THE ANKLE

1
THE ANKLE

• CHAPTER 18
• The Ankle and Lower Leg

2
Introduction

• Have you ever sprained your ankle, or do you
  know anyone who has?
• What did you do for it?
• How long did the pain last?
• Do you have any problems with that ankle?

3
Anatomy of the Ankle

• What bone make up the Ankle joint?
• Tibia
• Fibula
• Talus
• Calcaneus

4
Online Ankle Quiz

• Access the following link and take the online
  bones of the Ankle quiz.
• http//www.csuchico.edu/sbarker/shock/Anklequiz.h
  tml

5
Anatomy of the Ankle

• What type of joint is the Ankle?
• The Ankle joint is a HINGE JOINT
• The TALOCRURAL Joint

6
Major Ligaments of the Ankle

• LATERAL ASPECT
• Anterior Tibiofibular
• Anterior Talofibular- 3
• Calcaneofibular- 6
• Posterior Talofibular- 9

7
Major Ligaments of the Ankle

• MEDIAL ASPECT
• Posterior Talotibial
• Posterior Talocalcaneal
• Deltoid

8
Muscles and Tendons around the Ankle

• Achilles Tendon
• Peroneal Tendinitis
• Anterior Tibialis Tendinitis
• Posterior Tibialis Tendinitis

9
Common Ankle Injuries

• Inverted Ankle Sprain
• Everted Ankle Sprain
• Ankle Dislocation
• Muscle and Tendon Strains

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Inverted Ankle Sprain

• Inversion Ankle Sprain- the foot turns inward
  rolling over the lateral aspect of the ankle.
• Most common ankle sprain- about 85 of all ankle
  sprains

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Everted Ankle Sprain

• Eversion Ankle Sprain- the turns inward. The
  ankle rolls in medially.
• Uncommon sprain due to bone support.
• Occurs in about 10-15 of ankle sprains.

12
Ankle Dislocation/Fracture

• Ankle Dislocation -Fracture
• Medical Emergency
• Usually the foot is inverted.
• Frequently both the Tibia and Fibula are
  fractured.

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Ankle Dislocation/Fracture - Medical Emergency
14
Muscle and Tendon Strains

• Most common is the Achilles Tendon Strain.
• THOMPSON Test the Achilles.
• Peroneal tendon sometimes damaged with inversion
  ankle sprain.

15
Video on Ankle Injuries

• NOTES on VIDEO

16
Grading Scales for Sprained Ankles

• Most common ankle sprain.
• Mild pain, still weight baring.
• More painful, report popping sound.
• Can not bear weight.
• Stretching of lateral ligaments of the ankle.
• Extreme pain. Usually complete tear of one of
  the ankle ligaments.
• Sometimes fracture occurs also.

• GRADE I
• GRADE II
• GRADE III

17
Rehab/Treatment Plan for Sprained Ankles

• RICE
• Modalities
• Exercises

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RICE

• Rest- stay off the Ankle, crutches may be needed
• Ice- 15 minutes a 4 to 5 times a day
• Compression- ace wrap with horseshoe keeps the
  swelling down
• Elevation- keep ankle above heart level when
  possible, allows gravity to pump out swelling

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Goals of RICE

• Limit Swelling
• Reduce pain
• Return to sport/activity quicker

20
Modalities Used

• COLD WHIRLPOOL-
• 15 minutes a couple times a day
• Vasoconstrictors vessels around ankle
• Stimulates pain killing receptors
• Slows cell metabolism
• Aids in reducing swelling

21
Modalities Used

• HIGH VOLTAGE-
• Assists in activating pain killing receptors.
• Assists in muscle stimulation around ankle joint
  to aid in edema removal.
• ULTRASOUND-
• Assists in edema removal.
• Assists in bringing digestive enzymes to clean
  debris cells of the injured ankle.

22
Rehab Exercises

• Range of Motion ABCs
• One leg Stands
• BAPS Board
• Towel Curls
• Toe Pickups
• Toe Rises
• Theraband

23
Taping Vs. Wrapping

• TAPING-
• Psychologically better feeling to the athlete
• Tight fitting at first
• Tape looses a large percentage of its support
  within the first 15-20 minutes of competition

24
Taping Vs. Wrapping

• WRAPPING-
• Purpose in wrapping is injury prevention.
• Wrapping will not eliminate sprained ankle, but
  it does minimize the severity of the sprain.

25
Ankle Braces

• ANKLE BRACES-
• Many varieties and types.
• Lace Up
• Hinged
• Air Casts
• All offer different levels of support.
• Large and competitive business market for ankle
  braces.

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Ankle Braces
27
Ankle Braces
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Ankle Braces
29
Video on Cramer Ankle Brace

• Notes on Video

30
Questions Over Ankle

• Notes