LE Diagnostic Manual - MCD of Foot/Ankle Flashcards
outcome measures recommended by CPG for MCD of ankle/foot
LEFS
FAAM
– also PSFS and foot and ankle disability (FADI)
types of MCD at foot/ankle
ligamentous injury via ankle sprain
medial tibial stress syndrome
inversion sprain ligament sequence
ATFL - anterior talofibular ligament
CFL - calcaneofibular ligament
PTFL - posterior talofibular ligament
grade 1 ankle sprain
partial disruption of ATFL
grade 2 ankle sprain
complete disruption of the AFTL
partial disruption of CFL
Grade 3 ankle sprain
some level of involvement of all 3 ligaments
what are typical causes of acute ankle sprains
history of previous ankle sprain
no external support
improper warmup
abnormal ankle DF ROM
poor balance training post injury
what are typical precipitators of ankle instability
increased talar curvature
no external support
poor balance training post injury
what precipitates medial tibial stress syndrome (MTSS)
periostitis induced by fascial traction or local bone stress reaction at posteromedial tibial border
common subjective report associated with MTSS
pain during exercise along shin (mid-bottom third)
persistent pain
palpable tenderness
bilaterally
ROM findings associated with MCD at foot/ankle
varies - “it depends”
edema may limit
– key to measure DF throughout treatment
muscle performance findings associated with MCD at foot/ankle
poor coordination and performance
proximal chain weakness found
palpation findings associated with MCD at foot/ankle
edema likely
pain along the medial tibial border (MTSS)
joint mobility findings associated with MCD at foot/ankle
hypermobility of joint
– more specific laxity in direction of ligament affected
special tests for MCD at ankle/foot
lateral ankle sprain
- anterior drawer test
- talar tilt test
high ankle sprain
- squeeze test
what is necessary during weight bearing ther-ex
external supports
explain the structure of rehab advocated for in ligament sprains
protected active ROM
stretching
neuromuscular training
explain manual therapy interventions related to MCD at foot/ankle
lymphatic drainage
active / passive soft tissue / joint mobs
AP talar mobilizations
explain modalities indicated for MCD of foot and ankle
LASER - acute symptoms
pulsating short wave diathermy - edema/gait
explain interventions indicated for chronic ankle instability
proprioceptive / neuromuscular therapeutic exercise
– postural stability
manual therapy
explain manual therapy related to chronic ankle instability
graded joint mobilizations, manipulations, mob with movement (WB or NWB)
– dorsiflexion mainly
explain efficacy of dry needling in ankle sprain treatment
fibularis muscle group in conjunction with proprioceptive training program
explain interventions related to medial tibial stress syndrome
education
manual
ther ex
education related to MTSS
reduction of overuse activity
gradual return to activity
