR TENDON

1ST DEGREE- STRETCHED BUT NOT TORN2ND DEGREE- TORN BUT STILL INTACT3RD DEGREE- RUPTURED OR COMPLETELY TORN

Sprains/Strains

ANKLE INJURIES

Ankle Sprain Evaluation● First Degree ankle sprain usually

occurs to the anterior talofibular ligament

● usually takes the athlete 2-4 days (+/-) before returning to play.

Sports Medicine

ANKLE INJURIES

Ankle Sprain EvaluationFirst Degree

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ANKLE INJURIES

Ankle Sprain EvaluationSecond Degree ankle sprain usually

occurs to the anterior talofibular, posterior talofibular and calcaneofibular ligaments ● usually takes the athlete 7-10 days (+/-) before returning to play.

Sports Medicine

ANKLE INJURIES

Ankle Sprain EvaluationSecond Degree

Sports Medicine

ANKLE INJURIES

Ankle Sprain EvaluationThird Degree ankle sprain usually

occurs to the anterior talofibular, posterior talofibular, calcaneofibular ligaments,and deltoid ligament● usually takes the athlete 4-6 weeks (+/-) before returning to play.

Sports Medicine

ANKLE INJURIES

Ankle Sprain EvaluationThird Degree

Sports Medicine

ANKLE INJURIES

Ankle Sprain EvaluationSyndesmotic or “high” ankle sprain

occurs to the anterior tibiofibular, posterior tibiofibular ligament and usually takes the athlete 4 weeks (+/-) before returning to play.

Sports Medicine

ANKLE INJURIES

Ankle Sprain EvaluationSyndesmotic or “High”

Sports Medicine

ANKLE INJURIES

Ankle Sprain EvaluationSyndesmotic or “High”

Sports Medicine

ANKLE INJURIES

Ankle Sprain EvaluationInversion Ankle SprainMOI●Inversion ankle sprains

usually result from traumatic inversion or inversion plantar flexion.

Sports Medicine

ANKLE INJURIES

Inversion Ankle SprainSigns/Symptoms●Observation- Swelling, discoloration, decrease in motor function (ROM).

Sports Medicine

ANKLE INJURIES

Inversion Ankle SprainSigns/Symptoms●Palpation- Athlete will

exhibit pain and pointtenderness on the ATF, PTF, and/or CF depending upon severity.

Sports Medicine

ANKLE INJURIES

Inversion Ankle SprainSigns/Symptoms●Stress

Anterior drawer test: This test is used to evaluate injury to the ATF. This test is performed by first stabilizing the tibia and calcaneus. The tibia is then pushed posterior as the calcaneus is pulled anteriorly. A positive test is indicated if the talus slides forward from under the tibia.

Sports Medicine

ANKLE INJURIES

Inversion Ankle SprainSigns/Symptoms●Stress

Anterior drawer test:

Sports Medicine

ANKLE INJURIES

Inversion Ankle SprainSigns/Symptoms●Stress

Talar tilt test: This test is used to evaluate injury to the ATF, PTF, and CF ligaments. This test is performed by positioning the ankle at 90 degrees. While stabilizing the lower leg the calcaneus is then inverted.

Sports Medicine

ANKLE INJURIES

Inversion Ankle SprainSigns/Symptoms●Stress

Talar tilt test:

Sports Medicine

ANKLE INJURIES

Inversion Ankle SprainAIM●Rest, ice, compression, elevation.●Horse Shoe, compression sleeve/sock●The athlete is progressed according to clinical and functional symptoms exhibited.Rehab●Strengthen (How?) ●Proprioception (How?)

Sports Medicine

ANKLE INJURIES

Eversion Ankle Sprain●MOI

Eversion ankle sprains usually result from an eversion MOI and represent only 5-10 percent of all ankle sprains. Eversion ankle sprains are typically more severe than there inversion counterparts.

Sports Medicine

ANKLE INJURIES

Eversion Ankle Sprain●MOI

Sports Medicine

ANKLE INJURIES

Eversion Ankle SprainSigns/Symptoms

●Observation- Swelling, discoloration, decrease in motor function (ROM).

Sports Medicine

ANKLE INJURIES

Eversion Ankle SprainSigns/Symptoms

● Palpation- Athlete willexhibit pain andpoint tenderness onthe deltoid ligament.

ANKLE INJURIES

Eversion Ankle SprainSigns/Symptoms

●Stress- Ankle eversion test: This test is used to evaluate injury to the deltoid ligament. This test is performed by positioning the ankle at 90 degrees. While stabilizing the lower leg the calcaneus is then everted.

Sports Medicine

ANKLE INJURIES

Eversion Ankle SprainSigns/Symptoms

●Stress- Ankle eversion test:

Sports Medicine

ANKLE INJURIESEversion Ankle SprainAIM●Rest, ice, compression, elevation.●Horseshoe, compression sleeve/sock●The athlete is progressed according to clinical and functional symptoms exhibited.Rehab●Strengthening (How?)●Proprioception (How?)

Sports Medicine

ANKLE INJURIES

Syndesmotic Ankle Sprain (“High” Ankle Sprain)MOI●Syndesmotic ankle sprains occur to the distal tibiofibular joint and involve the anterior and/or posterior tibiofibular ligaments. ●Syndesmotic ankle sprains usually result from an external rotation or forced dorsiflexion MOI and are often injured in conjunction with inversion and/or eversion sprains.

Sports Medicine

ANKLE INJURIES

Syndesmotic Ankle Sprain (“High” Ankle Sprain)MOI

Sports Medicine

ANKLE INJURIES

Syndesmotic Ankle Sprain (“High” Ankle Sprain)

Sports Medicine

ANKLE INJURIES

Syndesmotic Ankle Sprain (“High” Ankle Sprain)Signs/Symptoms●Observation- Swelling, discoloration, decrease in motor function (ROM). Athlete is unable to bear weight.

Sports Medicine

ANKLE INJURIES

Syndesmotic Ankle Sprain (“High” Ankle Sprain)Signs/Symptoms●Palpation- Athlete will exhibit severe pain, point tenderness, and loss of function at the tibiofibular ligaments.

Sports Medicine

ANKLE INJURIES

Syndesmotic Ankle Sprain (“High” Ankle Sprain)Signs/Symptoms●Stress- The ankle is passively externally rotated and/or dorsiflexed.

Sports Medicine

ANKLE INJURIES

Syndesmotic Ankle Sprain (“High” Ankle Sprain)AIM●Rest, ice, compression, elevation .●The athlete is progressed according to clinical and functional symptoms exhibited.Rehab ●Strengthening (How?)●Proprioception (How?)

Sports Medicine

ANKLE INJURIES

Ankle/Lower Leg Fractures

Sports Medicine

ANKLE INJURIES

Ankle/Lower Leg Fractures

Sports Medicine

ANKLE INJURIES

Ankle/Lower Leg Fractures

Sports Medicine

ANKLE INJURIES

Ankle/Lower Leg Fractures

Sports Medicine

ANKLE INJURIES

Special Tests for Bony Integrity (Fracture)Squeeze Test

Sports Medicine

ANKLE INJURIES

Special Tests for Bony Integrity (Fracture)Heel Tap (Percussion)

Sports Medicine