Ankle Flashcards
How many degrees of DF do you need with knee flexed during heel/toe
10-15 degrees of DF
with knee flexed during stairs you need how many degrees of DF
ascending 15-25 degrees of DF
descending 20-35 degrees of DF
when walking and going up/down stairs you need how many degrees of PF
15-30 degrees of PF
the first MTP hyperextension need at least
65 degrees at heel and toe off
the three-foot arches are maintained by what?
-ligaments and aponeurosis most supported
-the shape of the bones and their relation to each other the keystone of the foot is (navicular)
-muscles only 15-25% of support so minimalability to strengthen any abnormal arch flattening
with the subtalar joint neutral the?
-talus is centered in the talocrural and on the calcaneus
-AKA the position the talus should be in
measurement for subtalar neutral are?
common and widely taught
poor and reliability and validity
not a sound basis for STJN or orthotic
it may produce + results but it is not measuring or assessing what is proposed
A better method should be pursed
measuring the medial longitudinal arch
the standing position is not predictable of dynamic function
Dynamic 2D measuring from a video or #D analysis are reliable measure of MLA
what is a Mild S&S; Activity may continue; Fibers are stretched but NOT torn so minimal to no change during ligamentous special tests
Grade 1/1st degree
what is Moderate S&S; Activity stops; Fibers stretched and torn so increased laxity with softer/later end feel during ligamentous tests
Grade 2/2nd degree
Severe S&S; Activity stops; Fibers torn completely with possible avulsion; Significant increase in laxity with empty end feels during ligamentous tests
Grade 3/3rd degree
what are the incidence and prevalence of sprains
-One of the MOST frequent injuries in sports39
-Up to ¼ of people unable to attend work for > 1 wk39
-Persistent symptoms in 3039-72%41
-80% re-injury rate following an IV sprain42; why?
what are the risk factors of a sprain?
Previous ankle sprain(s)
Lack of external support
Lack of warm up
Lack of coordination training
Impaired DF- what could be reasons for impaired DF?
what are sprain risk factors?
-Impaired DF 89 possibly due to…
*Shortened Triceps Surae (Calf)
*Talar hypomobility
Decreased posterior glide
Decreased ER
*Fibrosed capsule
Universal hypomobility
NO distraction and limited glides in all directions
-Limited DF may delay pronation and excessively load lateral foot
Lateral ankle sprians are caused by
excessive PF and IV
What are the structures involved with lateral sprains
the Talocrural Ligaments you have:
-ATF- MOST commonly torn
-CF :Primarily torn with pure IV and Will be on slack with PF
-PTF
Other structures involved with Lateral sprains are?
Subtalar or Talocalcaneal Ligaments
Anterior- interosseous lig
Lateral- attaches and runs parallel to CF lig so they will likely be damaged together
The Lateral sprains structures that are involved with bone are?
-Avulsion fx of lateral malleolus due to ligamentous attachment
-Avulsion fx of 5th MT from excessive action of Peroneus Brevis
-Medial malleolus fx due to compression with excessive IV
-Cuboid displacement due to excessive action of Peroneus Longus
-Fibula anteriorly subluxed on Tibia by reversal of m. action of Peroneals
-Muscles/tendons- possible Peroneal strain and/or subluxation if retinaculum torn
-Epiphyseal plate avulsions- lateral malleolus and 5th MT
what are the symptoms of Lateral Sprains?
-Sudden onset with trauma by “rolling ankle” and the foot turning inward
-Lateral ankle P!/swelling
-Limited and P!ful ROM, especially pointing foot and turning inward
- Difficult and painful weight bearing
what are signs of lateral sprains?
*Observation
Swelling and possible ecchymosis
Antalgic and asymmetrical gait
*Ottawa and Bernese Ankle Clinical Decision Rules (CDR)- determine need for radiographs89
*ROM- primary limited and P!ful PF and IV
*Resisted/MMT- possibly weak and P!ful EV
Signs of lateral ankle sprains?
-Special Tests- (+) lateral ligamentous tests
*Talocrural
Generally, with Ant ( high spec) and Reverse Ant Drawer (high spec)
*Specific lateral ligament tests: ATF with
Antlat Drawer (high sens) and Reverse Antlat Drawer (high sens/spec)
Antlat Talar Palpation
-CF with Medial Talar Tilt (higher sens/spec)
-PTF
Signs of Lateral Ankle sprains
Special Tests- (+) lateral ligamentous tests
Subtalar
-Anterior interosseous
-Lateral Talocalcaneal
*TTP over involved structures
