Download Common Athletic Injuries of the Ankle Slide 1 In the next few minutes

Common Athletic Injuries of the Ankle
Slide 1
In the next few minutes, we’re going to take a look at common ankle injuries experienced by
athletes.
Slide (title slide):
Common Athletic Injuries of the Ankle
Slide 2
Foot and ankle injuries are no stranger to athletes. Some of the most common ankle injuries,
which we’ll talk about today, are sprains, chronic lateral ankle instability, peroneal tendon
tears, and Achilles tendon tears.
Slide:
Common Injuries of the Ankle in Athletes
 Ankle Sprains
 Chronic Lateral Ankle Instability
 Peroneal Tendon Injuries
 Achilles Tendon Tears
Slide 3
Let’s first take a look at ankle sprains. These injuries occur so frequently that they send more
than 150,000 people to the emergency room or urgent care center each year.
Slide:
Ankle Sprains
Slide 4
As common as ankle sprains are, many people don’t know what exactly they involve. A sprained
ankle is an injury to one or more ligaments in the ankle. Ligaments are bands of tough, flexible
tissue—like rubber bands—that connect two bones or hold a joint together. The ankle has
three lateral ligaments, which give you stability by restricting wobbly, side-to-side movement.
The ankle also has medial ligaments, which also help stabilize the ankle. In a sprained ankle, the
injury involves either a stretching out of the ligament, or a tear.
Slide:
What’s an Ankle Sprain?
 An injury to one or more ligaments in the ankle
 Ligaments
 Connect two bones and hold a joint together
 3 lateral ligaments in the ankle give you stability
 Medial ligaments also help stabilize the ankle
 In an ankle sprain, ligament(s) are either stretched or torn
Slide 5
Not all ankle sprains are the same—some are much worse than others. The severity depends on
whether the ligament is stretched, partially torn, or completely torn. Severity also depends of
the number of ligaments injured. In some severe cases, a piece of bone may have broken off, or
there may be some other type of fracture.
Slide:
Some Sprains Are Worse Than Others
LESS SEVERE
Stretched
Partially torn
Completely torn
MORE SEVERE
More Ligaments Injured or Fracture
Slide 6
The symptoms of a sprained ankle can vary. Typically there will be pain and swelling, although
some people who have had previous sprains might just feel wobbly instead. Bruising typically
occurs, and it may be difficult—or in some cases impossible—to walk. Stiffness in the joint is
another symptom for some people.
Slide:
Symptoms of a Sprained Ankle
 Pain or soreness
 Swelling
 Bruising
 Difficulty walking
 Stiffness in the joint
Slide 7
What should you do if you think you’ve sprained your ankle? Prompt medical attention is
critical, for several reasons. For example, if the sprain isn’t treated properly, you could develop
a troublesome condition called chronic lateral ankle instability. The ER or urgent care center will
give you an initial diagnosis and temporary treatment, but be sure to follow up and make an
appointment with a specialist—a foot and ankle surgeon who specializes in treating ankle
sprains and other related conditions. In the meantime, be sure to ice your ankle, keep it
elevated, and stay off your foot as much as possible.
Slide:
What Should You Do?
 Seek prompt medical attention
 Follow-up with a specialist—a foot and ankle surgeon
 Ice, elevate, and rest!
Slide 8
After the foot and ankle surgeon thoroughly evaluates your injury, which might include more
advanced diagnostic imaging, you’ll receive a treatment plan aimed at your specific injury.
Many sprained ankles are treated with splinting or casting, rest, ice, compression, medication
such as a nonsteroidal anti-inflammatory drug, and physical therapy. Doing physical therapy as
soon as possible, as advised by your doctor, is important to rehabilitate the ankle. In more
severe cases, surgery may be needed to repair the damage.
Slide:
Treatment for Ankle Sprains
 Splinting or casting
 Rest, ice, compression
 Medication
 Physical therapy
 More severe cases may require surgery to repair the ligament(s).
Slide 9
Now let’s take a look at another common ankle injury in athletes—chronic lateral ankle
instability, or chronic ankle instability. I mentioned this condition earlier as a potential
consequence of a sprained ankle sprain that didn’t heal adequately or wasn’t completely
rehabilitated.
Slide:
Chronic Lateral Ankle Instability
Slide 10
Chronic lateral ankle instability is a weakness of the ankle that’s described as a recurring “giving
way” of the outer—or lateral—side of the ankle. This can occur while walking or doing other
activities, but it can also happen when you’re just standing.
This “giving way” can lead to spraining your ankle. And just as this condition can result in an
ankle sprain, it also is often caused by previous ankle sprains. That’s because when you sprain
your ankle, the injured ligaments can weaken and affect your sense of balance.
Slide:
What’s Chronic Ankle Instability?
 A “giving way” of the outer side of the ankle
 This “giving way” can lead to an ankle sprain
 Often caused by having previous sprains
Slide 11
This highlights the importance of proper rehabilitating a sprained ankle, through physical
therapy. Rehabilitation will strengthen the muscles and “retrain” the ankle for better balance—
and thereby help prevent chronic ankle instability from developing. In contrast, failing to
undergo proper rehabilitation can result in repeated ankle sprains.
Slide:
Proper Rehabilitation Can Help Prevent This Condition . . . and Future Sprains
Proper rehabilitation (physical therapy):
 Strengthens foot and ankle muscles
 “Retrains” the ankle for better balance
Slide 12
How do you know if you have chronic ankle instability? People with this condition often say
their ankle feels wobbly or unstable, and may have a repeated turning of the ankle, especially
on uneven surfaces or when participating in sports. There may also be persistent swelling and
discomfort, as well as pain or tenderness. And, of course, instability can easily lead to additional
ankle sprains.
Slide:
Signs and Symptoms of Chronic Ankle Instability
 Ankle feels wobbly
 A repeated turning of the ankle
 Chronic swelling and discomfort
 Pain or tenderness
Slide 13
If you have chronic ankle instability, your foot and ankle surgeon will determine the best
treatment for your case.
Conservative treatment begins with physical therapy, which will include various modalities and
exercises to strengthen the ankle, improve balance and range of motion, and retrain your
muscles. You’ll also receive training that relates specifically to your sport. Some patients are
also given an ankle brace to support the ankle. Nonsteroidal anti-inflammatory drugs are often
prescribed to reduce the pain and inflammation.
For some people, surgery is necessary because of the degree of their ankle instability or
because they didn’t improve enough with conservative treatment. Surgery will serve to repair
or reconstruct the damaged ligament or ligaments.
Slide:
Treatment for Chronic Ankle Instability
Non-surgical treatment:
 Physical therapy
 Bracing
 Medications
Surgery:
 Repair or reconstruction of damaged ligament(s)
Slide 14
The third category of common ankle problems among athletes consists of peroneal tendon
injuries. We’ll concentrate on two types of these injuries: acute (or sudden) tears and
subluxation.
Slide:
Peroneal Tendon Injuries
 Acute (sudden) tears
 Subluxation
Slide 15
The foot has two peroneal tendons. Tendons are bands of tissues that connect muscle to bone.
The peroneal tendons run side-by-side behind the outer ankle bone. The main function of these
is to stabilize the foot and ankle and protect them against sprains.
Slide:
The Peroneal Tendons
 Two tendons behind the outer ankle bone
 Stabilize the foot
 Protect against sprains
Slide 16
Acute tears of the peroneal tendons are very common in sports, especially those that involve
repetitive ankle motion. Symptoms include pain, swelling and weakness or instability of the
foot and ankle. As time goes on, these tears could lead to a change in the shape of the foot and
the arch may become higher
Slide:
Symptoms of a Peroneal Tendon Tear
 Pain
 Swelling
 Weakness of the foot and ankle
 With time, the foot shape may change
Slide 17
Subluxation—another common peroneal tendon injury—occurs when one or both tendons
have slipped out of their normal position. For athletes, this can occur following trauma, such as
an ankle sprain. It’s very important to have this promptly treated, because a tendon that
continues to move out of position is more likely to tear.
Slide:
Subluxation of the Peroneal Tendon(s)
 One or both tendons slip out of position
 Can occur after trauma, such as a sprained ankle
 Early treatment is a must!
Slide 18
One classic symptom of a peroneal tendon subluxation is a snapping feeling of the tendon
around the ankle bone. You may also have pain, on and off, behind the outside ankle bone.
Some people also have ankle instability or weakness.
Slide:
Symptoms of a Peroneal Tendon Subluxation
 A snapping feeling of the tendon around the ankle bone
 Sporadic pain behind the outside ankle bone
 Ankle instability or weakness
Slide 19
Treatment depends on the specific type of peroneal tendon injury. The foot may be placed in a
splint or cast, and medications—either oral or injected nonsteroidal anti-inflammatory drugs—
may be given. Physical therapy is also an option, and may run the gamut from ice, heat, and
ultrasound therapy to exercises once symptoms start to improve. Bracing may also be used. In
some cases, surgery may be needed to repair the tendon or tendons and perhaps the
supporting structures of the foot.
Slide:
Treatment for Peroneal Tendon Injuries
 Splinting or casting
 Oral or injected medications
 Physical therapy
 Bracing
 In some cases, surgery is necessary
Slide 20
Now let’s look at the final type of common ankle injuries in sports: Achilles tendon tears.
Slide:
Achilles Tendon Tears
Slide 21
The Achilles tendon—also called the “heel cord”—runs down the back of the lower leg and
connects the calf muscle to the heel bone. It helps to raise the heel off the ground, thereby
facilitating walking.
Slide:
The Achilles Tendon: The “Heel Cord”
 Runs down the back of the low leg
 Connects the calf muscle to the heel bone
 Helps to raise the heel off the ground.
Slide 22
An Achilles tendon tear, which can be a complete or partial tear, occurs when the tendon is
stretched beyond its capacity. This often happens with forceful jumping or pivoting, or sudden
accelerations in running. It’s very common among “weekend warriors.”
Slide:
What Causes an Achilles Tendon Tear?
 Can be a complete tear or partial tear
 Occurs when the tendon is stretched too much
 Can occur with jumping, pivoting, sudden accelerations in running
 Common among “weekend warriors”
Slide 23
People who have torn their Achilles tendon typically have sudden pain in the back of the ankle
or calf. It will feel like a kick or a stab, and then is often subsides into a dull ache. Many people
also describe a popping or snapping sensation. There may be swelling on the back of the leg
between the heel and the calf, and it may be difficult to walk, especially upstairs or uphill, and
difficult to rise up on your toes.
Slide:
Symptoms of an Achilles Tendon Tear
 Sudden pain
 Pain may then subside to a dull ache
 Popping or snapping sensation
 Swelling
 Difficult to walk (especially upstairs or uphill) and difficult to rise on toes
Slide 24
If you’ve had this kind of injury, prompt medical attention is needed. Once the foot and ankle
surgeon evaluates your injury, treatment based on the extent of the tear and your particular
situation can begin.
Non-surgical treatment is usually reserved for minor tears, less active people, and those who
cannot undergo surgery. A higher rate of re-tearing occurs when non-surgical treatment is
undertaken. Non-surgical options include wearing a cast, walking boot, or brace to allow the
tendon to heal.
Surgery offers important potential benefits over non-surgical treatment, including decreasing
the likelihood of another tear occurring. Also, surgery often increases push-off strength and
improve muscle function and ankle movement.
Slide:
Treatment Options for an Achilles Tendon Tear
Non-surgical treatment:
 Higher likelihood of re-tearing the tendon
 Wearing a cast, walking boot, or brace
Surgery:
 Lower likelihood of re-tearing the tendon
 May increase push-off strength
 May improve muscle function and ankle movement
Slide 25
I hope this has given you some useful information about common ankle injuries among
athletes. Knowing what to do if these injuries occur will do much to put you on the road to
effective treatment and good outcomes.
Slide:
For Ankle Injuries, Seek Prompt Medical Attention
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