1. Ankle Evaluation

2. HI(O)PS History History Inspection/Observation Inspection/Observation Palpation Palpation Special Tests Special Tests

3. History M: Mechanism of Injury (position of foot, playing surface, type of shoes, how injury happened M: Mechanism of Injury (position of foot, playing surface, type of shoes, how injury happened A: Acute or Chronic A: Acute or Chronic P: Pain (location & type: sharp, dull, burning, etc.) P: Pain (location & type: sharp, dull, burning, etc.) P: Previous Injury? (which ankle, when?) P: Previous Injury? (which ankle, when?) S: Sounds (noises at time of injury or since: popping, snapping, cracking, etc.) S: Sounds (noises at time of injury or since: popping, snapping, cracking, etc.) S: Signs & Symptoms S: Signs & Symptoms

4. Inspection/Observation Swelling (localized or general) Swelling (localized or general) Deformity (flat feet, high arches, etc.) Deformity (flat feet, high arches, etc.) Dislocation (abnormal positioning of the foot or ankle) Dislocation (abnormal positioning of the foot or ankle) Discoloration Discoloration

5. Palpation Palpate for areas of swelling, pain, or abnormaility. Palpate for areas of swelling, pain, or abnormaility. Palpate both extremities, uninjured first Palpate both extremities, uninjured first

6. Palpation Cont. Bony Landmarks: Bony Landmarks: –Tibia & Medial Malleolus –Fibula & Lateral Malleolus –Base of 5 th Metatarsal –Caclcaneus

7. Palpation Cont. Ligaments: Ligaments: –Medial: Deltoids –Lateral:  Anterior Talofibular  Calcaneofibular  Posterior Talofibular –Anterior:  Anterior Tibiofibular

8. Palpation Cont. Musculature: Musculature: –Gastrocnemius (calf muscle) –Achilles Tendon (posterior aspect of ankle) –Peroneal Muscles & Tendon (lateral aspect of lower leg and ankle) –Anterior Tibialis Muscle & Tendon (anterior aspect of lower leg and ankle)

9. Special Tests Do ALL tests bilaterally Do ALL tests bilaterally Uninjured side first Uninjured side first

10. Special Tests Cont. Range of Motion: Range of Motion: –Active ROM (PF, DF, Inv., & Ever.)  Athlete performs movement –Passive ROM (PF, DF, Inv., & Ever.)  Examiner performs movement –Resisted ROM (PF, DF, Inv., & Ever.)  Examiner applies resistance as athlete performs movement  Only do if athlete can perform active ROM & no fracture is suspected

11. Special Tests Cont. Stress Tests: Stress Tests: –Anterior Drawer Test:  Tests the Anterior Talofibular Ligament –Foot relaxed in neutral position, pull calcaneus anteriorly –+ result = pain, excess movement, or both –Inversion Test:  Tests Lateral Ligaments –Passively invert ankle in PF, Neutral, & DF –+ result = pain during movement

12. Special Tests Cont. Stress Tests Cont.: Stress Tests Cont.: –Eversion Test:  Tests Deltoid Ligaments –Passively evert ankle in DF, Neutral, PF –+ result = pain during movement –Thompson’s Test:  Tests Achilles Tendon –Athlete lying prone, foot relaxed in neutral position, squeeze Gastrocnemius, foot should PF normally –+ result = pain, lack of normal movement, or both

13. Special Tests Cont. Stress Tests Cont.: Stress Tests Cont.: –Percussion (Bump) Test:  Tests for fracture in lower leg or ankle –Tap plantar surface of calcaneus –+ result = pain radiating up leg –Compression Test:  Tests for fracture in lower leg or ankle –Compress Tibia & Fibula together all the way up & down lower leg –+ result = pain radiating up leg

14. Functional Tests Walking Walking Go up on toes (both feet together, then separately Go up on toes (both feet together, then separately Rock back on heels Rock back on heels Jogging, progressing to sprinting (straight ahead, figure 8, Z pattern) Jogging, progressing to sprinting (straight ahead, figure 8, Z pattern) Hopping (both feet together, then separately Hopping (both feet together, then separately Sports Specific Skills Sports Specific Skills