The Ankle
Bones
 Tibia
 Fibula
 Talus
Movements
 Dorsal Flexion- most stable position
 Plantar Flexion- Most unstable
 Eversion
 Inversion
Ligaments
 Medial Side
 Deltoid Ligament- has 4 attachments

Tibionavicular, tibiocalcaneal, anterior tibiotalar, posterior
tibiotalar
 Lateral Side
 Anterior talofibular (most commonly sprained)
 Calcaneofibular
 Posterior talofibular
 Anterior tibiofibular
 Posterior tibiofibular
 Posterior talocalcaneal
 Lateral talocalcaneal
Muscles, Arteries, Nerves
 See foot notes
Ankle Landmark Test
 Start Posterior then medial lateral last
 Achilles Tendon
 Medial Mallious
 Deltoid Ligament
 Lateral Mallious
 Posterior Talofibular
 Calcanealofibular
 Anterior Talofibular
 Base of the 5th

MUST COMPLETE IN THIS ORDER FOR 4.
Sprains
- 85% of injuries sprains
- 90% of sprains are inversion
The Ankle Story
 Trainer focus on lower body movement during play
 When player goes down trainer trot to athlete
 Keep athlete down
 Look for abnormal angles
The Ankle Story cont.
 Ask questions- feel anything tear, pop, pain or
discomfort, shooting pain
 If no deformity- ask if they can stand two man walk
with leg up. If they cant stand two man carry
The ankle story cont
 Bare ankle
 Look for swelling, discoloration
 Find point tender spot palpate


Start posterior, Achilles, deltoid ligaments, navicular, base of 5th,
posterior Talofibular, calcaneofibular, anterior talofibular
Fracture Test

s/sx- vertical shooting pain, heel tap, mallelous tap lower leg
squeeze
The Ankle Story Cont.
 Ligament stress test
 Drawer stress- tear of anterior talofibular


Hand on top of leg other on heel pull up hard
Invesion stress- tear calcaneofibular

Turn heel in
The Ankle Story Cont.
 Range of Motion (ROM)
 Passive and Active- DF,PF,IV, EV
 Manuel muscle Test- Tell athlete to not let you move
foot in all ROM
The Ankle Story
 Bare Foot Test
 Stand on toes of both feet
 Jump with both feet- watch for double slap
 Hop on injury
 Walk forward and backward
 Walk forward and backward
 Put Maximum Tape support
Have athlete run forward and backwards, figure 8, grapevine,
slides, skip.
 If pain stop

The ankle story cont.
If unable to return RICE.
If able to pass bare foot test return to play as tolerated.
Strains
 Can be independent of part or sprain
 Strain of the peroneal muscles
 Usually part of lateral ankle sprain
 Point tender over from base of 5th (in severe xray to rule out
avulsion fracture) posterior malleolus up lateral side of leg
 Weakness with eversion on muscle test
 Treatment- RICE, strength eversion.
Strains
 Anterior and dorsum muscle strains- extensor
 Cause by forced into extreme dorsal flexion, running
backwards
 Point tenderness over nails of toes
Strains
 Achilles Tendinitis
 Causes- overuse or acute, tight Achilles or part of ankle sprain,
or independent
 S/sx- point tenderness over achilles, pain with dorsal flexion,
weakness with plantar flexion
 Tx- Stretch achilles, strengthen plantar flexion, RICE, tape to
play
 Can lead to achilles tendon rupture.
Strains