Ankle: Ligament Pathology 2 Flashcards
Cuboid syndrome: definition
- ttp over cuboid
- decreased midtarsal mobility
- pain with gait
Cuboid syndrome: treatments
- cuboid manipulation
- gentle massage over cuboid
Chronic Ankle Instability: categories of insufficiencies
Mechanical
Functional
Chronic Ankle Instability:
Mechanical insufficiencies
- arthrokinematic restrictions
- pathological laxity
- degenerative changes
- synovial changes
Chronic Ankle Instability:
Functional insufficiencies
- impaired proprioception
- impaired neuromuscular control
- strength deficits
- impaired postural control
Arthrogenic inhibition: after a traumatic sprain injury, ankle function can be hindered by
Pain
Swelling
Arthrogenic inhibition: A painful, distended joint can cause what to the surrounding ankle musculature, also known as arthrogenic inhibition
Reflex inhibition
Arthrogenic inhibition: Where has this been observed?
- Acute ankle and knee injuries
- Patients with chronic ankle problems
In the acute phases of injury, arthrogenic inhibition has a clear influence on…
- neuromuscular activation patterns
- muscle strength
- balance
- a patient’s ability to fully mobilize and bear weight
CAI characteristics (general)
- arthrokinematic impairments
- altered neuromuscular control
- increased inversion at heel strike
CAI bottom line: Arthrokinematic impairments best addressed with what treatment?
Manipulation
CAI bottom line: Altered neuromuscular control best address with what treatment?
Manipulation
CAI bottom line: increased inversion at heel strike best addressed with what treatment?
Intrinsic foot exercise
Associated injuries from lateral ankle sprains
- synovitis
- posterior talotibial compression syndrome
- talar OCD lesions
- talar lateral process fractures
- peroneal nerve lesions
- anterolateral impingement
- sinus tarsi syndrome
- cuboid hypomobility
- 5th ray fx
High ankle sprains: AITFL and PITFL provide (%) of stability to syndesmosis
77%
High ankle sprains: Isolated injury is (rare/common)
Rare
High ankle sprains: Typically accompanied by
- fibular fracture and/or
- deltoid ligament injury
High ankle sprains: the mortise widens resulting in
1 mm lateral shift of the talus decreases the WB surface of the talus by (%)
40%
High ankle sprains: the mortise widens resulting in
3 mm lateral shift of the talus decreases the WB surface of the talus by (%)
> 60%
High ankle sprains: the mortise widens resulting in
5 mm lateral shift of the talus decreases the WB surface of the talus by (%)
80%
High ankle sprains: increased contact pressures led to
Early DJD
High ankle sprains: clinical presentation
Pain and tenderness
- pain localized to joint
- ttp to ATFL
High ankle sprains: pain with what motions?
AROM DF and eversion
High ankle sprains: Swelling?
Minimal present
High ankle sprains: Antalgic gait to avoid
DF
Deltoid ligament sprain: typical MOI
Forced eversion of talus/calcaneus
Deltoid ligament sprain: treatment impairments
- irritated posterior tibialis
- TCJ dysfunctions
- STJ dysfunctions
Deltoid ligament sprain: Overall ankle is very stable medially and most deltoid tears resolve with
Relatively easy rehab
