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A Sprain occurs when ligament fibers tear. This rarely happens in the middle, but rather a tear at the proximal or distal point of attachment, a small fragment of bone may be avulsed with the ligament instead of the ligament alone being torn.
Mechanism of Injury
An inversion sprain occurs when the ankle turns inward. The anterior talofibular ligament is most commonly affected with the calcaneofibular ligament tearing if the stress occurs with the ankle at right angles. Subluxation occurs at the ankle joint, implying a partial separation of the ankle bones.
Pain and swelling beneath the extensor tendons, along with weight bearing instability. Ecchymosis may occur, indicating inversion to a greater degree than normal, and the talus separates from the lateral malleolus. The foot can be moved into a position so that the sole is inverted at practically a right angle with the ground.
Palpation of pain and/ or excessive motion upon ankle orthotic testing. Abnormal gait pattern. Loss of ankle strength upon testing. Ankle mortise instability upon stress testing. Multiple lower extremity subluxations ( talus, fibula, cuboid, calcaneus, etc.).
Stress X-rays taken with the foot inverted reveal the abnormal tilt of the talus within the mortise. An excess of a 15 degree talar tilt indicates the presence and extent of ligamentous tear. Ankle series of radiographs is indicated to rule out fracture.
Thera Ciser Ankle series, with emphasis on Eversion and Dorsiflexion.
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