Evaluation of Ankle Injuries
Name ___________________________
Lower Leg, Ankle and Foot Injuries
1. Go to the following website to learn more about Ankle and foot injuries:
2. Click on Sports Injuries
3. Click on Lower Leg, shin and ankle pain for first part of lesson.
4. Click on Foot and Heel pain for second part of lesson.
5. Click on specific injuries on list on left for more information/to answer questions.
a. Hint: Look highlighted names of injuries.
Common Ankle Injuries:
1. Ankle sprain:
a. A sprain is a ____________________ or tearing of a ligament.
b. The most common ankle sprain is an
________________________________ sprain (or lateral ligament sprain).
i. Ankle turns over, so foot faces _________________, damaging ligaments on outside of ankle.
ii. Most commonly injured is the anterior ____________________ ligament.
iii. About 90 percent of all ankle injuries are of this type.
c. An ______________________ ankle sprain is rare, but often occurs with a fracture.
i. Ankle turns opposite directions, with foot facing
__________________. Damaging deltoid ligament on inside of ankle.
d. All sprains are graded:
i. Grade 1 - ___________________ and mild tearing
ii. Grade 2 – moderate tear
iii. Grade 3 – Complete _______________
e. High Ankle Sprain (syndesmosis sprain)
i. Refers to damage to the anterior tibiofibular ligament, just above the ankle, that
joins the _______________ and fibula.
ii. Typically caused by _____________________ and inversion movement
iii. Less common but more severe and takes longer to heal.
f. A common test to determine if an ankle is sprained is an anterior drawer test.
i. The examiner places one hand in front where the instep is, while the other is place behind the calcaneus. He then attempts to displace the foot forward on the ankle by exerting the anterior force, while stabilizing the tibia. A positive anterior drawer sign can be demonstrated if there is significant damage to the anterior talofibular ligament.
g. Swelling and discoloration are typical from this injury.
[pic] [pic]
2. Ankle Strains
a. Pulling or tearing of a tendon or muscle of the ankle.
3. Ankle Fractures or Breaks
a. Ankle Avulsion Fracture – A force on a tendon or ligaments
(such as a sprain or strain, causes a piece of _____________ to be
pulled away.
b. Complete – fracture all the way through the bone. Can occur in any bones of the ankle.
c. Stress Fracture – typically more in the leg – will talk more about it then.
4. Dislocated Ankle
a. Bone moves out of correct alignment. Very painful. Very uncommon.
b. Typically occurs with an ankle _____________________.
5. Achilles Tendonitis
a. Inflammation or deterioration of the Achilles or its tendon sheath causing pain. Can cause a thickening of the Achilles. Often hard to treat.
b. Typically an ___________-use injury. Can be an acute or a ________________ injury.
c. Can end up with a lump on the back of the heel. Often called a pump bump.
6. Complete Achilles Tendon Rupture
a. Complete tear of the Achilles.
b. More typical in _____________________ men.
c. After injury, it is typical to see that the athlete will drag their foot.
d. Patient will often describe feeling like they were shot.
7. Peroneal Tendon Dislocation (Subluxation)
a. The peroneal muscles are found on the outside of the
____________ leg. The long tendons of these muscles pass behind the outer ankle bone (lateral maleolus) and attach to the foot.
b. If the tissues or sheath around the tendons tears then the tendons slip forward over the
_______________________.
Lower Leg Injuries
1. Shin Contusion and Muscle Contusions
a. Bruise of the muscle or bones of the lower leg.
2. Cramp in the Calf Muscles
a. _______________________contraction of the muscles of the leg.
b. Caused by overuse, strains, dehydration, etc.
c. Treated by ___________________ or massaging the muscle.
d. Best if prevented.
3. Tibia or Fibula Fracture or Break
a. Complete fracture or break of lower leg one.
4. Stress Fracture
a. Tibia Stress Fracture
i. Pain typically in lower _____________ of tibia.
ii. Partial or incomplete break of bone.
iii. More common than fibular stress fracture because is weight bearing.
iv. Will not show up on an xray until starts healing at _____________ weeks.
b. Fibula Stress Fracture
i. Not as common as Tibia Stress Fracture.
ii. Small fracture or hairline ________________ in bone.
c. Stress fractures are treated by complete _______________.
d. Must also do _____________________ return to sports participation.
e. May also occur in any other bones of lower leg, foot, or ankle.
f. Typically caused by gait abnormality or ______________________________.
5. Calf Strain
a. Tear to the __________________________ or ______________________ muscles in the calf. Painful because are used to push-off or point toe. May also have pain behind knee.
6. Shin Splints
a. Name often given to any pain of the ___________________ leg.
b. Most common cause is Medial Tibial Stress Syndrome.
c. List several causes of shin pain.
i. ________________________________
ii. ________________________________
iii. ________________________________
iv.
7. Anterior Compartment Syndrome
a. Arises when a ___________________ becomes too big for the sheath that surrounds it.
b. Causes pain.
c. Can be acute, chronic, or exertional.
d. Most serious symptom, unable to raise foot, also
known as foot _________. IF THIS SYMPTOM IS PRESENT, GO TO THE EMERGENCY ROOM.
e. Caused either by an _________________ to the leg, a tear of a muscle, or another injury which causes bleeding inside the leg compartment.
f. Diagram shows the incisions that could be required during an emergency acute anterior compartment syndrome. Chronic and Exertional Compartment Syndrome requires much less invasive surgery.
Common Foot Injuries
1. Corns and Calluses
a. Calluses – Typically develop on sole of foot. Are ____________ and ________________ patches of skin. Usually not painful
b. Corns – Typically develop on non-weight bearing friction areas on foot. Typically on
____________. Usually painful.
c. Typically treated by removing calluses and corns. Dealing with biomechanical issues
causing the issues, and using cream on the area to prevent ______________________.
2. Plantar Fasciitis
a. Pain on __________________ of heel and sometimes
______________________ the arch.
b. Caused by overuse of the plantar fascia or arch of the foot.
c. Pain is usually __________________ first thing in the morning, but gets better as foot warms up.
d. Treatment may include rest, taping, ____________________________ the plantar fascia, and/or a night splint.
3. Flat Feet – Pes Planus
a. Over pronated feet. Feet roll in during weight bearing. Can cause shin pain as well as many other foot and leg issues. (see feet worksheet for more info)
4. High Arch – Pes Cavus
a. Over supinated feet. Feet very rigid. High arch. Causes shin pain as well as other foot and leg issues. (see feet worksheet for more info).
5. Turf Toe
a. Occurs after a very vigorous _________________ bending of the big toe.
b. Sprains the ligaments of the base of the big toe.
c. Typically caused by ___________ catching on turf.
d. Treat by taping the toe to ___________________ movement.
6. Foot Fractures – Complete break in the bones of the foot.
7. Foot Stress Fractures – Incomplete break of any bone of the foot. Stress fractures explained better under leg injuries.
8. Foot Strain – Pull or tearing of a tendon or muscle in the foot.
9. Foot Sprain – Pull or tearing of a ligament in the foot.
10. Black Toe Nail
a. Results from _________________ or impact to the toe.
b. Blood builds up between nail and nail bed, causing pain.
c. Nail may ______________- _____________ if pressure not released from under toe nail.
d. Treated by drilling hole in _____________ to release pressure or by removing the nail.
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