Discuss common injuries that occur to the ankle.
Demonstrate taping, wrapping, bracing, and padding techniques for the ankle when preventing, treating, and rehabilitating injuries.
Explain and demonstrate evidence-based practice for the implementation of taping, wrapping, bracing, and padding techniques for the ankle within a clinical case.
Injury to the ankle can occur during any weight-bearing activity due to excessive range of motion and repetitive stress. Injury to the bony and ligamentous structures of the ankle can occur from excessive range of motion caused by stepping off a curb while walking or sudden changes of direction during athletic activities. Casual and athletic activities on uneven or poorly maintained surfaces may also contribute to injury. Common injuries to the ankle include:
Ankle sprains are one of the most common sport-related injuries.1 Injuries are caused by excessive, sudden inversion or eversion at the subtalar joint and can be associated with plantar flexion or dorsiflexion at the talocrural joint (Figs. 4–1 and 4–2). Rotation of the foot, either internal or external, can also contribute to injury. An inversion or eversion sprain can result, for instance, when a baseball batter steps on the corner of first base while running straight ahead to beat a throw from the second baseman, causing excessive inversion, eversion, rotation, and/or dorsiflexion. Inversion sprains are more common and can lead to damage of the anterior talofibular, calcaneofibular, and/or posterior talofibular ligaments. Eversion sprains can result in injury to the deltoid ligament and are often accompanied by an avulsion fracture of the distal tibia with severe eversion force. Excessive dorsiflexion and external rotation can cause a syndesmosis sprain involving the anterior and posterior tibiofibular ligaments. A syndesmosis sprain can occur, for example, during a fumble recovery in football, as the ankle of a player on the ground is forced into dorsiflexion and external rotation by others diving for the ball.
Ligaments of the subtalar and talocrural joints.
Ankle sprain mechanism of injury.
Fractures of the distal tibia or fibula can occur in combination with ankle sprains. A severe inversion mechanism can cause an avulsion fracture of the lateral (fibular) malleolus and sometimes an accompanying fracture of the medial (tibial) malleolus, known as a bimalleolar fracture (Fig. 4–3). With eversion sprains, the longer fibular malleolus can be fractured as the talus is forced into the distal end. If the eversion mechanism continues, an avulsion fracture of the tibial malleolus can occur, resulting in a bimalleolar fracture. Mechanisms of injury for distal tibia and fibula fractures include forcible inversion, eversion, dorsiflexion, and internal rotation.