Ankle Sprain Pathology

Name 4 Special tests for the Ankle ligaments

•Anterior Drawer Test

•Eversion Stress Test

•Talar Tilt Test

•Posterior Drawer Test

Anterior Drawer Test

•It checks the ATFL for any damage.

•Excessive movement indicates damage(Sprain/Tear)

•Physio will pull the foot up

Posterior Drawer Test

•Checks the PTFL for any Injury/Damage

•Excessive movement indicates damage

•physio will pull heal down whilst stabilising tibia and fibula

Eversion Stress Test

•Checks for any deltoid ligament damage

•Any pain or excessive movement may indicate damage to medial ligaments

•Physio will evert the foot

Talar Tilt Test

•It tests for any damage in the CFL

•Any pain or excessive movement indicates damage to the ligament

•Physio will Turn the foot inwards (Inversion)

What’s Ottawa

-Clinical Test to decide if an X-Ray is needed

Ottawa Rules

-Can’t walk more than 4 steps

-Bone tenderness along medial/Lateral malleolus

-Bone tenderness along navicular or 5th meta Tarsal

Oxford Scale Grades 0-5

0-No Muscle Movement

1-Muscle movement without joint motion

2-Moves with gravity Eliminated

3-Moves against gravity but not resistance

4-Moves against gravity and light resistance

5-Normal Strength

When’s the Oxford Scale used?

Assessment of strength to determine severity and rehabilitation process

3 Different types of ankle sprains

•Lateral

•Medial

•High ankle sprain (Syndesmotic)

Grade 1-3 Sprain (Severity,Signs,Stability, Recovery)

Grade 1-Ligament is stretched, Mild pain and swelling, Stable Ankle, 1-3 weeks to recovery

Grade 2-Partial Ligament Tear, Moderate Pain/Swelling maybe bruising,Some Instability, Couple weeks to months for recovery

Grade 3-Complete Ligament Tear, Severe Pain/Bruising, Major Instability, Long Rehabilitation Process

Mechanisms For An Ankle Sprain

•Inversion (Lateral Ligaments)

•Eversion (Deltoid Ligaments)

•External Rotation (Foot Twisted Outwards) (High ankle Sprain)

Peace + Love (Meaning)

•Protection

•Elevation

•Avoid Anti inflammatory

•Compression

•Education

•Load

•Optimism

•Vascularisation

•Exercise

SMART (meaning)

•Specific

•Measurable

•Realistic

•Achievable

•Time

4 Key Steps Of Rehabilitation For Ankle Sprain (Acute Phase)

•Reduce Pain

•Control Swelling

•Protect Against Further Damage

•Rest

•POLICE

4 Key Steps of Rehabilitation for ankle sprain (Middle Phase)

•Restore Full ROM

•Begin Muscle Strengthening

•Improve Proprioception

•Return to Daily activities

4 Key Steps in Rehabilitation of ankle sprain (end Phase)

•Restore Full Strength + Power

•Regain Balance + Neuromuscular Control

•Preparation for specific movements

•Prevention of injury through training

5 key Principles of Rehabilitation

•Progressive Loading

•Restore Functional Movement

•Restore Complex movements (Sport)

•Motor Control/Proprioception

•Patient Self Care

Steps to assess the ankle

1-Subjective Assessment

2-Observe

3-Palpation

4-AROM

5-PROM

6-Resistance test (Oxford Scale)

7-Special Tests

How to improve Proprioception For Ankle Sprain (Acute, Intermediate, End)

Acute— Restore Static Balance

Intermediate— Controlled Instability

End— Multidirectional Movements

How to strengthen For Ankle Sprain (Acute, Intermediate, End)

Acute— Isometric Exercises (Doesn’t Aggravate Injured Tissue)

Intermediate—Improve Concentric+ eccentric Movement

End— Add Load + Dynamic Movements