Final Presentation

Chelsi Woodard
Project topic: Inversion and Eversion Ankle Sprains and How They lead to chronic
instability

Mentor- Mayra Reed, MS,ATC,LAT Head Athletic Trainer

P.O.B- Clear Springs High School
Independent Study Mentorship
Fall Semester
Mrs. Click
*Some information in this presentation comes from outside sources.

What is independent Study

Mentorship? (ISM)

Ism is a college level course that allows you to have up close and hands
on experience with a certain career field or topic of study. It gives you
more of a insight on what the career is really about behind the scenes
as well what is shown to the public eye.

COURSE REQUIREMENTS: COMPLETE 2-3 HOURS OF MENTOR

HOURS PER WEEK.

COMPLETE WEEKLY JOURNAL ENTRIES DOCUMENTATION OF

MENTORSHIP EXPERIENCES.

COMPLETE PROFESSIONAL ONLINE AND BINDER PORTFOLIO.

COMPLETE All given assignments

Complete mid term and final presentation

Develop a product for presentation at professional/ collegiate level

Myself and My Mentor- Mrs. Mayra Reed

Mentorship Site Clear Springs High School

Background and Credentials of My

Mentor
My

mentor obtained her bachelor of science in

sports and exercise science from West Texas A&M
University.

Also

has her Masters in Science Human and Health

Performance in Athletic Training from University of
Tennessee Chattanooga. She primarily works for
Houston Methodist Hospital but her position as an
outreach athletic trainer allows her to work at Clear
Springs.

What Is My Project Topic?

For the fall semester of this ISM course, I chose my project topic to be the
study and understanding of Inversion and Eversion ankle sprains. I chose
this particular topic because of the area of study I was interested in.
Athletic Training which is a branch of Sports Medicine and/or Kinesiology
has intrigued me since my freshman year during a mid season practice for
basketball. I mildly hurt my ankle and sought treatment for it in the training
room. That was the first time I experienced anything like that.

Understanding The Anatomy of The

Ankle
The ankle is a large joint made up of three bones,
the tibia, fibula, and the talus.
The ankle itself allows up and down movement of
the foot. The ligaments has a very important role in
the anatomy of the ankle as well as my project.
ligaments involved:

The lateral collateral ligament complex is made up

of the Anterior Talofibular, Calceneofibular, and
the Posterior Talofibular ligaments.

The medial collateral ligament complex is made

up of the The Deltoid Ligaments which consists
of the tibiocalcaneal, tibionavicular, posterior
superficial tibiotalar ligaments.

What Is An Ankle Sprain?

A ankle sprain is a injury to the ligaments of either the lateral or medial

area of ankle.

Ankle injuries usually occur in sports and could take a few weeks to
many months to heal completely.

Ankle injuries are the most common injury in sports. Ankle sprains are
most common diagnosis because the ankle is not a muscular joint and is
mostly supported by ligaments. Sprains cause a quick stretch and
possibly tear in the ligaments. So even when the patient has completed
treatment, there still may be some underlying weakness in the joint.
When you sprain a ligament, you damage the neural receptors inside,
and that leads to instability which can cause a reoccurring problem in
the ankle.

Keep in mind that every ankle sprain isnt the same.

Most Common Ankle Injuries

The most common ankle injuries occur on the lateral side or medial side
of the ankle but the lateral more primarily. There are numerous common
injuries but I've narrowed mine down to the two that I personally witness
very often. Because I'm a athlete myself I see Inversion and Eversion
injuries on a weekly if not daily basis.

They are so common in sports primarily because when involved in high

intensity activities, your more likely to over exert your body and stretch
out or tear ligaments that support your movement.

Lateral (Inversion) Sprains

inversion ankle sprain is a common injury in high

intensity athletics.
basketball, football, and soccer

It occurs when the foot is forced into inversion (turned

inward) beyond ligamentous or muscular control.

As a result of this excessive force, failure of the

involved ligaments may occur. Common reference to a
cause of this injury will be I twisted my ankle or I
landed on someones foot.

Signs & Symptoms

The area of pain will vary according to the severity of the
injury. Acutely there will be generalized pain throughout the medial
and lateral aspect of the ankle.

Specific point tenderness will be along the anterior and distal

end of the lateral ankle.

Active and passive movement of the ankle joint in all planes will
cause discomfort with an increase in discomfort upon inversion
and plantar flexion.

Ankle pain, tenderness and swelling.

Ankle bruising or discoloration.

Trouble moving the ankle.

Inability to put full weight on the ankle.

Ligaments Involved

As with most joints of the body, there are specific ligaments to prevent

excessive motion of that joint

. The anterior talofibular ligament (ATF) and the calcaneofibular ligament

(CF) are the primary restraints of ankle inversion. Because ankle sprains
usually occur with the foot in plantar flexion (foot pointed downward) the
ATF is the most frequently injured.

With the foot in plantar flexion the ATF is taught. With combined excessive
inversion and plantar flexion, tearing or complete rupture of the ATFL is the
usual occurrence. This exact mechanism may occur with any high intensity
activity involving lateral movement, jumping or running.

It may also occur with leisurely walking if the ground surface is uneven
(stepping into a hole). Occasionally, foot abnormalities may predispose an
athlete to ankle sprains. For these athletes orthotics may be required to
reduce the risk of further injuries.

Grade Classification

Classification of inversion ankle sprains is done through a grading

system according to the amount of damage.
Grade 1 is considered to be mild stretching within the ATF
little swelling, tenderness and laxity.

Grade 2 may vary depending on the source. Some sources will

identify complete rupture of the ATF without CF involvement and others
will claim partial tearing of both.
mild-moderate laxity, moderate pain, moderate inflammation and some loss of
motion.

Grade 3 sprains indicate rupture of both the ATF and CF.

severe swelling, an unstable joint, loss of function, and abnormal motion.

Eversion Ankle Sprain

An eversion ankle sprain is rare and occurs when the ankle rolls
too far inwards. It is often accompanied by a fracture of the fibula
bone.

Signs & Symptoms

An eversion sprain is a tear of the deltoid ligaments, on the inside of the ankle. It
is often called a medial ankle sprain or a deltoid ligament sprain. These
ligaments provide support to prevent the ankle turning inwards or everting.

It is rare for the deltoid ligaments to be sprained for two reasons. The fibula
bone tends to prevent the ankle from moving far enough to sprain or over
stretch the ligaments on the inside of the ankle. It simply does not allow the foot
to move far enough to cause damage.

Another reason is that the medical ligaments on the inside of the ankle are
stronger than the lateral ligaments on the outside.

Ankle pain, tenderness and swelling.

Ankle bruising or discoloration.

Trouble moving the ankle.

Inability to put full weight on the ankle.

Signs and symptoms Contd

The athlete will usually know they have

sprained their ankle.
There will be immediate pain on the inside
of the ankle after twisting it. There will be
rapid swelling and bruising may develop.
They will have difficulty weight bearing and
limited motion. In moderate to severe eversion
ankle sprains it is always recommended that an
x-ray is requested to rule out fractures.

What is Chronic And Acute

Instability?

Acute lateral ankle ligament injuries are common. If left untreated, they
can result in chronic instability.

Nonsurgical measures, including functional rehabilitation, are the

management methods of choice for acute injuries, with surgical
intervention reserved for high-demand athletes.

Chronic lateral ankle instability is multifactorial. Failed nonsurgical

management after appropriate rehabilitation is an indication for surgery.
Of the many surgical options available, anatomic repair of the anterior
talofibular and calcaneofibular ligaments is recommended when the
quality of the ruptured ligaments permits.

Treatment Options

RICE
is
an
acronym
that
stands
for Rest, Ice, Compression and Elevation and is a way
to remember the correct management in the first 24
hours following acute soft tissue injuries involving
damaged blood vessels.

Minimising bleeding inthis way at the injury site is

important because the application of a more aggressive
intervention, for example, Massage, will cause further
tissue damage.

When used appropriately, the RICE approach can

improve recovery time and reduce discomfort.

Rehabilitation Options

For the rehabilitation exercises, the patient progressively adds on to

their regimen as their ankle strengthens. The exercises are as follows.

The Alphabets

Windshield Wipers

Seated Calf Raises

Single-leg Standing

Eversion Isometrics

Inversion Isometrics

Exercise Band- Inversion & Eversion

Rehabilitation contd

Single-leg Calf Raises

Single-leg Standing with Towel

Lateral Step

Lateral Bound

Preventative Measures

Preventative measures and rehabilitation exercises go hand in hand

with each other because during the rehab process you are
strengthening the ankle, and that itself is an primary preventative
measure.

another important to make sure your ankle is safe from injury is security.
Athletes usually purchase an ankle brace or get there ankle taped by
their athletic trainer.

Video Taping Demonstration

Preparation for my tangible item

Conclusion

Pictures of my mentorship
experience

Thank you!!!

Lastly Id like to give a huge thank you to my mentor, my teachers, and

my parents for all the support and guidance through this journey.

Work Cited / Bibliography

http://www.webmd.com/fitness-exercise/picture-of-the-ankle
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855022/
https://www.athletico.com/2013/03/12/preventing-recurrent-ankle-sprains/
http://www.aofas.org/footcaremd/conditions/ailments-of-the-ankle/Pages/Ankle-Sprain-.aspx
http://www.backtothebox.com/inversion-lateral-ankle-sprain-structures-injury-rehab-repair/
http://go.galegroup.com/ps/retrieve.do?sgHitCountType=None&inPS=true&prodId=GVRL&userGroupName=j08491
0009&resultListType=RELATED_DOCUMENT&searchType=AdvancedSearchForm&contentSegment=97814144104
49&isBOBIndex=true&docId=GALE|CX2584700814#contentcontainer
www.journalofathletictraining.org

Nicolas Kofotolis, Ph.D.; Eleftherios Kelli Ph.D. Ankle Sprain Injuries. A 2-Year Prospective Cohort Study in Female
Greek Professional Basketball Players. Aristotle University of Thessaloniki, Agile Ioannis, Series, Greece. Volume
42-Number 3- September 2007. Journal of Athletic Training, Official Publication of the National Athletic Training
Association. Mayra Reed. Clear Springs High School, Training room., League City, TX. 22 Oct. 2014
http://loki.stockton.edu/~ospreys/ATInversionAnkle.htm
http://www.sportsinjuryclinic.net/sport-injuries/ankle-achilles-shin-pain/eversion-ankle-sprain

Work Cited/Bibliography
http://www.miridiatech.com/news/2012/11/pain-treatments-the-bestsequence/