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Primary ankle dorsiflexor
Tibialis anterior dorsiflexion and inversion
Primary plantarflexors
Gastrocnemius and Soleus
Muscle responsible for eversion
Fibularis longus and brevis
Muscle responsible for inversion
Tibialis posterior
Difference between gastroc and soleus
Gastroc crosses knee knee flexion and plantarflexion Soleus plantarflexion only
Most commonly injured ankle ligament
ATFL anterior talofibular ligament
MOI for ATFL sprain
Inversion and plantarflexion
MOI for deltoid ligament injury
Eversion stress
MOI for high ankle sprain
External rotation and dorsiflexion
Structures involved in high ankle sprain
Syndesmosis AITFL and PITFL
Test for ATFL
Anterior Drawer Test ankle
Positive anterior drawer indicates
ATFL laxity
Test for syndesmosis injury
Squeeze Test
Squeeze Test positive finding
Pain at distal tib fib indicates high ankle sprain
Test for Achilles tendon rupture
Thompson Test
Positive Thompson Test
No plantarflexion indicates rupture
Swelling location lateral ankle sprain
Around lateral malleolus
ROM limitation inversion sprain
Pain with inversion and plantarflexion
When to use joint distraction ankle
Pain and joint compression relief early phase
When to use posterior talar glide
Improve dorsiflexion
When to use anterior talar glide
Improve plantarflexion
When to use soft tissue mobilization
Muscle tightness scar tissue chronic stiffness
Early phase exercises ankle
Isometrics gentle ROM edema control
Moderate phase exercises ankle
Theraband strengthening balance training
Advanced phase exercises ankle
Plyometrics cutting sport specific drills
Short term goal ankle sprain example
Decrease swelling and pain restore partial ROM in 1 to 2 weeks
Long term goal ankle sprain example
Return to sport full ROM strength no instability in 4 to 6 weeks
Scenario inversion injury swelling lateral ankle
ATFL sprain
Scenario pain above ankle external rotation
Syndesmosis high ankle sprain
Scenario no plantarflexion with calf squeeze
Achilles rupture
Scenario limited dorsiflexion intervention
Posterior talar glide
Why inversion sprains are more common
Lateral ligaments weaker than deltoid ligament
Progression to next rehab phase
Decreased pain decreased swelling improved ROM strength at least 80 percent
Ankle dorsiflexion ROM
20 degrees
Ankle plantarflexion ROM
50 degrees
Ankle inversion ROM
35 degrees
Ankle eversion ROM
15 degrees
Max phase goal ankle
Decrease pain and swelling protect injured tissue
Max phase exercises ankle
Isometrics DF PF INV EV ankle pumps gentle AROM
Max phase joint mobilizations ankle
Grade 1 to 2 talocrural distraction for pain control
Max phase joint mobs ankle specific
Gentle posterior talar glide within pain free range
Max phase soft tissue ankle
Effleurage for edema control