Tibiofibular joint proximal motion
Anterior -- Dorsiflexion, Eversion
Posterior - Inversion, plantarflexion
Tibiofibular joint distal
Anterior medial -- plantarflexion
Posterior lateral -- dorsiflexion
Subtalar joint -- Pronation
eversion and dorsiflexion and abduction
Anteriomedial glide of the talus on the calcaneus
Subtalar joint -- Supination
Inversion and plantarflexion, adduction
Posteriolateral glide of the talus on the calcaneus
Most frequently injured ankle ligament with foot inverted ? What does it prevent ?
Anterior Talofibular ligament
Restricts anterior displacement of the talus in plantarflexion
In the case of an eversion sprain, what must be kept in mind and why ?
Deltoid ligament is sometimes stronger than bone
What nerve root is tested with the achilles tendon reflex ? What motion is expected ?
What type of strain is more common ? Inversion or eversion ?
Grade 1 ankle sprain
Partial tear of some of the fibers but ligament is intact.
Mild swelling and pain
Grade II ankle sprain
Usually there is a complete tear of the anterior talofibular ligament and partial tear of the calcaneofibular ligament
Restricted range of motion with moderate sweeling, bruising and associated tenderness
Grade III ankle sprain
Complete tear of both anterior talofibular ligament and calcaneofibular ligament.
Loss of function and marked abnormal joint motion
Marked swelling, hemorrhage and tenderness
Somatic Dysfunctions of a lateral ankle sprain - assume sprain is on right foot.
Supination of foot
externally rotated tibia
internally rotated femur
posterior right innominate
R on R sacral dysfunction
General Treatment for ankle sprains ?
Surgery for stage III
Treatment for type I lateral ankle sprain
isometric exercises as soon as pain abates
OMT - effleurage, counterstrain, Indirect MF
Treatment for type II lateral ankle sprain
Remove Crutches once weight bearing is painless
OMT - Effleurage, CS, Indirect MF, muscle energy to restricted areas
Treatment for type III lateral ankle sprain
Rehab -- same as others
OMT -- effleurage, CS, IMF, muscle energy
HVLA and articulatory techniques
Ottawa ankle rules
Pain in malleolar zone or mid foot zone + tenderness at points + unable to bear weight = XR
Ottawa ankle rules for ankle XR
Pain in malleolar zone
Tenderness at either medial or lateral mallelus
unable to bear weight
Ottawa ankle rule for foot XR
pain in mid foot zone
Tenderness at either base of 5 metatarsal or navicular
unable to bear weight
look for plantar flexion
+ achilles tendon rupture if no plantar flexion