ankle Flashcards
basic physical examination have?
5
the ankle ligaments have which of the following
posterior and anterior talufibular and calcaneofibular
the grades of the ankle sprains are
minor moderate and severe
the ankle is stable or unstable joint?
unstable without the ligaments
pronation and eversion
medial ligaments
supination and inversion
lateral ligaments
most common injury of the ankle is
inversion of the ankle , which ankle rolls outside
most common damaged ligament is
talofibular (anterior)
if the damage of the ankle is worse
calcaneofibular
ATFL and CFL sprains
results from inversion and plantarflexed foot
DCL sprain
from eversion mechanism injury
which to which
severe edema
little to no edema
mild to moderate edema
severe= grade three sprain
little to no= grade one sprain
mild to modertate= grade 2 sprain
which to which
stretching ligaments, especially ATFL
partially tearing the ATFL and CFL
substantial tearing ATFL and CFL with the PTFL
stretching ATFL= 1st grade
partial tearing ATFL=2nd grade
substantial tearing ATFL CFL and PTFL=3rd grade
which to which
point tenderness
point and diffuse tenderness
point tenderness= 1st grade
point and diffuse tenderness =2nd and 3rd grades
which to which
limited dysfunction
moderate dysfunction
moderate to severe dysfunction
limited dysfunction 1st grade
moderate dysfunction 2nd grade
moderate to severe dysfunction= 3rd grade
slight laxity
moderate laxity
moderate to severe laxity
slight=1st grade
moderate=2nd grade
moderate to severe=3rd grade
able to bear full weight
grade one
antalagic gait and pain with FWB and using AD
grade 2
no ability to FWB without supportive device
grade 3
return to activity for grade one is 1 to 3 weeks
true or false?
false from 1 to 2 weeks
return to normal activity for grade 2 from 4 to 6 weeks
true or false?
false
4 to 8 weeks
for grade three returning to normal activity from 12 t 16 weeks
true of false?
true
drawer test is for assessment of anterior talofibular ligament only
true
talar tilt test is for CFL only
false
ATL and CFL
how many steps for treating and rehabilitating ankle injuries
6 steps
what is the 1st step for treating the injury?
protect the area from further injuries
for the 3rd step of treating the injury is decreasing swelling and pain
true or false?
false it is the 2nd step
the mobility, ROM and flexibility reastabilitsh is for the 3rd step of treating the injury
true or false?
true
step 4 is neuromuscular control strength endurance and power for treating the injury
true or false
true
what is the 5th step for treating the injury?
reestablish proprioception, coordination and agility
what is the final step for treating the injury ?
reestablish function skills
how many stages for the ankle sprain?and what are they?
3 stages are acute, subacute, maturation
maintain over all body condition is related to which stage
all stages acute subacute and maturation
maintain the function of the noninjured tissues related to which stage
acute stage
prevent reinjury is for which stage
acute and subacute and maturation
encourage tissue healing and limitation swelling pain and spasm for which stage
acute stage
decreasing pain and swelling, Promote tissue healing.
* Restore ROM and flexibility.
* Re-establish neuromuscular control and restore muscular strength and endurance.
* Re-establish proprioception, agility, and coordination. are for which stage?
subacute stage
Restore ROM and flexibility.
* Improve muscular strength, endurance, and power.
* Improve proprioception, agility, and coordination.
for which stages
subacute and maturation
improve for functional activities like sports to which stage
maturation
how many goals for each stage have?
acute
subacute
and maturation
acute=5
subacute=7
maturation=6
how many criteria should the patient have for returning to activities?
6
what are the criteria for returning to functional activities
no pain and swelling
having full ROM, strength, endurance, and power
adequate proprioception, coordination, agility, and balance
psychologically ready
what is the method is used for the first 72 hours
PRICE
PRICE stands for what?
p= protection
R= rest
I= ice
C= compression
E= elevate
Taping
Functional bracing
Removable cast boot (grade2 and 3 sprains)
are used for what
protection
Reduce regular exercise and activities.
Avoid activities that cause pain, swelling and discomfort.
Use crutches
are used for what?
rest
how much ice is applied?
15 to 20 min repeat every 2-3 hours during the day and after exercise
what to use for compression?
elastic bandages and take it off during ex and bed for reducing swelling
list the modalities for treating sprains
ice
ultrasounds
transverse friction massage
high voltage galvanic or interferential
soft orthotic 1l8 - 3l16 inch lateral wedge
list some strengthening exercises
alphabet exercise
one leg standing with an eye opened and closed
ankle foot balance with clock and counter clock wise and gradually increase ROM
toe curls and pick up objects with toes are what ?
strengthening exercises
Weight bearing exercises.
Heel raises.
Toe raises.
Stair steps.
Quarter squats.
Concentric/Eccentric and isotonics
Peroneal strengthening
are for stretching exercises , true or false?
false , they are strengthening exercise
what are the stretching ex?
PROM , PF and DF but not eversion and inversion for acute phase
Achillis stress
joint mobilization
joint mobilization in stretching for which grades?
is for grade 2 and 1
what are the proprioceptive training examples
non-weight bearing to controlled weight bearing to full weight bearing
Standing BAPS board.
Standing wobble board.
Single-leg balance activities (Stable to unstable surfaces like ankle disc
what type of exercises should we give for sprain injuries?
stretching, strengthening, and proprioception training
the phases of training are they 3 or 4?
3
ice for 15-20 min and bandage compression after excersie are for which phase ?
1,2, and 3rd phase
what is the position of the 1st phase for exercising?
sitting or lying down
examples of exercises in phase one
1- slowly rotate, side to side, up and down 20 times for each in a lying positon
2- outstretched the injured leg in PF hold for 5 sec and repeat 1o times
outstretched the injured leg in DF hold for 30 sec repeat 2 times
alphapet exercise is mostly used for which phase
2nd phase
calf raises on toes for 3 sec as 3 sets and 10 repetitions and increasing WB on toes and then on one leg only then gradually on toes exercises are for which phase
2nd phase
in standing while pushing the wall the injured leg is the one forward and the non injured is backward
true or false?
false , the injured leg is backward and the noninjured in forward.
holding one leg standing for one minute to which phase ?
2nd phase
progressive return to sport at which phase
3rd phase
how many recommendations for the returning to sport are needed? list some of them
5 recommendations
. same strength in both feet and testing by raising toes and for 10 times
. can walk without limping
. can stand on injured leg for 10 sec
what is the first step for gradual jogging ?
1- walking or jogging on flat surface backward and forward
then
2- jogging like zigzags and number 8 with more difficult surfaces
then
3- doing step one and two without any pain and swelling progress to hopping on one leg
what are the 2nd and the 3rd steps on gradual progression of sport activities?
2nd tolerating hopping on one leg 5 times without any pain then the patient can return to the activity and using braces for increasing the stability is recommended
3rd returning fully to the competition if the full practice is done without any swelling and pain
how can we do the perturbation training?
by destabilizing forces
what does the perturbation enhance?
neuromuscular awareness and response and dynamic stability
examples of perturbation training
seated with tilt board
BOSU
examples of agility training
back pedaling
side stepping
carioca
what are the symptoms for Achilli’s tendinitis
morning stiffness
tenderness over the tendon
variable pain
what can we do to reduce last long morning stiffness of the Achillis tendinitis?
reduce reptetion of exercises if it didn’t work, we can take 2-5 days resting
what is the duration for Achilli’s tendonitis?
3-6 months
what exercise are done in phase one
1- tip toes raise with Stright legs with raising up with the healthy leg. and shift weight for both legs, repeat 3 sets for 15 repetitions twice a day
2-tip toes with bent knees
what is the progression to move for 2nd phase in Achillis tendinitis?
when there is no need to use the good leg to lower yourself you can progress, and the exercise becomes easier
what are the exercises for phase 2 on archils tendonitis
tiptoe raising on one leg with straight and bent knees 3 sets 15 rep. twice a day for each
explain phase 3 training for Achilli’s tendonitis
heel drops over the edge of a step with knee straight or knee bent
plantarflexed leg behind you with straight knee and putting flexed knee Infront of you like pushing the wall is stretching which muscle
gastrocnemius
plantarflexed leg behind you with Benting knee and putting flexed knee Infront of you like pushing the wall is stretching which muscle
soleus
plantar fasciae have what role in gait
dynamic function
obesity or sudden weight gain
tight Achillis tendonitis
foot arch
long distance running
shoes with poor arch support
are the risks factor for which injury?
plantar fascia
list characteristics of plantar fascia
severe in morning stiffness
pain alleviates with rest
severe with more wight or loading
occurs at bottom or near the heel
swollen heel and stiffness
US
Phonophoresis
Iontophoresis
Contrast bath are what?
electrotherapy treatment for plantar fascia
list the Manual Therapy for plantar fasciitis
Talocrural joint posterior glide
Subtalar joint lateral glide
Anterior and posterior glides of 1st tarsometatarsal joint
Subtalar joint distraction manipulation
what is the duration for stretching calf muscle for plantar fascitis?
sustained 3 min or intermittent 20 sec 3 to 2 times a day
calcaneal taping for relieving pain of the plantar fasciitis is for long term
true or fals?
false
short term relief
Prefabricated and custom-made orthosis
All these orthoses used for excessive foot supination and improvement of the condition.
false or true?
false
for pronation
Heel cuffs
Viscous elastic heel pad
Accommodative inlays
are what?
orthotic devices
how is the trigger point therapy applied?
Deep cross fiber friction or ischemic compression
night splints are used for patient with symptoms lesser than 6 months in duration.
true or false?
false greater than 6 months
splint maintain ankle in neutral position and toes in slight extension.
true or false?
true
list exercises for the plantar fasciitis
calf raises for 10rep
toe raises 30 sec for 3 times
stretch for 30 sec 2 times
tennis ball rollout 60 sec
heel pump 60 sec
toe curl 10 rep
