Ankle Flashcards
_______ ankle sprains account for about _____ of ankle sprains
Plantarflexion and inversion
90%
The talus is the ___ largest tarsal
2nd
What is the main weight bearing bone in the foot
Talus
What shape is the talus
Square
The most stable position of the ankle is in
Dorsiflexion
Dorsiflexion
Anterior tibialis
Plantarflexion
Gastrocnemius Soleus Posterior tibialis Peroneus longus Peroneus brevis
Inversion
Anterior tibialis
Posterior tibialis
Lateral ligament support
Anterior tibiofibular Posterior tibiofibular Anterior talofibular Posterior talofibular Calcaneofibular
Medial ligament support
Deltoid
Primary eversion resister
Deltoid ligament
Palpations should start with
Bony sites
What is the purpose of palpation
To detect obvious defects, swelling, localized tenderness
Bony palpation sights on the medial plane
Medial malleolus
Navicular
Talus
Cuneiforms
Bony palpation sites on the lateral side
Lateral malleolus
Proximal base of the 5th metatarsal
Cuboid
Soft palpation sites on the medial side
Deltoid ligament
Soft palpation sites on the lateral side
Anterior talofibular ligament Posterior talofibular ligament Calcaneofibular ligament Peroneal tendon Anterior tibiofibular ligament
Soft palpation sites on the posterior side
Achilles’ tendon
Restrains anterior displacement of talus
Anterior talofibular
Restrains inversion of calcaneous
Calcaneofibular
Restrains posterior displacement of talus
Posterior talofibular
Prevents eversion and abduction of ankle
Deltoid ligaments
Grade 1 inversion
CF ligament
Grade 2 Inversion
CF and ATF
Grade 3 inversion
CF, ATF, and PTF
Grade 1 inversion and plantarflexion
ATF
Grade 2 inversion and plantarflexion
ATF and CF
Grade 3 inversion and plantarflexion
ATF, CF, and PTF
Grade 1 forced ER and hyper dorsiflexion
Anterior tibiofibular (ATiF) and posterior tibiofibular (PTiF)
Grade 2 forced ER and hyper dorsiflexion
ATiF, PTiF, and interosseous membrane
Grade 3 forced ER and hyper dorsiflexion
ATiF, PTiF, interosseous membrane and fracture of lateral malleolus
Grade 1 eversion
Deltoid ligaments and possible avulsion fracture or medial malleolus
Grade 2 eversion
Deltoid, joint instability, and interosseous membrane
Grade 3 eversion
Deltoid, joint instability, interosseous membrane and fracture of lateral malleolus
What are the functions of the foot?
The foot is critical in walking, running, jumping, and changing direction
Shock absorber
Lever that propels body forward, back and side to side
What do the arches of the foot do?
Support the body weight, shock absorb
First metatarsal is abnormally short, making second toe appear longer
Mortons toe
Morton’s toe symptoms and treatment
Pain and point tenderness along 2nd metatarsal
Modified rest and non-weight bearing exercise
Fracture at the neck of the fifth metatarsal
Jones fracture
Jones fracture symptoms and treatment
Sharp pain on lateral border, hear a pop
Non-weight bearing short leg cast for 6-8 weeks
Painful deformity of head of first metatarsal
Bunion
Bunion symptoms and treatment
Tenderness, swelling, and enlargement
Proper shoes or surgery
Inflexibility of medial longitudinal arch, leg length discrepancy
Plantar fasciitis
Plantar fasciitis symptoms and treatment
Pain in anterior medial heel
Rigorous heel core stretching, night splint 8-12 weeks
Anterior drawer test
One hand grabs proximal to malleolus; one hand cups calcaneus and foot rests on forearm; shift calcaneus and talus anteriorly
Talar tilt
Same hand position as anterior drawer; tilt calcaneus into inversion and eversion
External rotation test
1 hand grabs proximal to malleolus; one hand grabs foot; externally rotate foot; can add dorsiflexion
Bump test
With foot relaxed, bump calcaneus with heel of hand; with foot passively dorsiflexed bump calcaneus with heel of hand
Squeeze test
Using heels of both hands and starting at mid lower leg, squeeze the tib/fib together as you go down to ankle
Thompson test
Athlete prone, squeeze muscle belly of gastrocnemius
Deep vein thrombosis test
Athlete supine; knee extended, ankle dorsiflexed, squeeze gastrocnemius
Active ROM
Athlete moves in 4 ankle movements; place hand on top, bottom, inside, and outside of ankle and they try to touch hand
Passive ROM
Athlete is a puppet and you move ankle in four movements
Resistive ROM
Hand stabilizes proximal malleolus, one hand resists movement of ankle
Functional testing
General ones that all athletes will have to do, sport and position specific
Ankle rehab phase 1
ABCs Towel scrunches Foam pick ups Balancing on the floor (3x30 sec) Calf stretch Passive ROM ICE Compression wrap w/horseshoe
Ankle rehab phase 2
ABCs Towel scrunches Balancing (tramp or foam pad) Calf stretch Resisted ROM bands Calf raises Ice Compression wrap with horseshoe Bike
Ankle rehab phase 3
ABCs Balancing (tramp) on one leg, catch ball Calf stretch Resisted ROM bands Calf raises single leg Functional activities Ice Compression wrap Tape
Full release ankle rehab
Full strength Sport specific testing Full ROM Support usually required Tape Brace
Functional activities
Walk on toes Walk on heels Walk on lateral border of feet Walk on medial border of feet Hop on both feet 10 times Run forward 70-100% Run backward 70-100% Zig zag down and back Figure 8
10 palpation sites
- Squeeze midshaft of calf
- Medial malleolus
- Lateral malleolus
- Base of the 5th metatarsal
- Calcaneus
- Achilles’ tendon
- Deltoid ligament
- Syndesmosis
- Posterior talofibular
- Anterior talofibular
Why do we do ABCs
To increase range of motion and decrease swelling
Why do we do towel scrunches
Strength
Why do we balance for 30 seconds (3 times)
It takes 30 seconds for the muscle to enlongate and relax
How long do we ice
20 minutes
