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| - most common injury in physically active people - caused by sudden inv or ev moments | Ankle sprain
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| Ligaments that can be sprained with inversion moment | - ant talofibular by inv, PF, and IR
- rotary ankle instab (talus rotates about long axis in transverse plain)
- post talofibular & calcaneal (with increased force)
- avulsion fracture at lat mall
- deltoid lig can impinged & contused
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| - occurs with inv PF - stretches ant talofibular lig - mild pain, disability, minimally impaired WB - point tenderness over lig with no laxity | Grade I ligament sprain
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| - moderate inv force causing great deal of disability - feel or hear pop or snap - moderate pain with difficulty WB - tenderness & edema present | Grade II ligament sprain
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| - relatively uncommon but extremely disabling - caused by significant inv force resulting in subluxation & reduction - damage ant/post talofibular & calcaneofibular lig and capsule - severe pain, swelling, hemarthrosis, discoloration - unable to WB | Grade III ligament sprain
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| - represent 5-10% of all ankle sprain bc bony protection & lig strength decrease likelihood - pain may be severe, unable to WB, pain ABD/ADD | Eversion sprains
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| Ligaments that can be sprained/common injuries with eversion moments | - deltoid lig
- possible fracture to fibula
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| - injury to the dist tibiofibular jt, ant/post tibiofibular lig - increased ER or DF - med & lat collateral ligs injured in conjunction - severe pain (usually located anterolaterally), loss of function - passive ER & DF causes pain | Syndesmotic sprain
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| Develops following 1/3 of all acute ankle sprains | Chronic ankle instability
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| Laxity that physically allows for mvmt beyond the physiologic limit of ankleâs ROM | Mechanical Instability
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| A subjective feeling that the ankle is unstable. Attributed to proprioceptive and/or neuromuscular deficits that negatively impacted postural control = stability & balance | Functional Instability
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| - caused by a number of mechanisms - avulsion & bimalleolar fractures - swelling & pain may be extreme with possibly no deformity | Ankle fractures/dislocations
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| - used to determine need for radiograph: - pain in malleolar or midfoot - inability to WB for 4 steps at time of injury & examination - tenderness over inf/post pole of either malleoli, base of 5th MT, navicular bone | Ottawa Ankle Rules
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| - occurs in sup med articular surface of talar dome - one/several fragments of articular cartilage w/ underlying subchondral bone partially/completely detached & moving within jt space - single or repeated trauma - pain, effusion, catching, locking, givi | Osteochondritis Dissecans
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| - common in sports, often occurs with sprains or excessive DF - pain may be mild to severe - most severe injury is partial/complete avulsion or rupture of Achilles | Injury to the Achilles
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| (1/2) - inflammatory cond to tendon or its sheath (paratendon); referred to as tenosynovitis - causes fibrosis & scarring that can restrict motion in sheath; may lead to tendinosis - typically no inflammation present, lost normal appearance, cell disorg/ | Achilles Tendinosis
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| (2/2) - tendon overloaded to extensive stress - decreased flexibility exacerbates cond - generalized pain/stiffness, localized prox to calcaneal insertion - limited strength, restricted mvmt (esp in morning) - crepitus with active PF & passive DF - chron | Achilles Tendinosis
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| - occurs with sudden stop & go (eccentric load!!), forceful PF with knee moving into full ext - common in athletes 30 yr & older - predisposition: history of chronic inflam - immediate pain which rapidly subsides (window shade) - point tenderness, swelli | Achilles Tendon Rupture
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| - occurs with dynamic forces applied to ankle - dramatic blow to post lat mall - mod/severe inv sprain resulting in tearing of fibularis retinaculum; potential for tendon rupture - complain of snapping in & out of groove with activity - ev against manua | Peroneal (fibularis) Tendon Subluxation/Dislocation
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| - commonly occurs after extensive down-hill running (eccentric!) - point tenderness over ant tib tendon | Anterior Tibialis Tendinitis
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| - direct blow to lower leg (impacting periosteum anteriorly) - intense pain & rapidly forming hematoma with jelly-like consistency | Shin Contusion
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| - common overuse injury in runners with foot hypermobility or over pronation - repetitive microtrauma - pain & swelling in med mall - edema, point tenderness, & increased pain during resistive inv & PF | Posterior Tibialis Tendinitis
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| - contusion of leg, particularly in gastroc region - bruise may develop causing pain, weakness, & partial loss of limb func - palpation will reveal hard, rigid, inflexible area due to internal hemorrhaging & muscle guarding | Muscle Contusions
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| - susceptible to strain near musculotendinous attachment - caused by quick start, stop, or jumping - variable amount of swelling, pain muscle disability - may feel like being âhit in the leg with a stickâ - edema, point tenderness, and func loss of s | Gastrocnemius Strain
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| - fibula has highest incidence of fracture in middle third - tibia fractures occur predominately in the lower third - result of direct blow or indirect trauma - pain, swelling, soft-tissue insult - leg will appear hard & swollen | Acute Leg Fractures
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| - pain in ant shin - accounts for 10-15% of all running injuries & 60% of leg pain in athletes - caused by repetitive microtrauma - weak muscles, improper footwear, training errors, varus foot, tight heel cord, hypermobile or pronated feet, and forefoot | Medial Tibial Stress Syndrome (MTSS)/Shin-splints
- stress fractures
- muscle strains
- ant compartment syndrome
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| Four Grades of Pain of MTSS | - pain after activity
- pain before & after activity, not affecting performance
- pain before, during, & after activity, affecting performance
- pain so severe performance is impossible
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| - complain of deep aching pain & tightness due to pressure & swelling - reduced circulation & sensation - must be recognized & treated early | Compartment Syndrome
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| Type of Compartment Syndrome that occurs secondary to direct trauma or medical emergency | Acute Compartment Syndrome
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| Type of Compartment Syndrome that evolves with minimal to moderate activity | Acute Exertional Compartment Syndrome
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| Type of Compartment Syndrome where symptoms arise consistently at a certain point during activity | Chronic Compartment Syndrome
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| - common overuse cond, in those with structural/biomechanical insufficiencies - Runners = lower third, Dancers = middle third - often occurs in nonconditioned & inexperienced individuals, training errors - component of female athlete triad - pain more in | Stress Fracture of Tibia or Fibula
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