The Ankle

Bones

TibiaFibulaTalus

Movements

Dorsal Flexion- most stable positionPlantar Flexion- Most unstableEversionInversion

Ligaments

Medial Side Deltoid Ligament- has 4 attachments

Tibionavicular, tibiocalcaneal, anterior tibiotalar, posterior tibiotalar

Lateral SideAnterior talofibular (most commonly

sprained) Calcaneofibular Posterior talofibular Anterior tibiofibular Posterior tibiofibularPosterior talocalcanealLateral talocalcaneal

Muscles, Arteries, Nerves

See foot notes

Ankle Landmark Test

Start Posterior then medial lateral last Achilles Tendon Medial Mallious Deltoid Ligament Lateral Mallious Posterior Talofibular Calcanealofibular Anterior Talofibular Base of the 5th

MUST COMPLETE IN THIS ORDER FOR 4.

Sprains

- 85% of injuries sprains- 90% of sprains are inversion

The Ankle Story

Trainer focus on lower body movement during play

When player goes down trainer trot to athleteKeep athlete downLook for abnormal angles

The Ankle Story cont.

Ask questions- feel anything tear, pop, pain or discomfort, shooting pain

If no deformity- ask if they can stand two man walk with leg up. If they cant stand two man carry

The ankle story cont

Bare ankle Look for swelling, discoloration Find point tender spot palpate

Start posterior, Achilles, deltoid ligaments, navicular, base of 5th, posterior Talofibular, calcaneofibular, anterior talofibular

Fracture Test s/sx- vertical shooting pain, heel tap, mallelous tap lower

leg squeeze

The Ankle Story Cont.

Ligament stress test Drawer stress- tear of anterior talofibular

Hand on top of leg other on heel pull up hard Invesion stress- tear calcaneofibular

Turn heel in

The Ankle Story Cont.

Range of Motion (ROM) Passive and Active- DF,PF,IV, EV

Manuel muscle Test- Tell athlete to not let you move foot in all ROM

The Ankle Story

Bare Foot Test Stand on toes of both feet Jump with both feet- watch for double slap Hop on injury Walk forward and backward Walk forward and backward Put Maximum Tape support

Have athlete run forward and backwards, figure 8, grapevine, slides, skip.

If pain stop

The ankle story cont.

If unable to return RICE.If able to pass bare foot test return to play as tolerated.

Strains

Can be independent of part or sprainStrain of the peroneal muscles

Usually part of lateral ankle sprain Point tender over from base of 5th (in severe xray to

rule out avulsion fracture) posterior malleolus up lateral side of leg

Weakness with eversion on muscle test Treatment- RICE, strength eversion.

Strains

Anterior and dorsum muscle strains- extensor Cause by forced into extreme dorsal flexion,

running backwardsPoint tenderness over nails of toes

Strains

Achilles Tendinitis Causes- overuse or acute, tight Achilles or part of

ankle sprain, or independent S/sx- point tenderness over achilles, pain with dorsal

flexion, weakness with plantar flexion Tx- Stretch achilles, strengthen plantar flexion, RICE,

tape to play Can lead to achilles tendon rupture.

Strains