Ankle sprains

Question 1

What are the two types of sprains?

Answer 1

• inversion (most common)

- eversion

Question 2

What ligaments are damaged in inversion sprain?

Answer 2

1st Anterior talofibular ligament (PF and inversion)

2nd calcaneofibular ligament (DF and inversion

Question 3

What ligaments are damaged in eversion sprains?

Answer 3

• deltoid ligament

- Avulsion fracture of medial malleolus often occurs with ligmanet damage

Question 4

What is the acute phase of conservative management of an ankles sprains?

Answer 4

• RICES
• PROM in pain free ranges
• modalities for swelling and pain
• depending on grade AD may be required
• gentle muscle setting

Question 5

What is the subacute phase of conservative management of an ankles sprains?

Answer 5

• con’t bracing during ambulation and activity
• progress PROM to AROM and into GENTLE stretching
• progress muscle setting into gentle resistance exercises (isometrics and isotonics both OC and CC in protected ranges)
• “gentle” balance and proprioception activities
• joint mobs as needed
• isokinetics in late portion of phase

Question 6

What is the chronic phase of conservative management of an ankles sprains?

Answer 6

• progressive stretching and joint mobs as indicated
• PRE’s with emphasis on peroneals (PF and Eversion)
• progressive balance, proprioception and agility activites
• endurance stability
• return to function: brace or high top shoes may be need during progression

Question 7

How long does it take to return to full activity?

Answer 7

takes 3-4 months for grade II and III

Question 8

Why do surgical repair of an ankle ligament?

Answer 8

• for chronic instability and that did not respond to conservative mangement
• technique may reposition and suture ligament or replace it with peroneous brevis tendon

Question 9

Describe the maximum protection phase after ankle ligament surgical repair

Answer 9

1. immobilization 6-8 weeks
2. weight bearing limitations
   - NWB 2-3 weeks
   - Then PWB addition 2-6 weeks usually with walking cast

Question 10

Describe the moderate protection phase after ankle ligament surgical repair

Answer 10

• Begins 6-8 weeks post op
• WBing may be limited early on
• progress similar to non-operative management of ankle sprains

Question 11

When do someone usually return to full activity following an ankle ligament surgical repair?

Answer 11

4-6 months