scholarly journals The epidemiology, evaluation, and assessment of lateral ankle sprains in athletes

2021 ◽  
Vol 6 (2) ◽  
pp. 008-017
Author(s):  
Cavazos Jr. G Javier ◽  
Harkless Lawrence B
Keyword(s):  
Best Practice ◽  
Healthcare Providers ◽  
Treatment Strategies ◽  
The United States ◽  
Ankle Injuries ◽  
Return To Play ◽  
Medical Attention ◽  
Ankle Sprains ◽  
Lateral Ankle ◽  
True Incidence

Approximately 30,000 ankle injuries occur every day in the United States. With the incidence estimated at more than 3 million a year and at a rate of 2.15/1,000 in the U.S. alone, medical specialists and other healthcare providers caring for the foot and ankle must take notice. Despite the millions of ankle injuries sustained annually, the true incidence may be underestimated, as fewer than half of individuals with ankle sprains seek medical attention from healthcare professionals. The economic burden associated with the evaluation, diagnosis, and treatment is close to $4 billion annually. Ankle sprains account for half of all sports injuries and remains a difficult diagnostic and therapeutic challenge in the athlete. Accurate diagnosis is critical as 40% of ankle sprains are misdiagnosed or poorly treated leading to chronic ankle pain and disability. Implementing evidence supported diagnostic and treatment strategies is the goal for ensuring safe and rapid return to play. The Lateral Ankle Sprain (LAS) is among the most common type of ankle sprains suffered during athletic activities. Up to 80% of LAS are of the inversion type, and 75% lead to recurrence and instability. Although most individuals experiencing a LAS return to activity within six weeks, many report continued pain, diminished function, and instability. The purpose of this review is to highlight the epidemiology, pathoetiology, pathoanatomy, and biomechanics of the LAS, enabling sports physicians to implement the best practice guidelines and protocols to manage this common enigma.

scholarly journals Predisposing factors to lateral ankle injury in male comrades marathon runners

2009 ◽  
Vol 65 (1) ◽  
Author(s):  
J. Hiemstra ◽  
N. Naidoo
Keyword(s):  
Correlation Coefficient ◽  
Undergraduate Research ◽  
The United States ◽  
Ankle Injury ◽  
Ankle Injuries ◽  
Distance Runners ◽  
Marathon Runners ◽  
Lateral Ankle ◽  
Ankle Ligament ◽  
Lateral Ankle Ligament

Introduction: More than two million people experience ankle ligament traumaeach year in the United States. Half of these are severe ligament sprains, however verylittle is known about the factors that predispose individuals to these injuries. The purpose of this study, (which was conducted as an undergraduate research project),was to find a correlation between the characteristics of height, weight and limbdominance and lateral ankle ligament injuries. Method: A  retrospective study was conducted on 114 ultra distance runners whoparticipated in the 2006 Comrades Marathon. During race registration, the runners’ height and weight were measuredafter answering a questionnaire regarding their training. Results: 114 runners responded to the questionnaire. From this cohort, 38 (33.3%) had sustained previous lateral ankle injuries. Of these 38 injuries, 47.4% of the injuries occurred on the runner’s dominant limb and 36.8% occurred on thenon-dominant side. 15.8% of the runners sustained previous ankle injuries to both ankles. There was a low negative correlation coefficient of 0.24 with regards to weight as a risk factor. This indicated that the power of the correlationwas 5.93%. The study demonstrates that there is no correlation between an increase in weight and an increase in theincidence of ankle injury. The correlation coefficient indicated a low correlation between an increase in height and the incidence of ankle injury. However, the power of the correlation at 18.37% makes inaccurate any attempt to predict the height at which a runner would be at most risk for lateral ankle injury. Conclusion: Height and weight are not risk factors predisposing subjects to lateral ankle injury. In addition, the studyillustrated that there was no effect of limb dominance on the incidence of lateral ankle injury.

scholarly journals The Effectiveness of Deep Oscillation Therapy on Reducing Swelling and Pain in Athletes With Acute Lateral Ankle Sprains

2019 ◽  
Vol 28 (8) ◽  
pp. 902-905
Author(s):  
Matt Hausmann ◽  
Jacob Ober ◽  
Adam S. Lepley
Keyword(s):  
Day Treatment ◽  
Athletic Trainers ◽  
Clinical Effectiveness ◽  
Standard Of Care ◽  
Return To Play ◽  
Ankle Sprains ◽  
Current Standard ◽  
Bottom Line ◽  
Lateral Ankle ◽  
Additional Loss

Clinical Scenario: Ankle sprains are the most prevalent athletic-related musculoskeletal injury treated by athletic trainers, often affecting activities of daily living and delaying return to play. Most of these cases present with pain and swelling in the ankle, resulting in decreased range of motion and strength deficits. Due to these impairments, proper treatment is necessary to avoid additional loss of play and prevent future injuries. Recently, there has been an increased use of deep oscillation therapy by clinicians to manage pain and swelling following a variety of injuries, including ankle sprains. However, very little evidence has been produced regarding the clinical effectiveness of deep oscillation therapy, limiting its application in therapeutic rehabilitation of acute lateral ankle sprains. Clinical Question: Is deep oscillation therapy effective in reducing pain and swelling in patients with acute lateral ankle sprains compared with the current standard of care protection, rest, ice, compression, and elevation? Summary of Key Findings: The literature was searched for studies of level 2 evidence or higher that investigated deep oscillation therapy on pain and inflammation in patients with lateral ankle sprains. Three randomized control trials were located and appraised. One of the 3 studies demonstrate a reduction in pain following 6 weeks of deep oscillation therapy compared with the standard of care or placebo interventions. The 2 other studies, 1 utilizing a 5-day treatment and the other a 1 time immediate application, found no differences in deep oscillation therapy compared with the standard of care. Clinical Bottom Line: There is inconclusive evidence to support the therapeutic use of deep oscillation therapy in reducing pain and swelling in patients with acute lateral ankle sprains above and beyond the current standard of care. In addition, the method of treatment application and parameters used may influence the effectiveness of deep oscillation therapy. Strength of Recommendation: Level B.

Evaluation of the Sports Ankle Rating System in Young, Athletic Individuals with Acute Lateral Ankle Sprains

2003 ◽  
Vol 24 (3) ◽  
pp. 274-282 ◽  
Author(s):  
Glenn N. Williams ◽  
Joseph M. Molloy ◽  
Thomas M. DeBerardino ◽  
Robert A. Arciero ◽  
Dean C. Taylor
Keyword(s):  
Ankle Injuries ◽  
Rating System ◽  
Ankle Sprains ◽  
Rating Score ◽  
Lateral Ankle ◽  
Life Measure ◽  
Initial Validation ◽  
Unique System ◽  
The Impact

The purpose of this paper is to introduce the Sports Ankle Rating System and provide the initial validation for its use. As its name implies, this outcomes measurement system is intended for use in assessing the functional outcomes of athletes with ankle injuries. This unique system consists of three distinct instruments: the Quality of Life Measure, the Clinical Rating Score, and the Single Assessment Numeric Evaluation. We began the validation process of the Sports Ankle Rating System with subjects who had sustained lateral ankle sprains because this is the most common injury in sports. The results of this study indicate that the Sports Ankle Rating System is: effective at assessing the impact that an ankle sprain has on an athlete's functional and psychosocial status responsive to changes in an athlete's ankle-related health status, and valid and reliable as tested.

Persistent Disability Associated with Ankle Sprains: A Prospective Examination of an Athletic Population

1998 ◽  
Vol 19 (10) ◽  
pp. 653-660 ◽  
Author(s):  
J. Parry Gerber ◽  
Glenn N. Williams ◽  
Charles R. Scoville ◽  
Robert A. Arciero ◽  
Dean C. Taylor
Keyword(s):  
Physical Examination ◽  
Ankle Sprain ◽  
The United States ◽  
Ankle Injuries ◽  
Return To Sports ◽  
Ankle Sprains ◽  
Residual Symptoms ◽  
Athletic Population ◽  
Early Return ◽  
Hop Test

The purpose of this study was to examine a young athletic population to update the data regarding epidemiology and disability associated with ankle injuries. At the United States Military Academy, all cadets presenting with ankle injuries during a 2-month period were included in this prospective observational study. The initial evaluation included an extensive questionnaire, physical examination, and radiographs. Ankle sprain treatment included a supervised rehabilitation program. Subjects were reevaluated at 6 weeks and 6 months with subjective assessment, physical examination, and functional testing. The mean age for all subjects was 20 years (range, 17–24 years). There were 104 ankle injuries accounting for 23% of all injuries seen. There were 96 sprains, 7 fractures, and 1 contusion. Of the 96 sprains, 4 were predominately medial injuries, 76 were lateral, and 16 were syndesmosis sprains. Ninety-five percent had returned to sports activities by 6 weeks; however, 55% of these subjects reported loss of function or presence of intermittent pain, and 23% had a decrement of >20% in the lateral hop test when compared with the uninjured side. At 6 months, all subjects had returned to full activity; however, 40% reported residual symptoms and 2.5% had a decrement of >20% on the lateral hop test. Neither previous injury nor ligament laxity was predictive of chronic symptomatology. Furthermore, chronic dysfunction could not be predicted by the grade of sprain (grade I vs. II). The factor most predictive of residual symptoms was a syndesmosis sprain, regardless of grade. Syndesmosis sprains were most prevalent in collision sports. This study demonstrates that even though our knowledge and understanding of ankle sprains and rehabilitation of these injuries have progressed in the last 20 years, chronic ankle dysfunction continues to be a prevalent problem. The early return to sports occurs after almost every ankle sprain; however, dysfunction persists in 40% of patients for as long as 6 months after injury. Syndesmosis sprains are more common than previously thought, and this confirms that syndesmosis sprains are associated with prolonged disability.

scholarly journals Trends in Pediatric Skateboard Related Foot and Ankle Injuries Presented to US Emergency Departments from 2009-2018: A Descriptive Epidemiology Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0043
Author(s):  
Devon Scott ◽  
Stephen P. Canton ◽  
MaCalus V. Hogan ◽  
Dukens LaBaze
Keyword(s):  
United States ◽  
Emergency Departments ◽  
The United States ◽  
Ankle Injuries ◽  
Urgent Care ◽  
Ankle Sprains ◽  
Foot And Ankle ◽  
Injury Surveillance System ◽  
Hospital Size ◽  
Time Period

Category: Ankle; Sports; Trauma; Other Introduction/Purpose: Skateboarding has been a part of American culture since its origins in the 1960s. ESPN’s X Games debuted in the 90s and popularity soared. In 1996, there were an estimated 5.8 millions children that participated in the sports with some 750,000 involved weekly. In 1999, there was approximately 51,000 pediatric skateboard related injuries seen in United States emergency rooms. Most injuries happen when the skateboard comes into contact with irregularities in the riding surface. A previous study showed that from 1987-1998, ankle sprains/strains were the most common injury seen in the emergency department (ED). The purpose of this study is to examine the updated trends of skateboard related foot and ankle injuries (SFA) from the years 2009 to 2018. Methods: Data was obtained from the National Electronic Injury Surveillance System (NEISS). Injury data is obtained daily from the emergency departments of approximately 100 hospitals across the United States and its territories. This serves as a probability sample of over 5000 hospitals across the country. Each case recorded is given a statistical weight based on the study design. CPSC analysis has the ability to make adjustments to more accurately represent the entire U.S. population. Hospitals are grouped into five strata mostly based on hospital size and number of ED visits they receive per year. The database was set with query inputs of patients aged 2-17 that presented to the ED with skateboard related lower leg, ankle, or foot (fracture and/or sprain. Time period queried was between January 1, 2009 to December 31, 2018. Results: An estimated total of 107,712 pediatric patients had a SFA injury between 2009-2018. With a mean age of 13.8 years. There was approximately 644,030 total skateboard related injuries. SFA injuries accounted 18.4 % in 2010 and 14.8 % in 2018. There was an estimated total of 4,263,682 foot and ankle sprains and/or fracture, of which 3.4% were SFA in 2010. The annual rate of injury per 100,000 children has decreased 72.1% from 23.3 to 6.5. Skateboard participation was approximately 7.35 millions riders above the age of 6 in the U.S in 2009, this number has declined 12.4% to 6.44 in 2016 with the lowest year being 2011 at 5.83 million. Since 2012 to 2016 this participation figure has ranged from 6.35 – 6.63 million. Conclusion: The decline in the number of participants in the sport has been far outpaced by the decline in injuries being seen in the ED. For the time period of this study, the style and structure of the footwear have not varied significantly. A study showed that shoe height did not change ankle inversion angle. Another possible factor is increase urgent care usage. The number of centers has increased 43.8% from 2013 to 2018. In 2016 these centers saw 4% of all their claims be sprains or strains. Further research is needed to trend data for other points of care.

The Role of the Accessory Malleolar Ossicles and Malleolar Avulsion Fractures in Lateral Ankle Ligament Reconstruction

2017 ◽  
Vol 11 (4) ◽  
pp. 308-314 ◽  
Author(s):  
Matthew M. Reiner ◽  
Jonathan J. Sharpe
Keyword(s):  
Risk Factor ◽  
Conservative Treatment ◽  
The United States ◽  
Ankle Sprains ◽  
Ligament Repair ◽  
Avulsion Fractures ◽  
Lateral Ankle ◽  
Accessory Ossicles ◽  
Ankle Ligament ◽  
Lateral Ankle Ligament

While it is well known that ankle sprains are one of the most common injuries in the United States, predictive factors regarding failure of conservative treatment are not well known. There are many biomechanical and epidemiological factors that play a role in recurrence and failure of conservative treatment, but most cases are able to be treated with immobilization and/or rest, ice, elevation, physical therapy, and bracing. We propose that one important risk factor is often overlooked simply due to the fact that a vast majority of these cases resolve without the need for surgery. Accessory ossicles and avulsion fractures of the malleoli or talus may represent a predisposition or marker for ligamentous damage that may lead to the need for lateral ankle ligament repair or reconstruction in the future. We have identified 61 consecutive patients who underwent lateral ankle ligament repair or reconstruction by the primary surgeon from the years 2007 to 2017. Out of those patients who met our inclusion and exclusion criteria, 66% had the presence of osseous pathology consisting of accessory ossicles or avulsion fractures of the medial or lateral malleolus or talus. The proportion of osseous pathology seen with lateral ankle ligament repair or reconstruction was higher than what has been previously reported in both operative and nonoperative settings. This may help identify a risk factor for failure of conservative treatment in patients presenting with acute ankle sprains or ankle instability especially in the active cohort. Levels of Evidence: Level IV: Case series

scholarly journals Evaluation of foot and ankle injuries in professional soccer

2020 ◽  
Vol 14 (2) ◽  
pp. 158-162
Author(s):  
Danilo Pizzo Kitagaki ◽  
Eduardo Souza Maciel ◽  
Nacime Salomão Barbachan Mansur ◽  
Eduardo Ramalho De Moraes ◽  
Gustavo Gonçalves Arliani
Keyword(s):  
Triceps Surae ◽  
Physical Contact ◽  
Ankle Injuries ◽  
Ankle Sprains ◽  
X Rays ◽  
Foot And Ankle ◽  
Time Loss ◽  
Lateral Ankle ◽  
Professional Soccer

Objective: To evaluate the profile of foot and ankle injuries in professional soccer. Methods: Data were collected prospectively during the 2016 São Paulo Soccer Championship using two electronic forms: an initial form (10 variables) and a follow-up form (6 variables). The results were standardized and evaluated in SPSS 23.0. Results: A total of 259 injuries were reported: 106 to the thigh (40.9%), 42 to the foot and ankle (16.2%), 39 to the knee (15.1%), 39 to the head or face (15.1%) and 33 in other locations (12.7%). Of the 42 foot and ankle injuries, 20 were lateral ankle sprains (47.6%), 5 were medial ankle sprains (11.9%), 3 were to the triceps surae (7.1%), 3 were leg contusions (7.1%), 3 were foot contusions (7.1%), 2 were myalgias (4.8%), in addition to 5 other types (11.9%). There was physical contact in 73.8% of the injuries (p <0.001), and six injuries (14.3%) were considered severe, i.e., involving a time loss of at least one month. Of the severe injuries, four were treated surgically (three by osteosynthesis and one by tenorrhaphy). The mean time loss due to injury was 19.7 days, and the overall incidence rate was 3.5 injuries per 1000 hours of exposure, with 2.1 ligament injuries per 1000 hours. X-rays and magnetic resonance imaging were the most requested tests in the follow-up of these patients. Conclusion: Foot and ankle injuries were the second most frequent injury in Brazilian professional soccer, 73.8% of which resulted from physical contact (p<0.001). Lateral ankle sprains accounted for 47.6% of these injuries, which reaffirms their high prevalence and importance for sports medicine. Level of Evidence III; Prognostic Studies; Prospective Study.

Determination of In Situ Ankle Ligament Strains in Cases of High and Medial Ankle Sprains

2012 ◽  
Author(s):  
Keith D. Button ◽  
Feng Wei ◽  
Eric G. Meyer ◽  
Kathleen Fitzsimons ◽  
Roger C. Haut
Keyword(s):  
Ankle Sprain ◽  
Ankle Injury ◽  
Ankle Injuries ◽  
Deltoid Ligament ◽  
Generic Model ◽  
Ankle Sprains ◽  
Ligament Injuries ◽  
Lateral Ankle Sprain ◽  
Lateral Ankle ◽  
Tibiofibular Ligament

Ankle sprain is a common occurrence in sports, accounting for 10–30% of injuries [1]. While approximately 85% of ankle sprains are lateral ankle injuries, syndesmotic (high) and medial injuries typically result in more time off the field. In order to help limit or mitigate ankle injuries, it is important to understand the mechanisms of injury. While numerous biomechanical studies have been conducted to investigate ankle injuries, most of them are designed to study ankle fractures rather than sprains. Ankle sprains have been graded in the clinical literature and associated with the degree of damage to a ligament resulting from excessive strains [2]. Recently, there have been studies of lateral ankle sprain in laboratory settings [3,4] and based on investigation of game films [5], providing considerable insight into the mechanism of lateral ankle sprain. On the other hand, few biomechanical studies have been conducted on high and medial ankle sprains. A more recent study from our laboratory used human cadaver limbs to investigate such injuries [6]. The study showed that the type of ankle injury, whether medial or high, under excessive levels of external foot rotation depends on the extent of foot eversion [6]. Everted limbs showed isolated anterior tibiofibular ligament injuries (high ankle sprain) only, while neutral limbs mostly demonstrated deltoid ligament failures (medial ankle sprain). Additionally, the study documented grade II (partial tears) and grade III (ruptures) ligament injuries. While a computational ankle model has also been developed and validated to help understand the mechanisms of injury [7], it is a generic model. The objective of the current study was to develop computational, subject-specific models from those cadaver limbs and determine the levels of ligament strain generated in the medial and high ankle injury cases, as well as correlate the grades of injury with ligament strains from the computational model.

scholarly journals National Athletic Trainers' Association Position Statement: Management of Sport Concussion

2014 ◽  
Vol 49 (2) ◽  
pp. 245-265 ◽  
Author(s):  
Steven P. Broglio ◽  
Robert C. Cantu ◽  
Gerard A. Gioia ◽  
Kevin M. Guskiewicz ◽  
Jeffrey Kutcher ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Best Practice ◽  
Athletic Trainers ◽  
The United States ◽  
Position Statement ◽  
Legal Aspects ◽  
Return To Play ◽  
Concussion Management ◽  
Best Practice Guidelines ◽  
National Athletic Trainers Association

Objective: To provide athletic trainers, physicians, and other health care professionals with best-practice guidelines for the management of sport-related concussions. Background: An estimated 3.8 million concussions occur each year in the United States as a result of sport and physical activity. Athletic trainers are commonly the first medical providers available onsite to identify and evaluate these injuries. Recommendations: The recommendations for concussion management provided here are based on the most current research and divided into sections on education and prevention, documentation and legal aspects, evaluation and return to play, and other considerations.

scholarly journals Ankle Reconstruction in Charcot's Neuroarthropathy: Challenges and Solutions

2016 ◽  
Vol 3 (2) ◽  
pp. 65-70
Author(s):  
Vinod K Panchbhavi
Keyword(s):  
Weight Bearing ◽  
Late Presentation ◽  
Ankle Injuries ◽  
Asia Pacific ◽  
Medical Attention ◽  
Main Concern ◽  
Ankle Sprains ◽  
True Nature ◽  
Vein Thrombosis ◽  
Stress Modality

ABSTRACT Ankle injuries in the presence of neuropathy have potential to cause deformity in the ankle, which can in turn cause ulcerations and infections leading to significant morbidity including loss of limb or even life. These injuries although devastating can start off innocuously and may not be immediately apparent to the patient because of lack of pain. This can lead to a late presentation. Often, the main concern is swelling, for which the patient seeks attention. And even when medical attention is sought, unless the physician is vigilant, the condition can potentially be missed or misdiagnosed as deep vein thrombosis or cellulitis. A sprain or even a fracture in the ankle is not suspected as the patient retains the ability to walk. This condition and its true nature further escapes detection if, as often is the case, a nonweight-bearing radiograph is obtained. Radiographs obtained without the weight-bearing or other stress modality may not reveal the instability at the ankle joint due to ligament damage. A thorough clinical evaluation including assessment for neuropathy and weight-bearing radiographs are necessary for diagnosis. Stable fractures and ankle sprains can be managed conservatively in a cast or boot. Unstable ankle following ligamentous disruption and/or fractures in the vicinity of the ankle needs internal or external stabilization. The stabilization in the presence of neuropathy should be stronger and the protection from weight bearing last longer and twice that used for patients with similar condition but without neuropathy. How to cite this article Panchbhavi VK. Ankle Reconstruction in Charcot's Neuroarthropathy: Challenges and Solutions. J Foot Ankle Surg (Asia-Pacific) 2016;3(2):65-70.

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