Use of Functional Foot Measurement in a Young Female with a First-Degree Lateral Ankle Sprain

Author: Randie Kuhar, Master of Athletic Training Student

Faculty Sponsors/Mentor: Kelly Stalker EdD, LAT, ATC, Michele Monaco DSc, LAT, ATC, Cathy Holt,
DHSC, LAT, ACT and Keith Johnson ATC, NRAEMT

Background Case Description International Classification of Function (ICF)

Lateral Ankle Sprain: • 18-year-old female patient
One of the most frequently injured joints of the body • High School Senior Health Condition
is the ankle; especially the anterior talofibular ligament • Varsity Lacrosse and Soccer 1st degree - Ankle Sprain
(ATF). Records show that lateral ankle sprains will
account for 85% of all athletic related ankle injuries. The Injury Presentation:
lateral side of the ankle is more predisposed to sprains
then the medial side due to the joint’s anatomy and • Date of Injury: 3/18/2022 (Lacrosse season) Body Function & Structure
• Date of Evaluation: 3/19/2022 Decease FAAM checklist for both Activity Participation
biomechanics. This sprain will result from an inversion
activities of daily living and sports Difficulty walking and running on Participates in sporting activities
stress and plantar flexion. Typically, multiple ligaments subscale, Impairments in ROM & uneven surfaces, ambulation of stairs, as tolerated
such as the CF and PTF will also be involved. The strength, decrease in overall well- Cutting/lateral Movements
extent of the injury will depend on the amount of stress • MOI: Rolled during game day warm-ups, Played game being
that is applied and the position of the talus within the • Nature: Acute
ankle mortise. • Body Part: L Ankle
• Edema: (+) Lateral Malleolus Environmental Factors
Personal Factors
Treatment Protocol: • PtT: Anterior Talofibular Ligament (ATF) ATs are advocates, external
Contact Sport, High School Senior stressors from
• ROM: WNL
parents/coaches/teammates
Phase 1 • Strength: WNL
- Immobilization, RICE • Neuro: (-) Paresthesia, Cap refill WNL
- Early weightbearing as tolerated • Special Test:(-) Ant. Drawer, (-)Talar Tilt
- Swelling/pain will last 2 to 3 days, walking • Treatment: Ice, Tape – Activity as Tolerated Interventions
may be difficult – recommendation of crutches Figure 1a/1b/1c – weekly images were taken to
• Athlete self reported to have a high-pain tolerance track the patient's progression Conclusion
Phase 2 (Functional rehabilitation)
- ROM exercises
- Isometric Strengthening Examination In conclusion, the patient continues to play

Figure 1a
- Proprioception through her final lacrosse season. As the weeks
 Foot and Ankle Ability Measure First Visit Second Third Visit progressed, the patient would report to the athletic
Phase 3 (FAAM) 3/21/2022 Visit 4/14/2022 training room each day with positive comments
3/28/2022
- Advancement of strengthening and about how she was feeling, her comfort level, and
Daily Living – 69/84=82% 82/84=98%  81/84=96%
proprioception exercises and the gradual return to Clinician Calculated % pain level. The patient continues to receive the
pre-injury activities Patient Reported % 90% 93% 90% same taping technique as shown in figure 2a and
- Early return to sporting and work activities may Sports Subscale – 22/32=69% 23/32=72% 25/32=78% 2b to provide more stability for the ankle.
Clinician Calculated % After reviewing the FAAM scores of this
require ankle taping or bracing. 
Patient Reported % 75% 85% 80% patient, her results began to increase due to the
Figure 1b

Figure 1c
Overall Level of Function Nearly Nearly Nearly ROM she was able to preform. The patient's
Normal Normal Normal plantarflexion increased by 7° and her
dorsiflexion increased by 2°. However, the area
• Tape Techniques as pictured below that did not see any change for this athlete was
Left Ankle AROM Right Ankle AROM
Involved Un-Involved during the manual muscle testing in which she
Figure 2a Figure 2b stayed at a 4/5.
  First Second Third   Initial Last
Plantarflexion  38 40 45 Plantarflexion 50 50 

Dorsiflexion  19 18 20 Dorsiflexion  20 20

Manual Muscle Testing Manual Muscle Testing
Plantarflexion  4/5 4/5 4/5  Plantarflexion 5/5 5/5 References
Dorsiflexion  4/5 4/5 4/5  Dorsiflexion 5/5 5/5
Inversion  4/5 4/5 4/5  Inversion 5/5 5/5 1. Kruckeberg, B., Beahrs, T., Haddad, S., & Fischer, S. (n.d.). Sprained ankle - orthoinfo - Aaos. OrthoInfo.
Eversion  4/5 4/5 4/5  Eversion 5/5 5/5 2.
Retrieved April 20, 2022, from https://orthoinfo.aaos.org/en/diseases--conditions/sprained-ankle/ 
Starkey, C., & Brown, S. D. (2015). Examination of Orthopedic & Athletic Injuries. F.A. Davis Company. 

Figure 2a/2b: Moleskin was used to act as stirrups,

following this, traditional ankle tape was
performed