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Group 2b

Winter 2013

Subjective Assessment
(Petty, 2011, pp. 396-399)

Body Chart
Map out area of symptoms noting quality, intensity and depth of pain as well as abnormal sensation or whether symptoms are constant or intermittent. Symptoms are most likely to be localised to the ankle and foot. Also check for symptoms in the lumbar spine, hip and knee joints.

History of Presenting Condition


Can you recall an event where your ankle was twisted or turned inwards? When did this occur? Are you able to weight bear on your ankle? How long have symptoms been present?

Behaviour of Symptoms
Have you noticed anything that eases or aggravates symptoms?

Past Medical History


Have you had any previous ankle sprains? Have you ever used some form of foot orthosis?

Special Questions

Do you have any other medical conditions (eg. diabetes, arthritis)? Are you currently on any medication?

Social and Family History


Is your pain limiting your participation in activities (eg. tennis)? How is your employer/co-workers/family responding to your pain?

Group 2b

Winter 2013

Physical Assessment (Petty, 2011, pp. 406-409)

Observation
Consider the patients posture, gait and performance in functional tasks (eg. sit to stand). Take note impaired balance or unevenness in weight bearing between the limbs in standing and during normal gait.

Active Movement Tests


Perform active movement tests of ankle dorsiflexion, plantarflexion, supination and pronation. Observe the quality and range of movement as well as the behaviour of pain and presence or absence of resistance.

Palpation
Palpate the foot and ankle paying attention to the presence of swelling, temperature, mobility and feel of superficial tissues and tenderness.

Passive Movement Tests


Perform passive movements tests of ankle dorsiflexion, plantarflexion, supination and pronation. Compare between results found in the active movement tests, if pain and restrictions were seen in the same movement in both tests ligamentous damage is highly likely.

Joint Integrity Tests


The anterior drawer test gages the integrity of the ATFL by considering the amount of anterior displacement of the talus. Increased anterior translation of the talus with respect to the tibia is a positive sign particularly if the translation is significantly different from the other side (Lynch, 2002, 407). The talar tilt test evaluates the integrity of the lateral ligament complex, particularly the CFL. Excessive adduction movement, a reduced or absent end feel and clicks/clunks suggest injury (Petty, 2011, p. 403).

Anterior drawer test

Retrieved from http://www.aafp.org/ afp/2006/1115

Talar tilt test

Group 2b

Winter 2013

References
Ankle Pain. (2013). Ankle Sprain Symptoms and Categories. Retrieved from http://anklepain.info/anklesprain-symptoms-and-categories/ Ivins, D. (2006). Acute Ankle Sprain: An Update. American Family Physician, 74(10), 1714-1720. Retrieved from http://www.aafp.org/afp/2006/1115/p1714.html Lynch, S. A. (2002). Assessment of the Injured Ankle in the Athlete. Journal of Athletic Training, 37(4), 406-412. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC164372/pdf/attr_37_0_0406.pdf Petty, N. (2011). Neuromusculoskeletal examination and assessment: a handbook for therapists (4th Ed). Sydney: Churchill Livingstone.

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