12: Ankle Pain

Question 1

Medial aspect of ankle stabilized by the _____ ligament.

Answer 1

Medial aspect of ankle stabilized by the deltoid ligament.

Question 2

Lateral aspect of ankle stabilized by _____, _____, and _____ ligaments.

Answer 2

Lateral aspect of ankle stabilized by anteror talofibular, posterior talofibular, and calcaneo-fibular ligaments.

Question 3

Talar tilt checks the _____ ligament which connects to the talus.

Answer 3

Talar tilt checks the calcaneofibular ligament which connects to the talus.

Question 4

Plantar flexion and inversion causes dorsal pain on the _____ side in an ankle strain.

Answer 4

Plantar flexion and inversion causes dorsal pain on the lateral side in an ankle strain.

Question 5

Plantar flexion and eversion that causes pain indicates a _____ strain.

Answer 5

Plantar flexion and eversion that causes pain indicates a deltoid strain.

Question 6

An _____ is frequently painful when moved in any direction, whereas a ligamentous sprain produces maximal pain when the ligament is stretched.

Answer 6

An arthritic joint is frequently painful when moved in any direction, whereas a ligamentous sprain produces maximal pain when the ligament is stretched.

Question 7

In the Thompson test, squeezing the calf should cause _____.

Answer 7

• In the Thompson test, squeezing the calf should cause plantar flexion.
• The asynch states the great toe of the foot should go down.

Question 8

Is an inversion or eversion ankle sprain more common?

Answer 8

Inversion

Question 9

Which ligaments are most commonly sprained?

Answer 9

• Talofibular
• Calcaneofibular

Question 10

T/F Ankle sprains are the most common musculoskeletal injury.

Answer 10

True

Question 11

Do you refer to a specialist with an inversion or eversion sprain?

Answer 11

• Eversion.
• These sprains are less common and require excessive force.
• If a deltoid ligament tear is suspected, refer to specialty.

Question 12

The anterior drawer test of the ankle tests what ligament?

Answer 12

• Anterior Talofibular Ligament
• Positive test is when the talus moves forward.

Question 13

Is the anterior drawer test useful in an inversion or eversion injury?

Answer 13

Inversion

Question 14

Management of ankle injuries (6).

Answer 14

1. RICE
2. Crutches (non-weight-bearing)
3. Splint (air cast)
4. NSAIDs
5. PT for grade 2/3
6. Bone scan if fracture suspected (no improvement after 10 days)

Question 15

T/F All ankle injuries need an x-ray.

Answer 15

False. X-ray not necessary for a sprain. Refer to Ottawa Ankle Rules.

Question 16

Ottowa Rules for ankles indicate an ankle x-ray in these 3 situations.

Answer 16

1. Pain near the malleoli
2. Inability to bear weight
3. Severe injury

Question 17

Ottowa Rules for ankles indicate a foot x-ray in these 3 situations.

Answer 17

1. Pain in the midfoot
2. Inability to bear weight
3. Bony tenderness at the base of the 5th metatarsal

Question 18

When do you refer ankle injuries (5)?

Answer 18

1. Eversion injury
2. Grade 3 sprain
3. No improvement after 2-3 weeks or instability present
4. Neurovascular compromise
5. Tendon rupture or subluxation