Transcript Ankle - Helena Public School District

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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Bones
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Tibia (Medial Malleolus)
Fibula (Lateral Malleolus)
Calcaneus
Talus
Lateral Ligaments
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Anterior talofibular
Calcaneofibular
Posterior talofibular
Medial ligaments
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Deltoid Ligaments
Ankle re-injury
 Tight Achilles
tendon is the
major cause of recurrent ankle
sprains
Prevention
Stretch musculature of the ankle
 Resistive strengthening of the musculature
 Inversion
 Eversion
 Plantar flexion
 dorsiflexion
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Mechanism of injury
Inversion
 eversion
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Inversion
Stepping in a hole
 Stepping on another persons foot
 Stepping on a rock
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Anterior talofibular ligament injured
Eversion ankle sprain
Stepping in a hole
 Stepping on another persons foot
 Stepping on a rock
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Deltoid ligament injured
1st degree (Mild) ankle sprain
Ligaments are stretched
 Minor discomfort
 Point tenderness
 Mild swelling
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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
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3rd degree (Severe) Ankle sprain
Ligaments are completely torn
 Extreme pain
 Total loss of function
 Point tenderness
 Rapid swelling
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Evaluation
 History
 Subjective
 Observation/Inspection
 Objective
 Palpation
 Action taken
 Specific testing
 Plan
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
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Observation
Bleeding
 Swelling
 Discoloration
 Deformity
 Bilaterally comparison
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Palpation
Look at bony landmarks
 Soft tissue
 Bilateral comparison
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Fracture
Direct pain
 Indirect pain
 Deformity
 Grating sounds (Crepitation)
 Testing
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Compression
 Percussion
 Tuning fork
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Functional Testing
Passive ROM
 Active ROM
 Resistive ROM
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Sports Specific Testing
Hop 10 times on injured limb
 Walk
 Run straight
 Run circles
 Figure 8’s
 Zig zag
 90 degree cutting
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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
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Once the bleeding has stopped
Apply heat before activity and ice after to…
 Remove waste product from injured area
 Promote healing
 Increase ROM
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Rehabilitation
Recovery is:
 Absence of pain
 Full ROM
 Full Strength
 Full flexibility
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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
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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
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Resistive Exercises continued
Closed chain kinetic exercises
 BOSU ball exercises
 Trapoline exercises
 Dinodisc exercises
 Voo doo board exercises
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Return to activity
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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
Heel Bruise
Heel and arch receives, absorbs and
transfers most of the impact
 Heel Bruise is one of the most disabling
contusions
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Heel bruise Treatment
Heel lift (poss. donut hole)
 Cold application before and ice after
Activity
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Plantar Fasciitis
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Wide inelastic ligament that supports the
arch of the foot
Cause of plantar Fasciitis
Overuse
 Overweight
 Tight Achilles
 Improper shoe support
 Running on hard surface
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Signs of plantar fasciitis
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Pain and tenderness on the bottom of the
foot near the heal
Treatment plantar fasciitis
RICE
 Tape support (slipper)
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Heel Spur
Bony growth on Calcaneus
 Cause
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Flat feet
Turf toe
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Sprain of the great toe (MP joint)
The great toe is important in movement, balance
and speed
Cause
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Treatment
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Foot sliding back on a slippery surface
Hyperextension of the big toe
RICE
Taping
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Turf toe taping
Taping Tests
Slipper
 Turf toe
 Achilles
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