0. Sports Medicine
ANKLE INJURIES
UNIT 6
FOOT, ANKLE, AND,
LOWER LEG

1. ANKLE INJURIES
Sports Medicine
Ankle Sprain Evaluation

2. Sprains/Strains Sprains 1st, 2nd, 3rd degree
Stretch or tear to a ligament
Ligaments connect bone to bone
Strains 1st, 2nd, 3rd degree
Stretch or tear to a muscle or tendon
1st degree- stretched but not torn
2nd degree- torn but still intact
3rd degree- Ruptured or completely torn

3. ANKLE INJURIES Ankle Sprain Evaluation
Sports Medicine
Ankle Sprain Evaluation
First Degree ankle sprain usually occurs to the anterior talofibular ligament
usually takes the athlete 2-4 days (+/-) before returning to play.

4. ANKLE INJURIES
Sports Medicine
Ankle Sprain Evaluation
First Degree

5. ANKLE INJURIES Ankle Sprain Evaluation
Sports Medicine
Ankle Sprain Evaluation
Second Degree ankle sprain usually occurs to the anterior talofibular, posterior talofibular and calcaneofibular ligaments
usually takes the athlete 7-10 days (+/-) before returning to play.

6. ANKLE INJURIES
Sports Medicine
Ankle Sprain Evaluation
Second Degree

7. ANKLE INJURIES Ankle Sprain Evaluation
Sports Medicine
Ankle Sprain Evaluation
Third Degree ankle sprain usually occurs to the anterior talofibular, posterior talofibular, calcaneofibular ligaments,and deltoid ligament
usually takes the athlete 4-6 weeks (+/-) before returning to play.

8. ANKLE INJURIES
Sports Medicine
Ankle Sprain Evaluation
Third Degree

9. ANKLE INJURIES Ankle Sprain Evaluation
Sports Medicine
Ankle Sprain Evaluation
Syndesmotic or “high” ankle sprain occurs to the anterior tibiofibular, posterior tibiofibular ligament and usually takes the athlete 4 weeks (+/-) before returning to play.

10. ANKLE INJURIES Ankle Sprain Evaluation Syndesmotic or “High”
Sports Medicine
Ankle Sprain Evaluation
Syndesmotic or “High”

11. ANKLE INJURIES Ankle Sprain Evaluation Syndesmotic or “High”
Sports Medicine
Ankle Sprain Evaluation
Syndesmotic or “High”

12. ANKLE INJURIES Ankle Sprain Evaluation Inversion Ankle Sprain MOI
Sports Medicine
Ankle Sprain Evaluation
Inversion Ankle Sprain
MOI
Inversion ankle sprains
usually result from
traumatic inversion or
inversion plantar flexion.

14. ANKLE INJURIES Inversion Ankle Sprain Signs/Symptoms
Sports Medicine
Inversion Ankle Sprain
Signs/Symptoms
Observation- Swelling, discoloration, decrease in motor function (ROM).

15. ANKLE INJURIES Inversion Ankle Sprain Signs/Symptoms
Sports Medicine
Inversion Ankle Sprain
Signs/Symptoms
Palpation- Athlete will
exhibit pain and point
tenderness on the
ATF, PTF, and/or CF
depending upon severity.

16. ANKLE INJURIES Inversion Ankle Sprain Signs/Symptoms Stress
Sports Medicine
Inversion Ankle Sprain
Signs/Symptoms
Stress
Anterior drawer test: This test is used to evaluate injury to the ATF. This test is performed by first stabilizing the tibia and calcaneus. The tibia is then pushed posterior as the calcaneus is pulled anteriorly. A positive test is indicated if the talus slides forward from under the tibia.

17. ANKLE INJURIES Inversion Ankle Sprain Signs/Symptoms Stress
Sports Medicine
Inversion Ankle Sprain
Signs/Symptoms
Stress
Anterior drawer test:

18. ANKLE INJURIES Inversion Ankle Sprain Signs/Symptoms Stress
Sports Medicine
Inversion Ankle Sprain
Signs/Symptoms
Stress
Talar tilt test: This test is used to evaluate injury to the ATF, PTF, and CF ligaments. This test is performed by positioning the ankle at 90 degrees. While stabilizing the lower leg the calcaneus is then inverted.

19. ANKLE INJURIES Inversion Ankle Sprain Signs/Symptoms Stress
Sports Medicine
Inversion Ankle Sprain
Signs/Symptoms
Stress
Talar tilt test:

20. ANKLE INJURIES Inversion Ankle Sprain AIM
Sports Medicine
Inversion Ankle Sprain
AIM
Rest, ice, compression, elevation.
Horse Shoe, compression sleeve/sock
The athlete is progressed according to clinical and functional symptoms exhibited.
Rehab
Strengthen (How?)
Proprioception (How?)

21. ANKLE INJURIES Eversion Ankle Sprain MOI
Sports Medicine
Eversion Ankle Sprain
MOI
Eversion ankle sprains usually result from an eversion MOI and represent only percent of all ankle sprains. Eversion ankle sprains are typically more severe than there inversion counterparts.

22. ANKLE INJURIES
Sports Medicine
Eversion Ankle Sprain
MOI

23. ANKLE INJURIES Eversion Ankle Sprain Signs/Symptoms
Sports Medicine
Eversion Ankle Sprain
Signs/Symptoms
Observation- Swelling, discoloration, decrease in motor function (ROM).

24. ANKLE INJURIES Eversion Ankle Sprain Signs/Symptoms
Palpation- Athlete will
exhibit pain and
point tenderness on
the deltoid ligament.

25. ANKLE INJURIES Eversion Ankle Sprain Signs/Symptoms
Sports Medicine
Eversion Ankle Sprain
Signs/Symptoms
Stress- Ankle eversion test: This test is used to evaluate injury to the deltoid ligament. This test is performed by positioning the ankle at 90 degrees. While stabilizing the lower leg the calcaneus is then everted.

26. ANKLE INJURIES Eversion Ankle Sprain Signs/Symptoms
Sports Medicine
Eversion Ankle Sprain
Signs/Symptoms
Stress- Ankle eversion test:

27. ANKLE INJURIES Eversion Ankle Sprain AIM
Sports Medicine
Eversion Ankle Sprain
AIM
Rest, ice, compression, elevation.
Horseshoe, compression sleeve/sock
The athlete is progressed according to clinical and functional symptoms exhibited.
Rehab
Strengthening (How?)
Proprioception (How?)

28. ANKLE INJURIES Syndesmotic Ankle Sprain (“High” Ankle Sprain) MOI
Sports Medicine
Syndesmotic Ankle Sprain (“High” Ankle Sprain)
MOI
Syndesmotic ankle sprains occur to the distal tibiofibular joint and involve the anterior and/or posterior tibiofibular ligaments.
Syndesmotic ankle sprains usually result from an external rotation or forced dorsiflexion MOI and are often injured in conjunction with inversion and/or eversion sprains.

29. ANKLE INJURIES Syndesmotic Ankle Sprain (“High” Ankle Sprain) MOI
Sports Medicine
Syndesmotic Ankle Sprain (“High” Ankle Sprain)
MOI

30. ANKLE INJURIES Syndesmotic Ankle Sprain (“High” Ankle Sprain)
Sports Medicine
Syndesmotic Ankle Sprain (“High” Ankle Sprain)

31. ANKLE INJURIES Syndesmotic Ankle Sprain (“High” Ankle Sprain)
Sports Medicine
Syndesmotic Ankle Sprain (“High” Ankle Sprain)
Signs/Symptoms
Observation- Swelling, discoloration, decrease in motor function (ROM). Athlete is unable to bear weight.

32. ANKLE INJURIES Syndesmotic Ankle Sprain (“High” Ankle Sprain)
Sports Medicine
Syndesmotic Ankle Sprain (“High” Ankle Sprain)
Signs/Symptoms
Palpation- Athlete will exhibit severe pain, point tenderness, and loss of function at the tibiofibular ligaments.

33. ANKLE INJURIES Syndesmotic Ankle Sprain (“High” Ankle Sprain)
Sports Medicine
Syndesmotic Ankle Sprain (“High” Ankle Sprain)
Signs/Symptoms
Stress- The ankle is passively externally rotated and/or dorsiflexed.

34. ANKLE INJURIES Syndesmotic Ankle Sprain (“High” Ankle Sprain) AIM
Sports Medicine
Syndesmotic Ankle Sprain (“High” Ankle Sprain)
AIM
Rest, ice, compression, elevation .
The athlete is progressed according to clinical and functional symptoms exhibited.
Rehab
Strengthening (How?)
Proprioception (How?)

35. ANKLE INJURIES
Sports Medicine
Ankle/Lower Leg Fractures

36. ANKLE INJURIES
Sports Medicine
Ankle/Lower
Leg Fractures

37. ANKLE INJURIES
Sports Medicine
Ankle/Lower Leg Fractures

38. ANKLE INJURIES
Sports Medicine
Ankle/Lower Leg Fractures

39. ANKLE INJURIES Special Tests for Bony Integrity (Fracture)
Sports Medicine
Special Tests for Bony Integrity (Fracture)
Squeeze Test

40. ANKLE INJURIES Special Tests for Bony Integrity (Fracture)
Sports Medicine
Special Tests for Bony Integrity (Fracture)
Heel Tap (Percussion)