1. Deltoid Ligament Sprain

2. 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

4. 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

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

6. 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

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

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

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

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

12. 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

13. 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

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

15. 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

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

17. 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 p.494

18. Thanks!!