Ankle

Question 1

How many degrees of DF do you need with knee flexed during heel/toe

Answer 1

10-15 degrees of DF

Question 2

with knee flexed during stairs you need how many degrees of DF

Answer 2

ascending 15-25 degrees of DF

descending 20-35 degrees of DF

Question 3

when walking and going up/down stairs you need how many degrees of PF

Answer 3

15-30 degrees of PF

Question 4

the first MTP hyperextension need at least

Answer 4

65 degrees at heel and toe off

Question 5

the three-foot arches are maintained by what?

Answer 5

-ligaments and aponeurosis most supported
-the shape of the bones and their relation to each other the keystone of the foot is (navicular)
-muscles only 15-25% of support so minimalability to strengthen any abnormal arch flattening

Question 6

with the subtalar joint neutral the?

Answer 6

-talus is centered in the talocrural and on the calcaneus
-AKA the position the talus should be in

Question 7

measurement for subtalar neutral are?

Answer 7

common and widely taught
poor and reliability and validity
not a sound basis for STJN or orthotic
it may produce + results but it is not measuring or assessing what is proposed
A better method should be pursed

Question 8

measuring the medial longitudinal arch

Answer 8

the standing position is not predictable of dynamic function

Dynamic 2D measuring from a video or #D analysis are reliable measure of MLA

Question 9

what is a Mild S&S; Activity may continue; Fibers are stretched but NOT torn so minimal to no change during ligamentous special tests

Answer 9

Grade 1/1st degree

Question 10

what is Moderate S&S; Activity stops; Fibers stretched and torn so increased laxity with softer/later end feel during ligamentous tests

Answer 10

Grade 2/2nd degree

Question 11

Severe S&S; Activity stops; Fibers torn completely with possible avulsion; Significant increase in laxity with empty end feels during ligamentous tests

Answer 11

Grade 3/3rd degree

Question 12

what are the incidence and prevalence of sprains

Answer 12

-One of the MOST frequent injuries in sports39
-Up to ¼ of people unable to attend work for > 1 wk39
-Persistent symptoms in 3039-72%41
-80% re-injury rate following an IV sprain42; why?

Question 13

what are the risk factors of a sprain?

Answer 13

Previous ankle sprain(s)
Lack of external support
Lack of warm up
Lack of coordination training
Impaired DF- what could be reasons for impaired DF?

Question 14

what are sprain risk factors?

Answer 14

-Impaired DF 89 possibly due to…
*Shortened Triceps Surae (Calf)
*Talar hypomobility
Decreased posterior glide
Decreased ER
*Fibrosed capsule
Universal hypomobility
NO distraction and limited glides in all directions
-Limited DF may delay pronation and excessively load lateral foot

Question 15

Lateral ankle sprians are caused by

Answer 15

excessive PF and IV

Question 16

What are the structures involved with lateral sprains

Answer 16

the Talocrural Ligaments you have:
-ATF- MOST commonly torn
-CF :Primarily torn with pure IV and Will be on slack with PF
-PTF

Question 17

Other structures involved with Lateral sprains are?

Answer 17

Subtalar or Talocalcaneal Ligaments
Anterior- interosseous lig
Lateral- attaches and runs parallel to CF lig so they will likely be damaged together

Question 18

The Lateral sprains structures that are involved with bone are?

Answer 18

-Avulsion fx of lateral malleolus due to ligamentous attachment
-Avulsion fx of 5th MT from excessive action of Peroneus Brevis
-Medial malleolus fx due to compression with excessive IV
-Cuboid displacement due to excessive action of Peroneus Longus
-Fibula anteriorly subluxed on Tibia by reversal of m. action of Peroneals
-Muscles/tendons- possible Peroneal strain and/or subluxation if retinaculum torn
-Epiphyseal plate avulsions- lateral malleolus and 5th MT

Question 19

what are the symptoms of Lateral Sprains?

Answer 19

-Sudden onset with trauma by “rolling ankle” and the foot turning inward
-Lateral ankle P!/swelling
-Limited and P!ful ROM, especially pointing foot and turning inward
- Difficult and painful weight bearing

Question 20

what are signs of lateral sprains?

Answer 20

*Observation
Swelling and possible ecchymosis
Antalgic and asymmetrical gait
*Ottawa and Bernese Ankle Clinical Decision Rules (CDR)- determine need for radiographs89
*ROM- primary limited and P!ful PF and IV
*Resisted/MMT- possibly weak and P!ful EV

Question 21

Signs of lateral ankle sprains?

Answer 21

-Special Tests- (+) lateral ligamentous tests
*Talocrural
Generally, with Ant ( high spec) and Reverse Ant Drawer (high spec)
*Specific lateral ligament tests: ATF with
Antlat Drawer (high sens) and Reverse Antlat Drawer (high sens/spec)
Antlat Talar Palpation
-CF with Medial Talar Tilt (higher sens/spec)
-PTF

Question 22

Signs of Lateral Ankle sprains

Answer 22

Special Tests- (+) lateral ligamentous tests
Subtalar
-Anterior interosseous
-Lateral Talocalcaneal
*TTP over involved structures