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THE ANKLE

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					THE ANKLE

      CHAPTER 18
 The Ankle and Lower Leg
   Introduction

 “Have you ever sprained
  your ankle, or do you
  know anyone who has?”

 What did you do for it?
 How long did the pain last?
 Do you have any problems
  with that ankle?
Anatomy of the Ankle
 What bone make up the
  Ankle joint?

 Tibia
 Fibula
 Talus
 Calcaneus
Online Ankle Quiz
 Access the following link and take the online
  bones of the Ankle quiz.
 http://www.csuchico.edu/~sbarker/shock/Ankl
  equiz.html
   Anatomy of the Ankle
 What type of joint is
  the Ankle?

 The Ankle joint is a
  HINGE JOINT

 The TALOCRURAL
  Joint
   Major Ligaments of the Ankle
 LATERAL ASPECT


 Anterior Tibiofibular


 Anterior Talofibular- 3


 Calcaneofibular- 6


 Posterior Talofibular- 9
   Major Ligaments of the Ankle
 MEDIAL ASPECT


 Posterior Talotibial
 Posterior
  Talocalcaneal
 Deltoid
   Muscles and Tendons around the
   Ankle
 Achilles Tendon


 Peroneal Tendinitis


 Anterior Tibialis Tendinitis


 Posterior Tibialis Tendinitis
Common Ankle Injuries
      Inverted Ankle Sprain


      Everted Ankle Sprain


      Ankle Dislocation


      Muscle and Tendon Strains
Inverted Ankle Sprain
 Inversion Ankle Sprain-
  the foot turns inward
  rolling over the lateral
  aspect of the ankle.

 Most common ankle
  sprain- about 85% of all
  ankle sprains
 Everted Ankle Sprain
 Eversion Ankle Sprain-
  the turns inward. The
  ankle rolls in medially.

 Uncommon sprain due
  to bone support.

 Occurs in about 10-15%
  of ankle sprains.
Ankle Dislocation/Fracture
 Ankle Dislocation -
  Fracture
 Medical Emergency
 Usually the foot is
  inverted.
 Frequently both the
  Tibia and Fibula are
  fractured.
Ankle Dislocation/Fracture
- Medical Emergency
Muscle and Tendon Strains

          Most common is
           the Achilles
           Tendon Strain.
          THOMPSON Test
           the Achilles.
          Peroneal tendon
           sometimes
           damaged with
           inversion ankle
           sprain.
Video on Ankle Injuries
 NOTES on VIDEO:
  Grading Scales for Sprained
  Ankles
 GRADE I      Most common ankle sprain.
               Mild pain, still weight baring.


 GRADE II     More painful, report popping sound.
               Can not bear weight.
               Stretching of lateral ligaments of the ankle.


 GRADE III    Extreme pain. Usually complete tear of one
                of the ankle ligaments.
               Sometimes fracture occurs also.
Rehab/Treatment Plan for Sprained Ankles

  RICE


  Modalities


  Exercises
   RICE
 Rest- stay off the Ankle,
  crutches may be needed
 Ice- 15 minutes a 4 to 5 times a
  day
 Compression- ace wrap with
  horseshoe keeps the swelling
  down
 Elevation- keep ankle above
  heart level when possible, allows
  gravity to pump out swelling
Goals of RICE
 Limit Swelling


 Reduce pain


 Return to
 sport/activity
 quicker
    Modalities Used
 COLD WHIRLPOOL-
 15 minutes a couple times
    a day
   Vasoconstrictors vessels
    around ankle
   Stimulates pain killing
    receptors
   Slows cell metabolism
   Aids in reducing swelling
    Modalities Used
 HIGH VOLTAGE-
 Assists in activating pain killing
    receptors.
   Assists in muscle stimulation
    around ankle joint to aid in
    edema removal.
   ULTRASOUND-
   Assists in edema removal.
   Assists in bringing digestive
    enzymes to clean debris cells of
    the injured ankle.
Rehab Exercises
           Range of Motion ABC’s
           One leg Stands
           BAPS Board
           Towel Curls
           Toe Pickups
           Toe Rises
           Theraband
 Taping Vs. Wrapping

 TAPING-
 Psychologically better
  feeling to the athlete
 Tight fitting at first
 Tape looses a large
  percentage of its
  support within the first
  15-20 minutes of
  competition
   Taping Vs. Wrapping

 WRAPPING-
 Purpose in wrapping is
  injury prevention.
 Wrapping will not
  eliminate sprained ankle,
  but it does minimize the
  severity of the sprain.
 Ankle Braces
 ANKLE BRACES-
 Many varieties and types.
 Lace Up
 Hinged
 Air Casts
 All offer different levels of
  support.
 Large and competitive
  business market for ankle
  braces.
Ankle Braces
Ankle Braces
Ankle Braces
Video on Cramer Ankle Brace
 Notes on Video:
Questions Over Ankle
 Notes:

				
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posted:10/22/2011
language:English
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