Ankle Evaluation

HI(O)PS History Inspection/Observation Palpation Special Tests

History M: Mechanism of Injury (position of foot, playing surface, type of shoes, how injury happened A: Acute or Chronic P: Pain (location & type: sharp, dull, burning, etc.) P: Previous Injury? (which ankle, when?) S: Sounds (noises at time of injury or since: popping, snapping, cracking, etc.) S: Signs & Symptoms

Inspection/Observation Swelling (localized or general) Deformity (flat feet, high arches, etc.) Dislocation (abnormal positioning of the foot or ankle) Discoloration

Palpation Palpate for areas of swelling, pain, or abnormaility. Palpate both extremities, uninjured first

Palpation Cont. Bony Landmarks: Tibia & Medial Malleolus Fibula & Lateral Malleolus Base of 5th Metatarsal Caclcaneus

Palpation Cont. Ligaments: Medial: Deltoids Lateral: Anterior: Anterior Talofibular Calcaneofibular Posterior Talofibular Anterior: Anterior Tibiofibular

Palpation Cont. Musculature: Gastrocnemius (calf muscle) Achilles Tendon (posterior aspect of ankle) Peroneal Muscles & Tendon (lateral aspect of lower leg and ankle) Anterior Tibialis Muscle & Tendon (anterior aspect of lower leg and ankle)

Special Tests Do ALL tests bilaterally Uninjured side first

Special Tests Cont. Range of Motion: Active ROM (PF, DF, Inv., & Ever.) Athlete performs movement Passive ROM (PF, DF, Inv., & Ever.) Examiner performs movement Resisted ROM (PF, DF, Inv., & Ever.) Examiner applies resistance as athlete performs movement Only do if athlete can perform active ROM & no fracture is suspected

Special Tests Cont. Stress Tests: Anterior Drawer Test: Tests the Anterior Talofibular Ligament Foot relaxed in neutral position, pull calcaneus anteriorly + result = pain, excess movement, or both Inversion Test: Tests Lateral Ligaments Passively invert ankle in PF, Neutral, & DF + result = pain during movement

Special Tests Cont. Stress Tests Cont.: Eversion Test: Tests Deltoid Ligaments Passively evert ankle in DF, Neutral, PF + result = pain during movement Thompson’s Test: Tests Achilles Tendon Athlete lying prone, foot relaxed in neutral position, squeeze Gastrocnemius, foot should PF normally + result = pain, lack of normal movement, or both

Special Tests Cont. Stress Tests Cont.: Percussion (Bump) Test: Tests for fracture in lower leg or ankle Tap plantar surface of calcaneus + result = pain radiating up leg Compression Test: Compress Tibia & Fibula together all the way up & down lower leg

Functional Tests Walking Go up on toes (both feet together, then separately Rock back on heels Jogging, progressing to sprinting (straight ahead, figure 8, Z pattern) Hopping (both feet together, then separately Sports Specific Skills