what happened before and after?. he did not pass his boards
TRANSCRIPT
What happened before and after?
He did not pass his boards
What is the most commonly injured joint?
Ankle is the most commonly sprained joint
How many ankle injuries occur each day?
25,000 ankle sprains per day
¼ of all sports related injuriesMost common sports related
problems
What are the risk factors?
Risk Factors
• Poor rehab• Poor proprioception• Weak muscles• Poor ankle instability• Lack of warm up• Running on uneven
surfaces• Poor heel support
Name how ankle sprains are classified?
Ankle sprains
• First degree
• Second degree- partial severe tear, moderate instability, ,moderate pain
• Third degree – severe pain and swelling, total tear, gross instability
Name three tests used in ankle injuries
Ankle Stress test
• Inversion stress test or talar tilt -
• Cross leg test
• Anterior drawer test
Cross leg test
• High ankle sprain• Pressure is applied to the medial side of the
knee produces pain in syndesmosis area
Inversion stress test or talar tilt -
Calcaneofibular ligament instabilityend feel it is grade three
Anterior Drawer test
Excessive anterior displacement of talus onto the tibia
How can you tell if there is a third degree sprain?
Grade three (96%)
• Swelling• Hematoma• Pain on palpation• Positive anterior drawer
Functional Ankle instability
Balance Impairments
• Balance Error Scoring System
• Time-in balance test
• Foot lift test
What is the BESS Test
Balance Error Scoring System
BESS Three stance conditions and two
surface conditions
Time-in balance test
60 seconds
Foot lift test
Single leg tests touch calf
High ankle sprain
Syndesmotic ankle sprain
Syndesmotic ligament
• Connects the shin to the fibula• Tender front• Pain worse if foot or leg is twisted outward• Positive squeeze test• Need surgery
Ottawa
Ottawa ankle rules
• Pain in the malleolar region plus• Bone tenderness distal 6 posterior edge of
tibia or tip of MM• Bone tenderness along the distal 6 cmof the
posterior edge of fibula or tip of LM• Inability to bear weight to bear weight the first
4 steps
Treatment depends on the grade
General Rehabilitation Principles
• PRICE• NASI• ROM• Strengthening• Proprioception of the
ankle joint
Cryotherapy
• Standard
• Intermittent
• Outcomes
Rehabilitation - PRICE
• 2nd degree – immobilization of the ankle• 3rd degree – cast immobilization for 2 to 3
weeks, surgery maybe needed
How soon can ankles be rehabilitated?
85% rehab is possible in as little as 7 to 10 days
Ligament Tightening Surgery
What is the cause and percentage of chronic ankle pain ?
Chronic ankle pain and instability after one year
5 to 30%
Chronic ankle pain
• Poor rehab • Functional instability• Ankle impingement• Undx fx• Post-traumatic arthritis• Osteochondritis dissecans• Syndesmotic ligament injury
