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THE ANKLE

CHAPTER 18
The Ankle and Lower Leg
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?
Anatomy of the Ankle
What bone make up the
Ankle joint?

Tibia
Fibula
Talus
Calcaneus
Online Ankle Quiz
Access the following link and take the online
bones of the Ankle quiz.
http://www.csuchico.edu/~sbarker/shock/Ankl
equiz.html


Anatomy of the Ankle
What type of joint is
the Ankle?

The Ankle joint is a
HINGE JOINT

The TALOCRURAL
Joint

Major Ligaments of the Ankle
LATERAL ASPECT

Anterior Tibiofibular

Anterior Talofibular- 3

Calcaneofibular- 6

Posterior Talofibular- 9
Major Ligaments of the Ankle
MEDIAL ASPECT

Posterior Talotibial
Posterior
Talocalcaneal
Deltoid
Muscles and Tendons around the
Ankle
Achilles Tendon

Peroneal Tendinitis

Anterior Tibialis Tendinitis

Posterior Tibialis Tendinitis
Common Ankle Injuries
Inverted Ankle Sprain

Everted Ankle Sprain

Ankle Dislocation

Muscle and Tendon Strains
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
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.
Ankle Dislocation/Fracture
Ankle Dislocation -
Fracture
Medical Emergency
Usually the foot is
inverted.
Frequently both the
Tibia and Fibula are
fractured.

Ankle Dislocation/Fracture
- Medical Emergency
Muscle and Tendon Strains

Most common is
the Achilles
Tendon Strain.
THOMPSON Test
the Achilles.
Peroneal tendon
sometimes
damaged with
inversion ankle
sprain.
Video on Ankle Injuries
NOTES on VIDEO:
Grading Scales for Sprained
Ankles
GRADE I


GRADE II



GRADE III
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.

Rehab/Treatment Plan for Sprained Ankles
RICE

Modalities

Exercises
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
Goals of RICE
Limit Swelling

Reduce pain

Return to
sport/activity
quicker
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

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.
Rehab Exercises
Range of Motion ABCs
One leg Stands
BAPS Board
Towel Curls
Toe Pickups
Toe Rises
Theraband
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
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.
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.
Ankle Braces
Ankle Braces
Ankle Braces
Video on Cramer Ankle Brace
Notes on Video:
Questions Over Ankle
Notes:

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