ankle sprain

Question 1

patient fell during activity or rolled ankle, reports diffuse lateral ankle pain with active movement, localized swelling distal and anterior to the lateral malleolus. what kind of sprain?

Answer 1

lateral ankle (inversion) sprain
typically ATFL anterior talofibular ligament damaged

Question 2

grade 2 of inversion sprain characteristics

Answer 2

localized swelling and more diffuse lateral tenderness
moderate to severe edema
antalgic gait 
pain limits AROM and strength deficits
pain with passive PF and inversion
bruising

Question 3

interventions for acute phase - grade 2 ankle sprain?

Answer 3

• crutches until can tolerate WB
• decrease pain
• • RICE, modalities
• • acetaminophen, NSAIDS
• decrease edema
• maintain mobility
• • joint mob - Gentle posterior talocrural joint mob
• • passive ROM
• • AROM in pain free range - ankle pumping and toe curls
• proprioceptive exercises

Question 4

interventions for sucacute phase - grade 2 ankle sprain?

Answer 4

4-14 days
ROM
- Gastrocnemius stretching with a strap while in long-sitting position- stretches the ankle out of the neutral position
endurace
- Stationary cycling - cardiovascular endurance, provide controlled ankle range of motion
prevent scar formation
- after inflammation over, cross friction massage
strength
- light resistance training, include peroneals
functional training
sport
- reintroduce agility individualized to patient

Question 5

prognosis for grade 2 lateral ankle sprain, return to PLOF?

Answer 5

2-6 weeks, if no other structures damaged

Question 6

what 2 ligaments comprise ankle lateral ligament complex? which is most likely to fail?

Answer 6

ATFL anterior talofibular - most likely fail
CFL calcaneofibular
PTFL posterior talofibular - strongest

Question 7

when is the ATFL taut

Answer 7

PF

Question 8

special test for atfl?

Answer 8

anterior drawer test
10-15 degrees of plantar flexion, therapist translates the rear foot anteriorly.
positive test result: talus translates forward.
Graded on a “0 to 3 scale”- 0 indicating no laxity & 3 indicating gross laxity

Question 9

special test for cfl?

Answer 9

talar tilt test
10-20 degrees of plantarflexion, hindfoot is inverted
+ laxity compared to contralateral side

Question 10

risk factors for lateral ankle sprain?

Answer 10

plays agility sports
poor ankle proprioception
obesity
deconditioning