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Ankle

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. Bones. Tibia (Medial Malleolus) Fibula (Lateral Malleolus) Calcaneus Talus. Lateral Ligaments.

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Ankle

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  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 muscular support

  2. Bones • Tibia (Medial Malleolus) • Fibula (Lateral Malleolus) • Calcaneus • Talus

  3. Lateral Ligaments • Anterior talofibular • Calcaneofibular • Posterior talofibular

  4. Medial ligaments • Deltoid Ligaments

  5. Ankle re-injury • Tight Achilles tendon is the major cause of recurrent ankle sprains

  6. Prevention • Stretch musculature of the ankle • Resistive strengthening of the musculature • Inversion • Eversion • Plantar flexion • dorsiflexion

  7. Mechanism of injury • Inversion • eversion

  8. Inversion • Stepping in a hole • Stepping on another persons foot • Stepping on a rock • Anterior talofibular ligament injured

  9. Eversion ankle sprain • Stepping in a hole • Stepping on another persons foot • Stepping on a rock • Deltoid ligament injured

  10. 1st degree (Mild) ankle sprain • Ligaments are stretched • Minor discomfort • Point tenderness • Mild swelling

  11. 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

  12. 3rd degree (Severe) Ankle sprain • Ligaments are completely torn • Extreme pain • Total loss of function • Point tenderness • Rapid swelling

  13. History Observation/Inspection Palpation Specific testing Subjective Objective Action taken Plan Evaluation

  14. 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

  15. Observation • Bleeding • Swelling • Discoloration • Deformity • Bilaterally comparison

  16. Palpation • Look at bony landmarks • Soft tissue • Bilateral comparison

  17. Fracture • Direct pain • Indirect pain • Deformity • Grating sounds (Crepitation) • Testing • Compression • Percussion • Tuning fork

  18. Functional Testing • Passive ROM • Active ROM • Resistive ROM

  19. Sports Specific Testing • Hop 10 times on injured limb • Walk • Run straight • Run circles • Figure 8’s • Zig zag • 90 degree cutting

  20. 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

  21. Once the bleeding has stopped • Apply heat before activity and ice after to… • Remove waste product from injured area • Promote healing • Increase ROM

  22. Rehabilitation • Recovery is: • Absence of pain • Full ROM • Full Strength • Full flexibility

  23. 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

  24. 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

  25. Resistive Exercises continued • Closed chain kinetic exercises • BOSU ball exercises • Trapoline exercises • Dinodisc exercises • Voo doo board exercises

  26. 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

  27. Heel Bruise • Heel and arch receives, absorbs and transfers most of the impact • Heel Bruise is one of the most disabling contusions

  28. Heel bruise Treatment • Heel lift (poss. donut hole) • Cold application before and ice after Activity

  29. Plantar Fasciitis • Wide inelastic ligament that supports the arch of the foot

  30. Cause of plantar Fasciitis • Overuse • Overweight • Tight Achilles • Improper shoe support • Running on hard surface

  31. Signs of plantar fasciitis • Pain and tenderness on the bottom of the foot near the heal

  32. Treatment plantar fasciitis • RICE • Tape support (slipper)

  33. Heel Spur • Bony growth on Calcaneus • Cause • Flat feet

  34. 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

  35. Taping Tests • Slipper • Turf toe • Achilles

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