1. Ankle Evaluation

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

3. 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

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

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

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

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

8. 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)

9. Special Tests
Do ALL tests bilaterally
Uninjured side first

10. 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

11. 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

12. 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

13. 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

14. 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