Grade I Inversion

Ankle Sprain
By: Christine Jimenez
 Anatomy
• Ligaments:

• Anterior talofibular

• Calcaneofibular

• Arteries:

• Lateral plantar

• Fibular
https://eastpennfoot.wordpress.com/2012/11/29/how-your-ankle-
• Posterior tibial works-a-quick-anatomy-lesson-on-a-very-complex-joint/blood-
vessels-of-foot-and-ankle/
Anterior Talofibular Ligament

• Weakest ligament in the ankle

• Connects the talus to the anterior fibula

• Consists of connective tissue outside of the

ankle

• Acts as protection to the joint from outside

forces
 Anatomy cont.
• Nerves: Posterior tibial
nerve, lateral plantar
nerve

• Tendons: Achilles tendon

• Bones: talus, tibia, fibula

• Muscles: gastrocnemius, https://www.mayoclinic.org/diseases-conditions/broken-ankle-broken-foo

multimedia/foot-and-ankle-bones/img-20008997
soleus, posterior tibialis,
anterior tibialis, peroneus
longus and brevis
 Risk Factors
• Fatigue- muscles and ligaments
become fatigued during activity
and are more susceptible to
injuries

• Conditioning- athlete not

conditioning prior to vigorous
activity such as strengthening
and stretching

• Warming up- athlete does not

warm up before activity in which
the muscles and ligaments
remain tight and are more prone
to sprains
https://www.popsugar.com/fitness/photo-gallery/31081972/
image/31081979/Dorsi-Flexion-Resistance-Band
 Mechanism of injury
• Awkward landing of foot

• Stepping on an uneven
surface

• Athlete landing on another

athlete’s foot

• Stretching force when foot

rolls inward

http://ionaphysio.com/ankle-sprain-rory-mcilroy/
 Kinetics-Average ROM
• Plantar flexion
(downward) : 0°-50°

• Dorsiflexion
(upward) : 0°-20°

• Inversion: 0°-35°

• Eversion: 0°-25°
https://www.pinterest.com/pin/305470787201410381/
 Classifications
• Grade I: • Grade II: incomplete • Grade III: complete
partial tear of tear of ligament tear of ligament
ligament
• Moderate pain • Severe
• Mild and swelling swelling
swelling • Tenderness • Severe
ecchymosis
• Slight • Some loss of
function motion and • Loss of
al loss function function

• Mild to moderate • Mechanical

ecchymosis instability
 Signs and symptoms
• Swelling

• Bruising

• Tenderness to touch

• Ankle instability http://www.wisdom-square.com/best-way-to-treat-a-

sprained-ankle.html
• Pain

• Limited ROM

• Discoloration

https://www.pinterest.com/pin/
404338872777337118/
Grade I Sprain Rehabilitation
• 4 phases

• About 6 weeks

• Non-surgical treatment for

Grade I Lateral Ankle Sprain

• Consisting of RICE, limiting

movement, progress to
exercises, strengthening, and
gaining balance back

• Southern California Orthopedic

Institute

• By: Dr. Michael Bahk

Phase 1: 1 Week
Purpose: Decrease swelling and pain
Protection from injury
Increase pain free ROM
 Treatment
• Rest- avoid putting load and walking

• Ice- 20 minutes three times daily to keep

swelling down

• Compression- any ace wraps or bandages

to provide support and prevent swelling

• Elevate- above level of your heart for the

first two days

• Applying tape, compression wrap, ankle

brace
https://copperjoint.com/rice-most-effective-ankle-sprain-remedy/

• Exercises: ankle alphabet, circles, calf

pumping, bio mechanical ankle platform
system (seated) with no weight

• Amount of reps vary on patient’s progress

http://marshallsportsmedicine.org/rehab-and-recovery/physical-therapy/
Phase 2: 1-3 Weeks
Goals: Pain free ROM
Pain free strengthening
Progression to exercise with weight
Start proprioceptive training
 Treatment
• Continuation of Phase 1 exercises Theraband
• Exercises: 4 plane ankle theraband,
towel sweeps, towel crunches, tissue
pickup, heel and toe raises, balance
activities on trampoline, quarter squats

• Progression on dorsiflexion and

plantarflexion for joint mobilization

• Bio mechanical ankle platform system

(seated) with weight, wobble board, single https://www.physioadvisor.com.au/exercises/
limb stance, stationary bike, and aqua strengthening-joints/ankle/
jogging

• Amount of reps vary on patient’s progress

Phase 3: Week 3-5
Goals: Progress strengthening
Progress proprioceptive training
Increase endurance
 Treatment
• Begin elliptical training, jog on
treadmill, leg presses, stand on bio
mechanical ankle platform system
with weights, wobble board, lateral
shuffles, toe walks, heel walks, single
leg trampoline ball catch, single leg https://www.aliexpress.com/item/Medium-Resistance-Exercise-Band-Tube-
squats, cariocas Pilates-Sport-Cord-stetch-tubing-yoga/561423146.html

• Incorporate sports cord for resistance

in strengthening and balance

• Number of reps vary depending on

progression of patient

http://www.truefitness.com/commercial-fitness/
strength/paramount/fuse-xl/fuse-0300-leg-press/
 Phase 4:
Goals: Regain full strength
Full ROM
Full balance and proprioception
Return to sport activity
 Treatment
• Increase time jogging on treadmill Grid Hops
• Single leg squat on dyna disc,
grid, double and single leg hops
(forward, backward, side to side),
balancing on 5 point star dyna
disc

• Amount of reps vary on

progression of patient
https://www.researchgate.net/figure/Y-Balance-test-performed-
• Completely remove support (tape, using-tape-grid_fig1_321226020

ankle brace, compression wrap)

 Summary
• 85% of ankle sprains are lateral (inversion) sprains

• The anterior talofibular ligament is the weakest ligament in

the ankle, making it more prone to injuries and consists of
connective tissue

• If an athlete does not condition or warm up, the muscles

will be tight and are more susceptible to injuries

• Rehabilitation for the ankle according to the Southern

California Orthopedic Institute is a 4 phase rehab program
and the amount of time varies with the progression of the
athlete
 Works Cited
• https://www.physio-pedia.com/Ankle_Sprain

• https://accessphysiotherapy.mhmedical.com/content.aspx?
bookid=855&sectionid=49735197

• https://orthoinfo.aaos.org/en/diseases--conditions/sprained-ankle/

• https://www.healthline.com/human-body-maps/anterior-talofibular-
ligament

• https://www.emedicinehealth.com/ankle_sprain/article_em.htm

• http://www.michaelbahkmd.com/pdf/general-ankle-rehab-
protocol.pdf