The Ankle pathologies

Question 1

MOI for a lateral ligament sprain?

Answer 1

Common ATFL
Then CFL

Usually occur rapid shift or body COM over the landing/ weight-bearing foot.
Inversion of the foot

Question 2

Symptoms of lateral ligament sprain?

Answer 2

Depending on grade

• instability
• swelling
• Tenderness
• pain on lateral aspect
• unable to weight bear (grade III)

sensation change in foot- suspect neurovascular compromise of peroneal nerve

Question 3

MOI for a medial ligament sprain?

Answer 3

Less common

Eversion

Question 4

Symptoms of medial ligament sprain?

Answer 4

Depending on grade

• instability
• Swelling
• Tenderness
• Pain on medial aspect
• Unable to weight bear (Grade III)

Question 5

MOI for a syndesmosis injury?

Answer 5

Transverse tibiofibular ligament
Forced external rotation and/or hyper dorsiflexion
Occurs when foot is planted and body falls forward

Question 6

Symptoms of syndesmosis injury?

Answer 6

Patient may complain of delayed recovery and persistent instability

Discomfort over joint line

Question 7

What is an anterior impingement?

Answer 7

Additional soft or bony tissue trapped between the tibia and talus during dorsiflexion

Question 8

MOI for anterior impingement?

Answer 8

Repeated dorsiflexion microtrauma
Repeated inversion injury causing damage to anteromedial structures e.g. articular cartilage
Common in sports with sudden acceleration, jumping and extremes of dorsiflexion e.g. dancers and runners

Question 9

Symptoms of anterior impingement?

Answer 9

starts with vague discomfort, becomes more localised and worse with activity- anterolateral joint tenderness

Soft tissue swelling over anterior joint- recurrent swelling

Question 10

Aggravating factors for anterior impingement?

Answer 10

Worsen with activity

Pain with squatting, stair climbing and hill climbing

Question 11

Age and gender for Achilles rupture?

Answer 11

Occurs in males 30-50 during recreational sports

Question 12

MOI for Achilles rupture?

Answer 12

May be due to intrinsic degeneration or overloading (active forceful plantar flexion)

Question 13

Symptoms of Achilles rupture?

Answer 13

Moment of rupture- sharp pain- popping sound

Question 14

Causes of Achilles tendinopathy?

Answer 14

Number of years running:
increase in activity 
Change of surface 
Change of footwear
Excessive pronation 
Muscle flexibility: gastrocnemius

Question 15

Symptoms of Achilles tendinopathy?

Answer 15

Morning pain- ‘start up pain’ localised to tendon

Question 16

Aggravating factors of Achilles tendinopathy?

Answer 16

Aggravating by dorsi-flexion

Question 17

Causes of Plantar fasciitis?

Answer 17

Often secondary to; foot posture, footwear, overuse, sudden increase in training
An increase in BMI- additional stresses

Question 18

Symptoms of Plantar fasciitis?

Answer 18

24hr pattern- worse a.m.- painful first few steps- ‘start up pain’
Commonly presents as plantar medial heel pain

Question 19

Aggravating factors of Plantar fasciitis?

Answer 19

prolonged rest & increased activity- prolonged walking/running