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What happened before and after?. He did not pass his boards. What is the most commonly injured joint?. Ankle is the most commonly sprained joint. How many ankle injuries occur each day?. 25,000 ankle sprains per day. ¼ of all sports related injuries Most common sports related problems.

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25 000 ankle sprains per day

25,000 ankle sprains per day

¼ of all sports related injuries

Most common sports related problems

risk factors
Risk Factors
  • Poor rehab
  • Poor proprioception
  • Weak muscles
  • Poor ankle instability
  • Lack of warm up
  • Running on uneven surfaces
  • Poor heel support
ankle sprains
Ankle sprains
  • First degree
  • Second degree- partial severe tear, moderate instability, ,moderate pain
  • Third degree – severe pain and swelling, total tear, gross instability
ankle stress test
Ankle Stress test
  • Inversion stress test or talartilt -
  • Cross leg test
  • Anterior drawer test
cross leg test
Cross leg test
  • High ankle sprain
  • Pressure is applied to the medial side of the knee produces pain in syndesmosis area
inversion stress test or talar tilt

Inversion stress test or talar tilt -

Calcaneofibularligament instabilityend feel it is grade three

anterior drawer test

Anterior Drawer test

Excessive anterior displacement of talus onto the tibia

grade three 96
Grade three (96%)
  • Swelling
  • Hematoma
  • Pain on palpation
  • Positive anterior drawer
functional ankle instability

Functional Ankle instability

Balance Impairments


Balance Error Scoring System

  • Time-in balance test
  • Foot lift test
balance error scoring system

Balance Error Scoring System


Three stance conditions and two surface conditions

foot lift test

Foot lift test

Single leg tests touch calf

high ankle sprain

High ankle sprain

Syndesmotic ankle sprain

syndesmotic ligament
Syndesmotic ligament
  • Connects the shin to the fibula
  • Tender front
  • Pain worse if foot or leg is twisted outward
  • Positive squeeze test
  • Need surgery
ottawa ankle rules
Ottawa ankle rules
  • Pain in the malleolar region plus
  • Bone tenderness distal 6 posterior edge of tibia or tip of MM
  • Bone tenderness along the distal 6 cmof the posterior edge of fibula or tip of LM
  • Inability to bear weight to bear weight the first 4 steps
general rehabilitation principles
General Rehabilitation Principles
  • NASI
  • ROM
  • Strengthening
  • Proprioception of the ankle joint
  • Standard
  • Intermittent
  • Outcomes
rehabilitation price
Rehabilitation - PRICE
  • 2nd degree – immobilization of the ankle
  • 3rd degree – cast immobilization for 2 to 3 weeks, surgery maybe needed
chronic ankle pain
Chronic ankle pain
  • Poor rehab
  • Functional instability
  • Ankle impingement
  • Undxfx
  • Post-traumatic arthritis
  • Osteochondritisdissecans
  • Syndesmotic ligament injury