Sports Medicine: Case Study Quiz

Cause

• A mild sprain

• Happens when the foot twists inward (inverts) too much. This can occur if someone lands on another player’s foot after jumping (like in basketball) or steps awkwardly on an uneven surface.

Grade 1

Symptoms:

• Mild pain

• Weight bearing is only slightly uncomfortable

• Point tenderness

• Swelling around the injured area

Grade 1

Management

• Follow POLICE (Protection, Optimal Loading, Ice, Compression, Elevation) for the first 1-2 days

• A horseshoe pad may be placed around the ankle to reduce swelling

• Avoid putting too much weight on it for about two days, then slowly return to moving it

• Start range of motion exercises (ankle circles, towel scrunches, & heel raises)

• Balance training should be utilized to help prevent future injuries

• Recovery usually takes 7-10 days

Grade 1

Cause

• Moderate sprain / slight tear

• Happens when the ankle is forced into an awkward position, (inversion, plantar flexion, or adduction) stretching or slightly tearing the ligament. This often happens when landing on the side of the foot or rolling it too far.

Grade 2

Symptoms:

• A pop or snap might be felt on the lateral side of the ankle

• Moderate pain, swelling, and tenderness

• Weight bearing is difficult

• Discoloration of the skin resulting from bleeding underneath (caused by bruising)

• Positive talar tilt test

Grade 2

Management

• POLICE should be done on and off for at least 72 hours

• X-ray examination may be needed

• Anterior and posterior ankle movements should start 48 hours after the injury to maintain flexibility

• Crutches are usually needed for 5-10 days gradually progressing to full weight bearing

• A brace or other support should be worn for 1-2 weeks to protect the ankle

• Balance and movement exercises help restore normal function

Grade 2

Cause

• Full tear / severe sprain

• Happens when the ankle twists forcefully, causing a full tear of one or more ligaments. This is often due to extreme rolling of the foot (adduction) combined with forward motion (plantar flexion).

Grade 3

Symptoms

• Severe pain Near the lateral malleolus

• Weight bearing is not possible because of immense swelling and/or pain

• Discoloration

• Positive talar tilt + positive anterior drawer test

• Bruising and internal bleeding may be present

• Rotary ankle instability

Grade 3

Management

• POLICE for at least 3 days

• May put the ankle in a cast or a weight-bearing brace for 3-6 weeks

• Crutches are usually needed after the cast

• While in the cast, small exercises can help keep some strength

• Once the cast is removed, range-of-motion, strength, and balance exercises are started

• In some cases, surgery may be needed

Grade 3