Mrs.

Groves
SMED 20
2020-11-16
Lower Leg Injury Assignment (a more in depth analysis, not presented in class)
High Ankle Sprain and Inversion Ankle Sprain, language used is friendly for the general public
Inversion Ankle Sprain
1. Location and Function of the Body Parts Involved
a. Inversion sprains occur when the ankle rolls onto the lateral side in an inward motion,
placing stress on the outer ligaments of the ankle. Examples include:
i. Walking or exercising on uneven surfaces.
ii. Landing awkwardly on your feet after jumping or pivoting.
Inversion sprains (the anterior talofibular ligament) are the most common injury out of
the main 3-ligament complex.

2. Describe the injury/MOI

a. Inversion: When you twist your foot upward and the ankle rolls inward.
b. The sprain occurs when the ankle is forced to move out of its normal position which leads
to subtle or immense tearing or stretching of one or more of the ankle ligaments.

3. Degrees of severity
a. Grade 1: There is only minor damage that has occurred to the ligament, and the ankle is
quite stable. There is usually minor swelling and pain, but the patient should still be able
to walk - with a degree of difficulty.
b. Grade 2: There will be a degree of difficulty in walking and severe pain, and a moderate
amount of tearing of the ligament (with significant tears in the issues). The ankle will be
unstable. Swelling and bruising will most definitely occur.
c. Grade 3: The ankle will be completely unstable and the individual will not be able to
walk or put any weight on it. Complete tearing of the ligament has occurred. The pain
will be severe, and an immense amount of swelling and bruising. Most definitely surgical
intervention will be required to repair the ligament.

4. Sports injury is most common

a. Basketball
b. Football
c. Soccer
Mrs. Groves
SMED 20
2020-11-16

5. Acute or chronic
A ‘diagnosis’ of an inversion ankle sprain is ultimately an acute injury, commonly occurring
(primarily in sports). Hence, an inversion sprain is a suddenly obtained injury, minimizing heal
time required (in contrast to chronically identified diagnoses).

6. Signs and symptoms

a. Signs
i. Tenderness
ii. Swelling
iii. Bruising
b. Symptoms
i. Pain
ii. Restricted range of motion
iii. Popping sensation

7. Describe the assessment techniques used to determine the type and extent of the injury
(preferably performed by a physician)
a. Talar Tilt Test (also referred to as the inversion stress test): Stabilize the leg into a
neutral position which stretches the lateral ligaments, and inverts the ankle, the examiner
will determine the laxity of the inversion.
b. Trainers will carry out the required procedure for treatment (refer to below). With a
greater degree of severity, however, physician referral should be quite urgent (specified
below).

8. Treatment
Treatment after the injury is focused mainly on the RICE Guidelines.
a. Rest: Not walking on the ankle
b. Ice: Ice (not directly on the skin, however) should be immediately applied to keep
swelling down.
c. Compression: Bandages or dressing will immobilize and support the injured ankle
d. Elevation: Elevate your ankle above the level of your heart frequently in the first 48
hours.
e. Crutches can be used if necessary.
f. For a Grade 3 injury, severity doctors may recommend surgery to repair the damage.

9. Rehabilitation
a. It is essential to perform ankle flexibility exercises, some important areas to stretch with
and severity of the sprain includes the gastrocnemius and soleus, the peroneal muscles,
and the IT band.
b. Additionally, balance training (proprioceptive), such as standing on one leg, slowly
working into single-leg squats, and various exercises with a wobble board should be
carried out.
Mrs. Groves
SMED 20
2020-11-16
10. Return to play management
a. Make sure to have a physical therapist to help you rehabilitate so you can start playing
again.
b. It is best that you make sure you have healed enough to slowly start participating in
minor activities.
c. As you heal slowly, increase your play gradually; increased healing time = increased
exertion.

High Ankle Sprain

1. Discuss the location of the body parts involved. Include diagrams/illustrations.
a. The high ankle sprain occurs in the upper ligament of the ankle (talus) which connects to
the tibia and the fibula of the lower leg.
b. Function: Keeping stability with the addition of the ligaments involved responsible for
mobility (walking and running).

2. Describe the injury/MOI

a. The high ankle sprain is damage to the high ankle ligaments that connect the tibia and
fibula. In some cases, the deltoid of the ankle can get torn as well.
b. It is usually caused by a forceful rotation of the ankle that causes the high ankle ligaments
to tear. It can also be caused by inversion of dorsiflexion trauma. Diagnosis of this injury
can occur if the ankle is broken at a high extremity.
c.
3. Degrees of severity
a. The first degree of the injury is when the interosseous membrane has only a few ligament
fibers that are damaged.
b. The second degree widens the tibio-fibular joint and has more severe damage to the
interosseous membrane.
c. The last degree is when a joint in the ankle is possibly dislocated and the interosseous
membrane is fully ruptured.

4. Sports the injury is the most common

a. Football
Mrs. Groves
SMED 20
2020-11-16
b. Soccer
c. Lacrosse
d. Basketball

5. Acute or Chronic
a. Acute - this is primarily the case because it only takes approximately six weeks to three
months to heal with treatment, depending on the severity of the injury. In some cases,
with inadequate treatment, the injury may take longer to heal because they are not given
more effective treatment like a splint or a boot.

6. Describe the signs and symptoms. Make sure to differentiate between the two
a. Signs
i. Very rarely will have swelling or bruising, but can occur at times
ii. Stiffness
b. Symptoms
i. Pain
ii. Restricted range of motion

7. Describe the assessment techniques use to determine the type and extent of the injury
(preferably carried out by orthopaedic surgeon)
a. Squeeze Test - Squeezing the tibia and fibula together to indicate fracture or high ankle
sprain from pain present in the talus.
b. External Rotation Test - With a bent knee and the ankle at a ninety degree angle, the
patient will be asked to rotate their leg externally to indicate fracture or high ankle sprain
from pain present in the talus.

8. Treatment
a. RICE
b. Anti-inflammatory and pain medicine
c. Physical therapy
d. In some cases, surgery
e. Splint

9. Rehabilitation
a. Physician referral
b. You will need physical therapy due to restricted range of motion

10. Return to Play Management

a. Make sure to have a physical therapist to help you rehabilitate so you can start playing
again.
b. It is best that you make sure you have healed enough to slowly start participating in
minor activities.
Mrs. Groves
SMED 20
2020-11-16
c. As you heal slowly, increase your play gradually; increased healing time = increased
exertion.

Resources
● High Ankle Sprain
○ https://www.footcaremd.org/conditions-treatments/ankle/high-ankle-sprain
○ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3438867/
○ https://www.hss.edu/conditions_high-ankle-sprain-whats-different.asp
● Inversion Ankle Sprain
○ https://www.upmc.com/services/sports-medicine/conditions/ankle-sprain#:~:text=Types
%20of%20ankle%20sprains&text=Eversion%20ankle%20sprains
%20%E2%80%94%20occurs%20when,and%20the%20ankle%20rolls%20inward.
○ https://www.physio-pedia.com/Ankle_Sprain
○ https://pivotalphysio.com/inversion-or-lateral-ankle-sprain/