3. Ankle Sprains

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Grade 3 - ant drawer - talar tilt - lig damage instability - swelling - loss of function - loss of ankle motion

- ant drawer: POS - talar tilt: POS - lig damage instability: Complete tear, need sx - swelling: >2cm - loss of function: near total - loss of ankle motion: >10deg

Grade 2 ankle sprain - ant drawer - talar tilt - lig damage instability - swelling - loss of function - loss of ankle motion

- ant drawer: POS - talar tilt: neg - lig damage instability: partial tear, slight - swelling: 0.5-2cm - loss of function: some - loss of ankle motion: 5-10deg

Grade 1 ankle sprain - ant drawer - talar tilt - lig damage instability - swelling - loss of function - loss of ankle motion

- ant drawer: neg - talar tilt: neg - lig damage instability: stretchedl lig, no instability - swelling: =<0.5cm - loss of function: minimal - loss of ankle motion: =<5deg

when does inflammation subside for Grade 1 Grade 2 Grade 3

1 and 2: 2-4 days 3: 1-2w

when can you start progressive loading/sensorimotor training with Grade 1 Grade 2 Grade 3

1 and 2: 2-6w 3: 8-24w

freq of high ankle sprains

1-11% of all ankle sprains 40-74% in athletes ankle sprains

what is the recurrence rate of ankle sprains

40%

most common lig sprained in LCL ankle sprain - %

ATF- PF and inversion 73%

2 secondary lig for LCL ankle sprain and the test

Calcaneal fib- calc varus stretch (Medial Talar Telt Stress test) Posterior Talofib - evert and PF to pinch

Most common mechanism of injury for a lateral ankle sprain is... - FF (add/abd) - HF (inv/ever) - tib (ER/IR) - ankle (PF/DF)

FF add HF inv tib ER PF

exam test for chronic high ankle sprain

Kleiger test: ER stress test

what is the A level evidence ankle sprain intervention for progressive loading/sensorimotor training phase

Manual Therapy: mobs, manip

what injury is associated with syndesmosis injury

Med collateral or deltoid lig sprain during eversion

what 2 differential osseous injuries can occur during ankle sprain

Ottawa Ankle Rules Osteochondral lesion of talus

how to test for eversion ankle sprain

PF and evert

what is contraindicated during acute ankle sprain phase

US

Grade 1 sprain tx - WB? - crutches? - type of support - time lost from activity

WBAT crutches 0-4days ankle stabilization lose 4-14 days

Grade 2 sprain tx - WB? - crutches? - type of support - time lost from activity

WBAT crutches 1-3w ankle stabilization lose 2-6 w

Grade 3 sprain tx - WB? - crutches? - type of support - time lost from activity

WBAT crutches 3-6w walking boot 3w-->ankle stab 3w lose 4-26w

Mechanical instability compared to FAI

all the same BUT Positive Drawer sign is present

ICF for ankle ligament sprains

ankle stability and movement coordination impairments

gold standard for ankle sprains

ant drawer test

test for ATF sprain

anterior drawer test 20deg PF and pull talus forward excessive motion or pain for positive

positive impingement sign test indicates what

anterolateral ankle impingement of synovium btw talus and tib also ATF lig arthroscopy could be needed

Chronic Ankle instability CAI - develops when - occurence rate - 2 categories

develop after ankle sprains occurence in 20-40% of ankle sprain 1. FAI (functional ankle instability) 2. MI (mechanical instabilty)

high ankle sprain causes what to distal tibfib jt

diastasis or widening normally ligs prevent widening during WB

FAI - due to what - what deficits are present - is it associated with joint laxity

due to recurrent ankle sprains balance and sensorimotor deficits present NOT ASSOCIATED WITH JT LAXITY

what are the 3 A level evidence ankle sprain interventions for ACUTE phase

early WB w external support Cryo Therapeutic exercise

common mechanism of injury for high ankle sprain

forced excessive ankle motion w foot planted

will ant drawer test be positive for Functional or mechanical ankle instability

only for mechanical

common symptom of high ankle sprain

pain prox to TCJ cannot push off

during a lateral ankle sprain what muscles and nerves are also injured

peroneal muscles common fib n sural n

risk factors for ankle sprains

prev hx no external support after injury no warm up decr DF ROM No balance/prop program after injury Great Calcaneal varus Hip Ext weakness

what is the most common mechanism of injury for ankle sprains

sport athletics 45%

exam test for acute high ankle sprain

squeeze test: compress calf at midpoint

during a medial ankle sprain what muscles and nerves are also injured

tib posterior tibial n

Greater Calcaneal Valgus or Varus is a risk factor for ankle sprains and why

varus due to standing on the outside of the feet


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