The Ankle: Anterior Ligament Sprainbenbenjamin.com/webinars/DI Ankle Notes.pdf · 2013. 2. 16. ·...

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Debilitating Orthopedic Injury Sampler #5

The Ankle: Anterior Ligament Sprain

Presented by Dr. Ben Benjamin 1

Instructor: Ben Benjamin, Ph.D.

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Instructor: Ben Benjamin, Ph.D.

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Thank You

DrBen@BenBenjamin.com 4

Webinar Goals

•  Explore the assessment and treatment the most common ankle injury.

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Logistics •  Time: 60 minutes

•  Schedule: •  Presentation 30-40 minutes •  Questions 15–20 minutes

•  Ongoing questions: Use Question box. If I don’t get to your question, ask me on my Dr Ben Benjamin Facebook page after the webinar.

•  Get a pen and paper please 6

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Things to think about 1.  Do you know what is most commonly injured

structure in ankle?

2.  Do you know why lateral ankle sprains are more common than medial ones?

3.  Do you know the major cause of ankle sprains?

4.  Do you know which other structures are often confused with lateral ankle sprains?

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Anatomy

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The Primary Ankle Ligaments

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The Talus

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The Anterior Talofibular Ligament (ATFL)

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The Anterior Talofibular Ligament

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3 Categories of Sprains

§  Grade 1 = Mild

§  Grade 2 = Moderate to Severe

§  Grade 3 = Rupture

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Ankle Sprains

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Assessment

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Taking an Ankle History Did you see a doctor or therapist? If so, Who? What was the diagnosis?

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Taking an Ankle History

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Did you have an x-ray? If so, What was the result?

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Taking an Ankle History Did you have an accident? If it was an accident can you describe how it happened?

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Taking an Ankle History

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If it was not an accident do you have any idea how you injured yourself? When did the pain come on?

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Taking an Ankle History

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Was this the first time you had a pain in the ankle? If not, when was the first time? How many times have you sprained your ankle?

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Taking an Ankle History

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Did you get any treatment? Did treatment help?

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Taking an Ankle History Did you have surgery on this ankle or anywhere in the foot?

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Taking an Ankle History

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Did your foot or ankle swell? Did your foot and ankle turn black and blue or become discolored anyway?

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Taking an Ankle History

Could you walk soon after the sprain?

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Taking an Ankle History

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Are there any things that you do that will bring on the pain?

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Taking an Ankle History

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Do you ever get sudden sharp pains?

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Taking an Ankle History

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Point to exactly where it hurts you.

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Taking an Ankle History

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Do you have any other pain or injuries in your foot or lower leg?

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Taking an Ankle History

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Did you hear or feel a popping sound or sensation when the injury occurred?

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Assessment Tests

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Assessment Tests

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1. Passive supination

2. Passive dorsiflexion

3. Passive plantar flexion

4. Anterior draw test

5. Heat test

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Passive Supination

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Passive Dorsiflexion

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Passive Plantar Flexion

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Anterior Draw Test

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Heat Test

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Theory

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Anterior Talofibular Ligament Sprain Positive Tests

MI: Passive Supination painful (this is the major indicator) AUX: Passive Dorsiflexion of the ankle is painful and often limited AUX: Passive Plantarflexion of the ankle is painful and often limited AUX: Heat Test is positive. The injured ankle is often hot or at least warmer then the other one

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Anterior Draw Test

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Anterior Talofibular Ligament

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ATFL in Two Varieties

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How it Happens •  Jumping •  Running •  Dancing •  Soccer •  Basketball •  Football •  Poor knee alignment

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Treatment

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Friction Therapy

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Myofascial Therapy

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Massage Therapy

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Exercise Therapy

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Exercise Therapy

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Exercise Therapy

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Exercise Therapy

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AIS Ankle Exerciser

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Exercise Therapy

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Exercise Therapy

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Questions

www.facebook.com/benjamininstitute

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WEBINAR SERIES Unraveling the Mystery of

Ankle Pain 1. Anterior Ankle Ligament Sprains

2. Lateral Ankle Ligament Sprains 3. Posterior & Retinaculum Ligament Sprains 4. Medial Ankle Ligament Sprains

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Dr.  Ben  Benjamin  Unraveling the Mystery Series:

•  Low Back Pain •  Cervical Pain •  Shoulder Pain •  Knee Pain •  Ankle Pain •  Hip & Thigh Pain

Webinars Avai lable On Demand

Whitney Lowe •  Orthopedic Approaches to

Upper Body Disorders •  Orthopedic Approaches to

Lumbo-Pelvic Pain

Tom Myers •  Anatomy Trains: Clinical

Applications of Myofascial Meridians

•  Beyond Good Posture: Fascial Release for Structural Balance

Tracy Walton •  Massage in Cancer Care •  More about Cancer Care & Massage •  Cardiovascular Conditions & Massage

Carole Osborne •  Pregnancy Massage 101

And Many More…

All Webinars Available at www.TheBenjaminInstitute.com 57

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Keep Learning

www.benbenjamin.com/webinars.php

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