the ankle chapter 15. ankle anatomy bones two bones in the lower leg tibia – medial, larger,...
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ANKLE ANATOMYBONESTwo bones in the lower leg
Tibia – medial, larger, weight bearing Medial Malleolus
Fibula Lateral Malleolus
Two tarsal boneTalusCalcaneus
ANKLE ANATOMY
TRUE ANKLE JOINTTibia, fibula and talusMortise
Definition: where the talus fits into the tibia and the fibula
LIGAMENTS – p. 317LATERAL SIDE– 3 ligaments named for bonesAnterior talofibular
(ATF)Calcaneofibular
(CF)Posterior talofibular
(PTF)
LIGAMENTS
TIBIOFIBULAR LIGAMENTS – holds tibia and fibula together Anterior tibiofibular Posterior tibiofibular
MUSCLES
The muscles that move the ankle are found in the lower leg – not around the ankle joint (we will talk more about this in the lower
leg injury section)
TYPES OF ANKLE SPRAINS
InversionMost common type of ankle sprain
Accounts for 80% of all sprainsAKA ‘a lateral ankle sprain’
First degree sprainOnly involves the anterior talofibular ligamentMild pain, tenderness, and swellingNo instability
TYPES OF ANKLE SPRAINS
InversionSecond degree sprain
Anterior talofibular ligament is torn and calcaneofibular ligament is injured as well
Most painfulModerate swellingMild Instability
MECHANISMS OF ANKLE SPRAINS
InversionThird degree sprain
Complete tear of all three lateral ligamentsUncommonLots of pain, but it can subsideVery unstableUsually requires surgery
TESTING ATF STABILITY
Drawer TestStablize lower leg with one handPull heel forward (like opening a drawer)Should not move forward if ligament is intact
TYPES OF ANKLE SPRAINS
Eversion Not as common Can occur more on tartan surfaces and artificial turf Everything is worse (pain, swelling, etc) when compared
to an inversion injury If the deltoid tears, the tibiofibular ligaments may tear also
High Ankle Sprain
Involves Anterior Inferior Tibiofibular (AITFL) Ligament
Injury allows tibia and fibula to separate
High Ankle Sprain
Cause: Inversion with rotation; rotation of footS/S: pain with external rotation of foot; tender over AITFLTreatment: RICE, may need to be immobilized; possible surgery if severe enough
Treatment of Ankle Sprains
Prevention – once you sprain an ankle it is easy to do again – tape and rehab
Rest – No activity for 24-48 hours
Ice – 20 minutes on, 40 minutes off
Compression – ace wrap with horseshoe
Elevation – ankle above the heart
Support – crutches and aircast if needed
Ankle Rehab
ABCs
Circles
Theraband exercises
Single Leg Balance
Balance Board
Calf Raises
And so much more….
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