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Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor muscular support
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Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Dec 16, 2015

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Page 1: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Ankle

The ankle is the most commonly injured joint in athletics

The bony structure of the ankle is very strong

With moderate ligament support And poor muscular support

Page 2: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Bones

Tibia (Medial Malleolus) Fibula (Lateral Malleolus) Calcaneus Talus

Page 3: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Lateral Ligaments

Anterior talofibular Calcaneofibular Posterior talofibular

Page 4: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Medial ligaments

Deltoid Ligaments

Page 5: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Ankle re-injury

Tight Achilles tendon is the major cause of recurrent ankle sprains

Page 6: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Prevention

Stretch musculature of the ankle Resistive strengthening of the musculature Inversion Eversion Plantar flexion dorsiflexion

Page 7: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Mechanism of injury

Inversion eversion

Page 8: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Inversion

Stepping in a hole Stepping on another persons foot Stepping on a rock

Anterior talofibular ligament injured

Page 9: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Eversion ankle sprain

Stepping in a hole Stepping on another persons foot Stepping on a rock

Deltoid ligament injured

Page 10: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

1st degree (Mild) ankle sprain

Ligaments are stretched Minor discomfort Point tenderness Mild swelling

Page 11: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

2nd Degree (Moderate) Ankle Sprain

Ligaments are stretched and/or Partially torn

Moderate pain Point tenderness Some loss of function Slight abnormal movement at the joint

Page 12: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

3rd degree (Severe) Ankle sprain

Ligaments are completely torn Extreme pain Total loss of function Point tenderness Rapid swelling

Page 13: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Evaluation

History

Observation/Inspection

Palpation

Specific testing

Subjective

Objective

Action taken

Plan

Page 14: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

History

How did it happen When did it happen Did you hear or feel a pop Where you able to walk on it right away

Page 15: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Observation

Bleeding Swelling Discoloration Deformity Bilaterally comparison

Page 16: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Palpation

Look at bony landmarks Soft tissue Bilateral comparison

Page 17: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Fracture

Direct pain Indirect pain Deformity Grating sounds (Crepitation) Testing

Compression Percussion Tuning fork

Page 18: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Functional Testing

Passive ROM Active ROM Resistive ROM

Page 19: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Sports Specific Testing

Hop 10 times on injured limb Walk Run straight Run circles Figure 8’s Zig zag 90 degree cutting

Page 20: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Treatment

Rest Ice 20 minutes every two hours Compression with horseshoe/elastic wrap Elevation Avoid heat in any form Remove elastic wrap before bedtime Follow this treatment for 1-72 hours

Page 21: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Once the bleeding has stopped

Apply heat before activity and ice after to… Remove waste product from injured area Promote healing Increase ROM

Page 22: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Rehabilitation

Recovery is: Absence of pain Full ROM Full Strength Full flexibility

Page 23: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Range of motion

Working toward complete pain free ROM Flex & Plantarflex foot as far as possible Invert and evert foot as far as possible Circular motion clockwise and counter Write capital letters with the toes Achilles tendon stretch

Page 24: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Resistive Exercises

Walk on hells and toes (toes up, out, & in) Pick up marbles with toes Towel toe curl Isometric inversion and eversion with chair

legs Calf (heel) raises with feet straight in & out

Page 25: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Resistive Exercises continued

Closed chain kinetic exercises BOSU ball exercises Trapoline exercises Dinodisc exercises Voo doo board exercises

Page 26: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Return to activity

Do all of the following at 50,75, & 100% Hop 10 times on injured limb Walk Run straight Run circles Figure 8’s Zig zag 90 degree cutting

Page 27: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Heel Bruise

Heel and arch receives, absorbs and transfers most of the impact

Heel Bruise is one of the most disabling contusions

Page 28: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Heel bruise Treatment

Heel lift (poss. donut hole) Cold application before and ice after

Activity

Page 29: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Plantar Fasciitis

Wide inelastic ligament that supports the arch of the foot

Page 30: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Cause of plantar Fasciitis

Overuse Overweight Tight Achilles Improper shoe support Running on hard surface

Page 31: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Signs of plantar fasciitis

Pain and tenderness on the bottom of the foot near the heal

Page 32: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Treatment plantar fasciitis

RICE Tape support (slipper)

Page 33: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Heel Spur

Bony growth on Calcaneus Cause

Flat feet

Page 34: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Turf toe

Sprain of the great toe (MP joint) The great toe is important in movement, balance

and speed Cause

Foot sliding back on a slippery surface Hyperextension of the big toe

Treatment RICE

Taping Turf toe taping

Page 35: Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor.

Taping Tests

Slipper Turf toe Achilles