Ankle Evaluation

HI(O)PS
History
Inspection/Observation
Palpation
Special Tests
 History
 M: Mechanism of Injury (position of foot,
playing surface, type of shoes, how
injury happened
 A: Acute or Chronic
 P: Pain (location & type: sharp, dull,
burning, etc.)
 P: Previous Injury? (which ankle, when?)
 S: Sounds (noises at time of injury or since:
popping, snapping, cracking, etc.)
 S: Signs & Symptoms
 Inspection/Observation
 Swelling (localized or general)
 Deformity (flat feet, high arches,
etc.)
 Dislocation (abnormal positioning
of the foot or ankle)
 Discoloration
 Palpation
 Palpate for areas of swelling,
pain, or abnormaility.
 Palpate both extremities,
uninjured first
 Palpation Cont.
 Bony Landmarks:
– Tibia & Medial Malleolus
– Fibula & Lateral Malleolus
– Base of 5th Metatarsal
– Caclcaneus
 Palpation Cont.
 Ligaments:
– Medial: Deltoids
– Lateral:
 Anterior Talofibular
 Calcaneofibular
 Posterior Talofibular
– Anterior:
 Anterior Tibiofibular
 Palpation Cont.
 Musculature:
– Gastrocnemius (calf muscle)
– Achilles Tendon (posterior aspect of ankle)
– Peroneal Muscles & Tendon (lateral aspect of
lower leg and ankle)
– Anterior Tibialis Muscle & Tendon (anterior
aspect of lower leg and ankle)
 Special Tests
 Do ALL tests bilaterally
 Uninjured side first
 Special Tests Cont.
 Range of Motion:
– Active ROM (PF, DF, Inv., & Ever.)
 Athlete performs movement
– Passive ROM (PF, DF, Inv., & Ever.)
 Examiner performs movement
– Resisted ROM (PF, DF, Inv., & Ever.)
 Examiner applies resistance as athlete performs
movement
 Only do if athlete can perform active ROM & no
fracture is suspected
 Special Tests Cont.
 Stress Tests:
– Anterior Drawer Test:
 Tests the Anterior Talofibular Ligament
– Foot relaxed in neutral position, pull calcaneus anteriorly
– + result = pain, excess movement, or both
– Inversion Test:
 Tests Lateral Ligaments
– Passively invert ankle in PF, Neutral, & DF
– + result = pain during movement
 Special Tests Cont.
 Stress Tests Cont.:
– Eversion Test:
 Tests Deltoid Ligaments
– Passively evert ankle in DF, Neutral, PF
– + result = pain during movement
– Thompson’s Test:
 Tests Achilles Tendon
– Athlete lying prone, foot relaxed in neutral position,
squeeze Gastrocnemius, foot should PF normally
– + result = pain, lack of normal movement, or both
 Special Tests Cont.
 Stress Tests Cont.:
– Percussion (Bump) Test:
 Tests for fracture in lower leg or ankle
– Tap plantar surface of calcaneus
– + result = pain radiating up leg
– Compression Test:
 Tests for fracture in lower leg or ankle
– Compress Tibia & Fibula together all the way up & down
lower leg
– + result = pain radiating up leg
 Functional Tests
 Walking
 Go up on toes (both feet together, then
separately
 Rock back on heels
 Jogging, progressing to sprinting (straight
ahead, figure 8, Z pattern)
 Hopping (both feet together, then separately
 Sports Specific Skills