CHAPTER 18 The Ankle and Lower Leg
Introduction “Have you ever sprained your ankle, or do you know anyone who has?” What did you do for it? How long did the pain last? Do you have any problems with that ankle?
Anatomy of the Ankle What bone make up the Ankle joint? Tibia Fibula Talus Calcaneus
Online Ankle Quiz Access the following link and take the online bones of the Ankle quiz. http://www.csuchico.edu/~sbarker/shock/Anklequiz.html
Anatomy of the Ankle What type of joint is the Ankle? The Ankle joint is a HINGE JOINT The TALOCRURAL Joint
Major Ligaments of the Ankle LATERAL ASPECT Anterior Tibiofibular Anterior Talofibular- 3 Calcaneofibular- 6 Posterior Talofibular- 9
Major Ligaments of the Ankle MEDIAL ASPECT Posterior Talotibial Posterior Talocalcaneal Deltoid
Muscles and Tendons around the Ankle Achilles Tendon Peroneal Tendinitis Anterior Tibialis Tendinitis Posterior Tibialis Tendinitis
Common Ankle Injuries Inverted Ankle Sprain Everted Ankle Sprain Ankle Dislocation Muscle and Tendon Strains
Inverted Ankle Sprain Inversion Ankle Sprain- the foot turns inward rolling over the lateral aspect of the ankle. Most common ankle sprain- about 85% of all ankle sprains
Everted Ankle Sprain Eversion Ankle Sprain- the turns inward. The ankle rolls in medially. Uncommon sprain due to bone support. Occurs in about 10-15% of ankle sprains.
Ankle Dislocation/Fracture Medical Emergency Usually the foot is inverted. Frequently both the Tibia and Fibula are fractured.
Ankle Dislocation/Fracture - Medical Emergency
Muscle and Tendon Strains Most common is the Achilles Tendon Strain. THOMPSON Test the Achilles. Peroneal tendon sometimes damaged with inversion ankle sprain.
Video on Ankle Injuries NOTES on VIDEO:
Grading Scales for Sprained Ankles Most common ankle sprain. Mild pain, still weight baring. More painful, report popping sound. Can not bear weight. Stretching of lateral ligaments of the ankle. Extreme pain. Usually complete tear of one of the ankle ligaments. Sometimes fracture occurs also. GRADE I GRADE II GRADE III
Rehab/Treatment Plan for Sprained Ankles RICE Modalities Exercises
RICE Rest- stay off the Ankle, crutches may be needed Ice- 15 minutes a 4 to 5 times a day Compression- ace wrap with horseshoe keeps the swelling down Elevation- keep ankle above heart level when possible, allows gravity to pump out swelling
Goals of RICE Limit Swelling Reduce pain Return to sport/activity quicker
Modalities Used COLD WHIRLPOOL- 15 minutes a couple times a day Vasoconstrictors vessels around ankle Stimulates pain killing receptors Slows cell metabolism Aids in reducing swelling
Modalities Used HIGH VOLTAGE- Assists in activating pain killing receptors. Assists in muscle stimulation around ankle joint to aid in edema removal. ULTRASOUND- Assists in edema removal. Assists in bringing digestive enzymes to clean debris cells of the injured ankle.
Rehab Exercises Range of Motion ABC’s One leg Stands BAPS Board Towel Curls Toe Pickups Toe Rises Theraband
Taping Vs. Wrapping TAPING- Psychologically better feeling to the athlete Tight fitting at first Tape looses a large percentage of its support within the first 15-20 minutes of competition
Taping Vs. Wrapping WRAPPING- Purpose in wrapping is injury prevention. Wrapping will not eliminate sprained ankle, but it does minimize the severity of the sprain.
Ankle Braces ANKLE BRACES- Many varieties and types. Lace Up Hinged Air Casts All offer different levels of support. Large and competitive business market for ankle braces.
Ankle Braces
Ankle Braces
Ankle Braces
Video on Cramer Ankle Brace Notes on Video:
Questions Over Ankle Notes: