Skills Check 3

Question 1

Case:

Lateral ankle sprain

Treatment

3 tests/measures and treatment approach

Answer 1

Rule out fracture with Ottawa ankle rules

Anterior drawer
Talar tilt (inversion)
Figure 8

Acute: PRICE, WBing
Subacute: AROM to pregressive strengthening
Chronic: Strengthening, Balance/proprioceptive training

Question 2

Case:

Medial ankle sprain

3 tests/measures and treatment approach

Answer 2

Rule out fracture with Ottawa ankle rules

Talar tilt (eversion)
Observe gait for collapse of arch
Figure 8

Acute: PRICE, WBing
Subacute: AROM to pregressive strengthening
Chronic: Strengthening, Balance/proprioceptive training

Could use an orthotic to support the medial arch

Question 3

Case:

High ankle sprain (syndesmosis)

3 tests/measures and treatment approach

Answer 3

Rule out fracture with Ottawa ankle rules

Thompson test
Kleiger’s test
Heel thump (pain in syndesmosis)

Acute: PRICE, WBing
Subacute: AROM to pregressive strengthening
Chronic: Strengthening, Balance/proprioceptive training

Question 4

Case:

Achilles tendinopathy

3 tests/measures and treatment approach

Answer 4

Palpate tendon (thickening? nodules? Pain?)
Heel raise test
Gait

Rest
Stretch calf
Isometric>concentric>isotonic>eccentric

Question 5

Case:

Posterior Tibialis tendinopathy

3 tests/measures and treatment approach

Answer 5

Resisted PF and inversion
Palpate tendon
Observe gait for medial collapse or poor push off

Orthotics or taping to support arch
Strengthen tibialis posterior
Tempoarary activity modification

Question 6

Case:

Post ankle ORIF Management

Answer 6

Take goniometric measures
Squat
Figure 8

Gentle AROM
Joint mobilizations if cleared

Question 7

Case:

Limited squat

How do you help?

Answer 7

Observe squat
Wall Lunge
Modified thompson test

Joint mobilizations
Stretch calf, hip flexors
Squat education - can they widen stance, toe out a bit

Question 8

Case:

Patient demonstrating Genu Valgum and Hindfoot valgus

3 tests/measures and treatment approach

Answer 8

Lateral step down
Gait observation
Hip abduction strength testing

Strengthen hip abductors
Orthotics
Mirror training (proprioception)

Question 9

Case:

Tarsal Tunnel syndrome

3 tests/measures and treatment approach

Answer 9

Clear lumbar!
Tinel’s sign
Twistability - overpronation?

Clothing/shoes tight?
Low dye taping - offload tunnel
Nerve glides

Question 10

Case:

Plantar Fasciitis

3 tests/measures and treatment approach

Answer 10

Windlass
Palpate medial calcaneal tubercle
Gait - short steps, decreased heel strike

Stretch calf mm
Modify activity - breaks from standing etc
Night splint
taping
Strengthen foot intrinsics