The Ankle Joint

Anatomy Review
The ankle is made up of two joints; the talocrural joint and the subtalar joint. The
bones that make up the ankle joint are the tibia, fibula, talus and the calcaneous. The
movements which occur are plantarflexiondorsiflexion, and inversioneversion.

!ote" Assistin# in inversioneversion are the mid tarsal joints between the
taluscalcaneous and navicular and calcaneous cuboid.
The stability of the ankle mainly comes from the bones $tibia and fibula%, the li#aments
on the lateral and medial side of the ankle, and the tendons on all sides of the ankle.
The ankle is often sprained because of an inversion sprain thus potentially tearin#
the anterior talofibular li#ament, and the calcaneofibular li#ament. The calcaneofibular
li#ament is often torn with pure inversion, while the AT& li#ament sprains with inversion
while the ankle is plantar flexed. The posterior talofibular li#ament is not often torn.
't is less likely to injure the medial li#aments of the ankle $deltoid% because of the
stren#th of these li#aments. 'n addition, the lateral malleolus extends further than the
medial malleolus thus preventin# excessive eversion.
Ankle Tensorin#
(urpose
'mmediately after an ankle sprain there is the potential for swellin# in around both
malleolli. )urin# an inversion ankle sprain, as the lateral ankle li#aments are stretched or
torn, and the calcaneous, as it inverts, pinches the musculature wrappin# around the
medial malleolus $tibialis posterior, flexor hallucis lon#us and flexor di#itorum lon#us%.
This means there may be dama#e to both sides of the ankle thus havin# the possibility of
swellin# on both sides. This techni*ue is used to reduce the amount of swellin# around
the ankle, especially around the malleolli, by applyin# compression $part of the (.'.+.R.
principle%.
(osition of ankle
,ave the person sit with hisher foot dorsiflexed as much as possible, as lon# as it
is pain free $about -. de#rees to the tibia%.
/aterial
Two 0.1 or 2.cm tensor
Two .1cm thick horseshoe shaped rubatex pads
Application
3ut two horseshoe shaped pads
from the rubatex pad
(lace pads around the malleolus
4sin# the tensor, start the wrap
at the top of the foot leavin#
only the toes exposed so that
you can check for circulation
(ass around the medial side of
the foot, under the sole and
back to cover the startin# point.
This is your anchor for the rest
of the techni*ue.
The next wrap should an#le
across the last, at about 5.
de#rees on the top in a criss6
cross fashion
Repeat the last step advancin#
the tensor to the ankle
Roll the tensor up the lateral
side, cross over the front of the
foot $to the medial side%,
around the back of the le# to
the lateral side
3ontinue around the front of
the ankle, to the medial side,
An#le down towards the
calcaneous, around the back of
the ankle, to the medial side,
crossin# over the lateral
calcaneous
Roll the tensor under the
bottom of the foot, to the
medial side
7rap around the foot, rollin#
the tensor over the top of the
foot $anterior ankle%, to the
lateral side,
7rap around the back of the
ankle, to the medial side
An#le the tensor down towards
the medial side of the
calcaneous
Roll the tensor under the foot
Roll the tensor up the lateral
foot, over the front of the
ankle, to the medial side
7rap the tensor around the
back of the le# , to the lateral
side
3ontinue wrappin# up the le#.
A second tensor may be needed
to continue up the calf for
maximum compression. The
tensor should at least reach mid6
calf. 't is important that swellin#
is not allowed to settle close to
the ankle as this will decrease
ankle R8/.
9ecure end of tensor with tape
$not the clips%
3losed :asket67eave Ankle Techni*ue
(urpose
Ankle tapin# is a more supportive techni*ue than the ankle wrap. 't is most often
used as an injury mana#ement techni*ue to provide stability to a sprained ankle so that
the athlete can return to activity. 't should be done 8!;< after the ankle has been
properly and thorou#hly rehabilitated. 7ith a few modifications, the ankle can be taped
for both inversion and eversion ankle tape jobs. (lantarflexion is not limited with this
techni*ue.
(osition
9it with knee strai#ht, ankle held at -. de#rees and sli#htly everted.
/aterials
skin lubricant and heel and lace pads $or prowrap%
tape adherent
2.1= adhesive tape
Application
(roximal Anchors
(lace heel and lace pads
over the tendons on the
dorsal foot and over the
attachment for the
Achilles tendon
Apply two to three
anchor strips to the lower
le# startin# just into the
base of the bulk of the
#astrocnemius. To ensure
that there are no wrinkles
and that the tape is
applied evenly, the anchor
must be applied at an
an#le followin# the
contours of the calf.
9tirrup 2
9tart on the medial side of
the anchors; lay the first
stirrup parallel with the le#
over the medial malleolus.
(ass under the foot directly
on the calcaneous. (ull tape
firmly up the lateral side and
attach tape on the lateral side
of the anchors.
>ibney 9trip
Apply the first #ibney strip
startin# on the medial side of
the calf anchor at the bottom
of the proximal anchors.
9tirrups and ,orseshoes ? and 5
9tart the second stirrup on the
medial side of the anchors.
9tartin# anterior to 9tirrup 2.
(ass under the foot directly
over the first stirrup on the
heel of the calcaneous. (ull
tape firmly up the lateral side
and attach tape on the lateral
side, either just in front of, or
just behind the top of the first
stirrup.
9tart the second #ibney strip
just below the first,
overlappin# by half.
Repeat the last stirrup,
posterior to the first stirrup,
and apply a #ibney strip
below the second #ibney strip
)istal Anchors
Apply two anchors,
startin# from the medial
side to the lateral side,
startin# half the tape
width from the most
anterior stirrup. /ake
sure the anchor passes the
base of the fifth
metatarsal.
Apply #ibney strips down
the le# past the malleolus
,eel ;ock
9tartin# at the top of the
ankle tape down the medial
side of the ankle $from
front of ankle, an#lin#
down over the malleolus
down to the attachment of
the Achilles tendon%
7rap around the back of
the calcaneous , an#lin#
down across the lateral
calcaneous
Then under the bottom of
the foot $just anterior to the
calcaneous%
Return to the start position
3ontinue with the tape
around the ankle once and
then perform a second heel
look startin# down the lateral
side

To perform the second heel
lock follow the pictures
3losin# off
3lose off the bottom of
the foot
3lose off at the top of the
tape job where #ibney
strips have not been
applied