Ankle Sprains Flashcards
(25 cards)
How to prevent development of CAI after LAS
Evaluating all joints affected by injury
Strategies to correct hypermob
Strategies to correct hypomob
Protection of healing structures
management of CAI
Balance training
Strengthening
Bracing for 6 month following sprains
Surgery to be considered
How to prevent ankle injury in sports
Functional support and exercise therapy
Ankle bracing (50-60% reducing risk)
Neuromuscular training (40% reducing risk)
Thought of kinesio taping
May not provide enough support but ++ for proprioception
why using an ankle brace
It allows loading and protection of the healing tissue and should be used for at least 6 month after moderate to severe sprains
Bracing/taping
1/2 : early mobilisation and functional support that allow functional rehabilitation
3/4 : 10 days of immo in below-knee cast or rigid brace following by therapeutic exercise
Why is early protection WB recommend
It helps in
Reducing swelling
Restoring normal ROM
Preventing mechanical instability long term
Preventing further injury
Promoting return to activity
Manual therapy in sprains
Reduce pain
Improve stiffness
Functional recovery
Improve ankle DF
Improve proprioceptivr awareness
what is a good management for ROM and functional outcomes
Manual therapy
management ankle sprain
Reduce swelling/pain/bruise
Improve ROM
Poor balance
Poor endurance
Poor motor control
When and why occur CAI
Secondary to LAS
May occur due to damaged mechanoceptor after LAS
Deficit in CAI
Include both mech and functional instability
Deficit in perception of somatosensory information; reflex; efferent motor control
Both feed forward and feedback mechanism affected
Lead to a deficit in proprioception and postural control
positive finding for risk in CAI
ROM <34 degree knee to wall
Strength isometric ABD <34% BW
Balance single leg stance : <10s ; <5s heel raise
Poor score on star execution balance test
Inability to do 10 lat hop in less than 15s
imaging good to identify ruptured in ligament
US
why is MRI not recommended
It is good to identify ligament injury but burden on healthcare system/cost
in which position to do Xray
WB
what is functional instability test used for
Differentiating between mechanical and functional instability.
To do when lasting functional instability following a LAS
Feeling of giving away when mechanical stable
patient reported outcomes
CAIT
FAAM
FUNCTIONAL INSTABILITY TEST
why performing knee to wall test
To achieve true end of DF ROM (use gravity and eccentric DF)
what is important to consider when assessing strength
Eccentric
Could have delay in contraction (motor control assessment) (lying down/eyes closed, push foot in eversion to see delay to react in performing inversion)
subjective outcomes
Mechanisms of injury
How much WB
First/repeating injury
Previous rehab
objective outcome measures
Static and dynamic movement
Strength
ROM
Patient reported outcomes
Arthokinematics
Ligament
Bone
role of subtalar joint
Keep the foot stable and flat on the floor
Joints of ankle
Talocrural
Subtalar
Inferior tib-fib joint (with syndesmosis)
