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Ankle Sprain

The document discusses the anatomy and rehabilitation of grade I lateral ankle sprains. It describes the anterior talofibular ligament as the weakest ligament in the ankle. A 4-phase rehabilitation program is outlined, beginning with RICE treatment and progressing to proprioceptive and strength exercises over 6 weeks. The goal is to regain full range of motion and strength to allow a return to sport activities.

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0% found this document useful (0 votes)
88 views20 pages

Ankle Sprain

The document discusses the anatomy and rehabilitation of grade I lateral ankle sprains. It describes the anterior talofibular ligament as the weakest ligament in the ankle. A 4-phase rehabilitation program is outlined, beginning with RICE treatment and progressing to proprioceptive and strength exercises over 6 weeks. The goal is to regain full range of motion and strength to allow a return to sport activities.

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© © All Rights Reserved
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Grade I Inversion

Ankle Sprain
By: Christine Jimenez
Anatomy
• Ligaments:

• Anterior talofibular

• Calcaneofibular

• Arteries:

• Lateral plantar

• Fibular
https://eastpennfoot.wordpress.com/2012/11/29/how-your-ankle-
• Posterior tibial works-a-quick-anatomy-lesson-on-a-very-complex-joint/blood-
vessels-of-foot-and-ankle/
Anterior Talofibular Ligament

• Weakest ligament in the ankle

• Connects the talus to the anterior fibula

• Consists of connective tissue outside of the


ankle

• Acts as protection to the joint from outside


forces
Anatomy cont.
• Nerves: Posterior tibial
nerve, lateral plantar
nerve

• Tendons: Achilles tendon

• Bones: talus, tibia, fibula

• Muscles: gastrocnemius, https://www.mayoclinic.org/diseases-conditions/broken-ankle-broken-foo


multimedia/foot-and-ankle-bones/img-20008997
soleus, posterior tibialis,
anterior tibialis, peroneus
longus and brevis
Risk Factors
• Fatigue- muscles and ligaments
become fatigued during activity
and are more susceptible to
injuries

• Conditioning- athlete not


conditioning prior to vigorous
activity such as strengthening
and stretching

• Warming up- athlete does not


warm up before activity in which
the muscles and ligaments
remain tight and are more prone
to sprains
https://www.popsugar.com/fitness/photo-gallery/31081972/
image/31081979/Dorsi-Flexion-Resistance-Band
Mechanism of injury
• Awkward landing of foot

• Stepping on an uneven
surface

• Athlete landing on another


athlete’s foot

• Stretching force when foot


rolls inward

http://ionaphysio.com/ankle-sprain-rory-mcilroy/
Kinetics-Average ROM
• Plantar flexion
(downward) : 0°-50°

• Dorsiflexion
(upward) : 0°-20°

• Inversion: 0°-35°

• Eversion: 0°-25°
https://www.pinterest.com/pin/305470787201410381/
Classifications
• Grade I: • Grade II: incomplete • Grade III: complete
partial tear of tear of ligament tear of ligament
ligament
• Moderate pain • Severe
• Mild and swelling swelling
swelling • Tenderness • Severe
ecchymosis
• Slight • Some loss of
function motion and • Loss of
al loss function function

• Mild to moderate • Mechanical


ecchymosis instability
Signs and symptoms
• Swelling

• Bruising

• Tenderness to touch

• Ankle instability http://www.wisdom-square.com/best-way-to-treat-a-


sprained-ankle.html
• Pain

• Limited ROM

• Discoloration

https://www.pinterest.com/pin/
404338872777337118/
Grade I Sprain Rehabilitation
• 4 phases

• About 6 weeks

• Non-surgical treatment for


Grade I Lateral Ankle Sprain

• Consisting of RICE, limiting


movement, progress to
exercises, strengthening, and
gaining balance back

• Southern California Orthopedic


Institute

• By: Dr. Michael Bahk


Phase 1: 1 Week
Purpose: Decrease swelling and pain
Protection from injury
Increase pain free ROM
Treatment
• Rest- avoid putting load and walking

• Ice- 20 minutes three times daily to keep


swelling down

• Compression- any ace wraps or bandages


to provide support and prevent swelling

• Elevate- above level of your heart for the


first two days

• Applying tape, compression wrap, ankle


brace
https://copperjoint.com/rice-most-effective-ankle-sprain-remedy/

• Exercises: ankle alphabet, circles, calf


pumping, bio mechanical ankle platform
system (seated) with no weight

• Amount of reps vary on patient’s progress

http://marshallsportsmedicine.org/rehab-and-recovery/physical-therapy/
Phase 2: 1-3 Weeks
Goals: Pain free ROM
Pain free strengthening
Progression to exercise with weight
Start proprioceptive training
Treatment
• Continuation of Phase 1 exercises Theraband
• Exercises: 4 plane ankle theraband,
towel sweeps, towel crunches, tissue
pickup, heel and toe raises, balance
activities on trampoline, quarter squats

• Progression on dorsiflexion and


plantarflexion for joint mobilization

• Bio mechanical ankle platform system


(seated) with weight, wobble board, single https://www.physioadvisor.com.au/exercises/
limb stance, stationary bike, and aqua strengthening-joints/ankle/
jogging

• Amount of reps vary on patient’s progress


Phase 3: Week 3-5
Goals: Progress strengthening
Progress proprioceptive training
Increase endurance
Treatment
• Begin elliptical training, jog on
treadmill, leg presses, stand on bio
mechanical ankle platform system
with weights, wobble board, lateral
shuffles, toe walks, heel walks, single
leg trampoline ball catch, single leg https://www.aliexpress.com/item/Medium-Resistance-Exercise-Band-Tube-
squats, cariocas Pilates-Sport-Cord-stetch-tubing-yoga/561423146.html

• Incorporate sports cord for resistance


in strengthening and balance

• Number of reps vary depending on


progression of patient

http://www.truefitness.com/commercial-fitness/
strength/paramount/fuse-xl/fuse-0300-leg-press/
Phase 4:
Goals: Regain full strength
Full ROM
Full balance and proprioception
Return to sport activity
Treatment
• Increase time jogging on treadmill Grid Hops
• Single leg squat on dyna disc,
grid, double and single leg hops
(forward, backward, side to side),
balancing on 5 point star dyna
disc

• Amount of reps vary on


progression of patient
https://www.researchgate.net/figure/Y-Balance-test-performed-
• Completely remove support (tape, using-tape-grid_fig1_321226020

ankle brace, compression wrap)


Summary
• 85% of ankle sprains are lateral (inversion) sprains

• The anterior talofibular ligament is the weakest ligament in


the ankle, making it more prone to injuries and consists of
connective tissue

• If an athlete does not condition or warm up, the muscles


will be tight and are more susceptible to injuries

• Rehabilitation for the ankle according to the Southern


California Orthopedic Institute is a 4 phase rehab program
and the amount of time varies with the progression of the
athlete
Works Cited
• https://www.physio-pedia.com/Ankle_Sprain

• https://accessphysiotherapy.mhmedical.com/content.aspx?
bookid=855&sectionid=49735197

• https://orthoinfo.aaos.org/en/diseases--conditions/sprained-ankle/

• https://www.healthline.com/human-body-maps/anterior-talofibular-
ligament

• https://www.emedicinehealth.com/ankle_sprain/article_em.htm

• http://www.michaelbahkmd.com/pdf/general-ankle-rehab-
protocol.pdf

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