Deltoid Ligament Sprain

What is a Deltoid Ligament Sprain? A sprain of the deltoid ligaments with an eversion mechanism The deltoid ligaments are Posterior tibiotalar ligament Tibiocalcaneal ligament Anterior tibiotalar ligament Tibionavicular ligament

5-10% of ankle sprains are deltoid ligament sprains Also called an eversion ankle sprain Less common because of ligamentous strength and structure Avulsion fracture normally will occur before a sprain Deltoid ligaments may be contused from an inversion ankle sprain because of the compression of the ligaments or impingement of medial malleolus

Cause Forceful sudden eversion of ankle External blow to lateral leg with foot planted

Sign and Symptoms Pain with ROM of ankle mostly in eversion Tenderness over the medial side of ankle Swelling Ecchymosis Instability Inflammation Gross deformity with a grade 3 Inability to bear weight

Examination Eversion stress test Single heel raise Evaluation of other ligamentous structure ROM Talar Tilt Squeeze test Bump Test Bounce Percussion test

Classification Grade 1- Mild partial tear -Mild or no instability -Mild Pain -Little swelling -Some joint stiffness

Grade 2- More of a severe Partial Tear - Moderate instability - Moderate to severe pain - Swelling - Stiffness in joint

Grade 3- Complete tear - Gross instability - Severe to no pain - Severe swelling

Diagnostic Testing X-ray to rule of fracture Use of ottawa rules for x-rays needed to be taken to help rule out x-rays not needed

Treatment Healing takes longer than an inversion ankle sprain Untreated sprains may lead to a pes plantus deformity If a fracture is ruled out than treatment is similar to an inversion ankle sprain but you would want to limit eversion ROM Ice Compression Elevation

Anti inflammatories Contrast bath in later stages to help reduce swelling if needed Jobst pump

Rehab ABC’s Wobble board Theraband exercises Heel to toe walking Heel raises Balance exercises Bike Be sure to check eversion ROM for pain free ROM

Return to Play Pain free ROM walking and running Deltoid tape job Ankle brace

References Gallaspy, J.B. May Signs and Symptoms of Athletic Injuries. Mosley Inc., St.Louis 1996, p.375 Arnheim, Daniel, Prentice, W.E. Principles of Athletic Training. McGraw Hill: Boston 10th ed. 2000 p.494 www.aafp.org/20010101/93.html www.tausportsmedicine.com/ottawa2htm. www.google.com/deltoidligament.com

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