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Published byAbner Johnston Modified over 9 years ago
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The Ankle & Lower Leg Bones: Tibia (Medial Malleolus) Fibula (Lateral Malleolus) TalusCalcaneus (Heel Bone) Ankle Ligaments (Lateral & Medial) Lower leg muscles (Gastrocnemius = Calf Muscle)
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Ankle Sprains (cont.) Eversion Sprain: Less common, Injury to MEDIAL side They are less common because the tibia is stronger than the fibula and the ligaments are stronger on the inside Signs/Symptoms: (Remember, Sprains have Grades 1, 2, and 3) Pain, Swelling, Stiffness, Pain during walking, Ecchymosis (Black & Blue discoloration) Treatment: R.I.C.E. Rest Ice Compression Elevation X-Ray if severe pain is present, pain along the bone, Positive Fracture tests
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Ankle Sprain: One of the most common injuries seen in athletics 3 Types: Inversion & Eversion & High Ankle Sprain Inversion: Most common, Injury to LATERAL side “Rolling” your ankle is an inversion Sprain
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Ankle Sprain (Cont.)
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Ankle Sprains (cont.) www.footanklealliance.com
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Ankle Injuries: Sprains Signs and symptoms depend on degree of sprain. 1 st degree: Pain, mild disability, point tenderness, little laxity, little or no swelling 2 nd degree: Pain, mild to moderate disability, point tenderness, loss of function, some laxity, swelling (mild to moderate) 3 rd degree: Pain and severe disability, point tenderness, loss of function, laxity, moderate to severe swelling
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Ankle Injuries: Sprains (cont.) First Aid Apply ice and compression. Elevate. Apply a horseshoe- or doughnut-shaped pad. Courtesy of Brent Mangus
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Ankle Injuries: Sprains (cont.) First Aid (cont.) Have athlete use crutches with three- or four-point gait if a second- or third- degree sprain has occurred. If there is any question regarding the severity of the sprain, refer athlete to a medical facility for physician’s evaluation.
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Ankle Injuries: Sprains (cont.) Tibiofibular (tib-fib) Sprains These injuries are often treated inappropriately as lateral ankle sprains, hindering recovery. The difference is the mechanism of injury. Tib-fib sprains involve dorsiflexion followed by axial loading with external rotation of the foot. Symptoms include a positive sprain test, but athlete is also in great pain. “Squeeze test” elicits pain in syndesmosis area.
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Ankle Injuries: Sprains (cont.) First Aid Immediately apply ice and compression, and elevate the leg. Apply a doughnut-shaped pad kept in place with an elastic bandage to provide compression. Have athlete rest and use crutches for first 72 hours, followed by wearing a walking boot for 3 to 7 days.
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Preventing Ankle Injuries Taping or bracing will reduce the number of ankle injuries. Prophylactic adhesive taping supports the ankle only for a short time. Bracing may be better than taping. Bracing combined with some high-top shoes may be helpful. Courtesy of McDavid
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Ankle Sprain Treatment (cont.) Athlete should be fitted for crutches to avoid weight bearing Rehabilitation exercises should be performed before return to Practice/Games Ankle Taping / Bracing to provide support
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Tibia / Fibula Fracture Fractures are common to the Tibia & Fibula MOI: Acute Trauma, Strike to the Lower Leg, Sudden Rotation S/Sx: Immediate pain, Swelling, Deformity (Open vs. Closed) Tx: Immediate referral for X- Rays, by ambulance if necessary Immobilization/Cast Weeks to Months depending on severity Possible Surgery
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Tibia / Fibula Fracture
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Stress Fracture Usually result of repetitive Overuse (Running, Cross Country, Soccer, Basketball, etc.) S/Sx: Pain along bone, May be worse after activity, night pain Tx: Referral for X-Rays, Bone Scan, REST!, Immobilization
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Shin Splints Refers to any type of shin pain? No! Medical Term: Medial Tibial Stress Syndrome Condition involving pain along the inside (Medial) tibia Involves a muscle called the Posterior Tibialis Can be caused by foot mechanics (high arch or flat foot) Muscle tightness or weakness, Improper shoes, Surface
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Shin Splints (cont.) & Shin Contusion Signs/Symptoms: Pain along the medial tibia Treatment: Refer to doctor to rule out stress fracture, Rest, Foot Orthotics, Ice, Stretching, Taping, Medication Shin Contusion The tibia lies just below the skin in the shin, it is vulnerable to kicks/hits No protection from fat or muscle S/Sx: Pain, Swelling, Hematoma (Space filled with blood) Prevention is important (especially in soccer…shinguards) Tx: Compression wrap, Ice, Elevation Aspiration (Draining by doctor with needle), Padding/Taping
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Achilles’ Tendonitis “-itis” means “Inflammation of” Inflammation of Achilles’ Tendon, the thick cord you can feel in the back of the ankle (Attaches the calf muscles to the heel bone) Causes: Repetitive Stresses (running/jumping) S/Sx: Pain & Stiffness along the Achilles’ Tendon, Swelling Treatment: RICE, Stretching, Heel Lift, Medication, Taping
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Achilles’ Tendonitis
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Achilles Tendon Rupture (Tear) Largest Tendon in Body Caused by sudden, forceful plantarflexion Common in athlete’s above 35, activities with lots of ballistic (quick sprinting) movements S/Sx: Athlete may feel or hear a “pop” and feel like they were kicked in the back of the leg; Pain, Palpable defect Ability to plantarflex will be painful or impossible
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Achilles’ Tendon Rupture (cont.) Treatment: Surgery vs. No Surgery Immobilization for 6-8 Weeks Special Test : Thompson Test
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