1. Ankle The ankle is the most commonly injured joint in athletics The bony structure of the ankle is very strong With moderate ligament support And poor muscular support

2. Bones Tibia (Medial Malleolus) Fibula (Lateral Malleolus) Calcaneus Talus

3. Lateral Ligaments Anterior talofibular Calcaneofibular Posterior talofibular

4. Medial ligaments Deltoid Ligaments

5. Ankle re-injury Tight Achilles tendon is the major cause of recurrent ankle sprains

6. Prevention Stretch musculature of the ankle Resistive strengthening of the musculature Inversion Eversion Plantar flexion dorsiflexion

7. Mechanism of injury Inversion eversion

8. Inversion Stepping in a hole Stepping on another persons foot Stepping on a rock Anterior talofibular ligament injured

9. Eversion ankle sprain Stepping in a hole Stepping on another persons foot Stepping on a rock Deltoid ligament injured

10. 1 st degree (Mild) ankle sprain Ligaments are stretched Minor discomfort Point tenderness Mild swelling

11. 2 nd Degree (Moderate) Ankle Sprain Ligaments are stretched and/or Partially torn Moderate pain Point tenderness Some loss of function Slight abnormal movement at the joint

12. 3 rd degree (Severe) Ankle sprain Ligaments are completely torn Extreme pain Total loss of function Point tenderness Rapid swelling

13. Evaluation H istory O bservation/Inspection P alpation S pecific testing S ubjective O bjective A ction taken P lan

14. History How did it happen When did it happen Did you hear or feel a pop Where you able to walk on it right away

15. Observation Bleeding Swelling Discoloration Deformity Bilaterally comparison

16. Palpation Look at bony landmarks Soft tissue Bilateral comparison

17. Fracture Direct pain Indirect pain Deformity Grating sounds (Crepitation) Testing Compression Percussion Tuning fork

18. Functional Testing Passive ROM Active ROM Resistive ROM

19. Sports Specific Testing Hop 10 times on injured limb Walk Run straight Run circles Figure 8’s Zig zag 90 degree cutting

20. Treatment Rest Ice 20 minutes every two hours Compression with horseshoe/elastic wrap Elevation Avoid heat in any form Remove elastic wrap before bedtime Follow this treatment for 1-72 hours

21. Once the bleeding has stopped Apply heat before activity and ice after to… Remove waste product from injured area Promote healing Increase ROM

22. Rehabilitation Recovery is: Absence of pain Full ROM Full Strength Full flexibility

23. Range of motion Working toward complete pain free ROM Flex & Plantarflex foot as far as possible Invert and evert foot as far as possible Circular motion clockwise and counter Write capital letters with the toes Achilles tendon stretch

24. Resistive Exercises Walk on hells and toes (toes up, out, & in) Pick up marbles with toes Towel toe curl Isometric inversion and eversion with chair legs Calf (heel) raises with feet straight in & out

25. Resistive Exercises continued Closed chain kinetic exercises BOSU ball exercises Trapoline exercises Dinodisc exercises Voo doo board exercises

26. Return to activity Do all of the following at 50,75, & 100% Hop 10 times on injured limb Walk Run straight Run circles Figure 8’s Zig zag 90 degree cutting

27. Heel Bruise Heel and arch receives, absorbs and transfers most of the impact Heel Bruise is one of the most disabling contusions

28. Heel bruise Treatment Heel lift (poss. donut hole) Cold application before and ice after Activity

29. Plantar Fasciitis Wide inelastic ligament that supports the arch of the foot

30. Cause of plantar Fasciitis Overuse Overweight Tight Achilles Improper shoe support Running on hard surface

31. Signs of plantar fasciitis Pain and tenderness on the bottom of the foot near the heal

32. Treatment plantar fasciitis RICE Tape support (slipper)

33. Heel Spur Bony growth on Calcaneus Cause Flat feet

34. Turf toe Sprain of the great toe (MP joint) The great toe is important in movement, balance and speed Cause Foot sliding back on a slippery surface Hyperextension of the big toe Treatment RICE Taping Turf toe taping

35. Taping Tests Slipper Turf toe Achilles