1/14/2015 1 A. Holly Johnson, M.D. Massachusetts General Hospital Harvard Medical School Boston, MA USA I have no potential conflicts with this talk Epidemiology >2 million ankle sprains every year in US 40-45% of sports injuries are ankle injuries 85% inversion sprains Anatomy Lateral ligaments ATFL CFL PTFL Medial ligaments Deltoid Syndesmosis AITFL, PITFL, transverse, interosseous membrane Classification Grade I Grade II Grade III Initial Evaluation Palpate the ankle and the foot! Bones Ligaments Tendons Attempt gentle ROM X-rays ankle +/- foot – WB if possible Can’t walk Suspicious tenderness
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1/14/2015
1
A. Holly Johnson, M.D. Massachusetts General Hospital
Harvard Medical School
Boston, MA
USA
I have no potential conflicts with this talk
Epidemiology
>2 million ankle sprains
every year in US
40-45% of sports
injuries are ankle
injuries
85% inversion sprains
Anatomy
Lateral ligaments
ATFL
CFL
PTFL
Medial ligaments
Deltoid
Syndesmosis
AITFL, PITFL, transverse, interosseous membrane
Classification
Grade I Grade II Grade III
Initial Evaluation
Palpate the ankle and
the foot!
Bones
Ligaments
Tendons
Attempt gentle ROM
X-rays ankle +/- foot –
WB if possible
Can’t walk
Suspicious tenderness
1/14/2015
2
Initial Treatment
RICE
NWB vs WBAT Ankle supports Functional
Rehabilitation
Recovery Phases Phase 1 (1-2 weeks)
Protect the ankle, reducing swelling
Phase 2 (1-2 weeks, when WB) Restore ROM, strength,
flexibility
Phase 3 (weeks to months) Gradual return to
running, elliptical, swimming, sport
RICE
PT – gait, strength,
PT – proprioception, prepare for return to sport, then cutting, plyo, sport specific activ