Ankle +foot

Question 1

lateral ankle sprain/ inversion ankle sprain

Answer 1

In forced Inversion:

– Grade 1: ATFL with capsule
– Grade 2: Then the calcaneofibular tears
with capsular damage and medial damage
& bruising
– Grade 3: Then the posterior talo-fibular
ligament
 Risk of fracture / dislocation

Question 2

Eversion Ankle Sprain/deltoid ligament

Answer 2

Anatomy
– The deltoid ligament is much thicker &
stronger than the lateral ligaments
– Injury to the deltoid is more severe &
disabling than the lateral & takes longer to
heal / recover
– External rotation mechanism is common
for deltoid tear

Question 3

Syndesmosis

Answer 3

Anterior inferior tib-fib ligament
– Posterior inferior tib-fib ligament
– Interosseous ligament

MOI:
twisting with foot on the ground

Question 4

Ankle Sprain Risk Factors

Answer 4

 Modifiable Intrinsic risk factors
– Restricted dorsiflexion ROM
– Reduced proprioception
– Poor single leg balance

 Other factors
– BMI – lower BMI
– Poor strength
– Coordination
– Poor aerobic fitness
– Restricted overall ankle joint ROM

 Non-modifiable Intrinsic Risk Factors
– Female
– Previous ankle sprain injury
– Greater height
 Modifiable Extrinsic Risk Factors
– Sport (volleyball and soccer)
– Wearing high heels (9.5cm vs 1.3cm)

Question 5

Acute Ankle Sprain
Assessment/ treatment

Answer 5

Ottawa
Anterior Draw
Lateral Talar Tilt

Education- nature, treatment
physio specific- ice, manual, rehab
mechanical- tape

referral gp, imaging

Question 6

Acute Ankle Sprain
Assessment/ treatment

Answer 6

Ottawa
Anterior Draw
Lateral Talar Tilt

Education- nature, treatment
physio specific- ice, manual, rehab
mechanical- tape

referral gp, imaging

Question 7

Plantar Facitiis

Answer 7

 Pain & stiffness on morning first foot
contact
– Hobbling
 Eases initially
 Hurts later with standing and walking on
hard floors

Management Physiotherapy
– Ice (frozen bottle of water)
– Massage
– Taping
– NSAIDs
– Dry needling
– Stretch tight muscles
– Strengthening of intrinsic foot muscles
– Heel raises
– Strasbourg sock

 Podiatry / Orthotist Mx
– Orthotics to correct excessive
pronation & support arch
– Better shoes
 Medical Mx
– Cortisone injections
– Surgery in the worst case

Question 8

Navicular Stress Fracture

Answer 8

Common in track athletes
- tender n sport- proximal dorsal navicular
-need tri or ct