Foot and Ankle Sprains Quiz
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Questions and Answers

Which ligament is primarily injured in a low ankle sprain?

  • Calcaneofibular Ligament
  • Posterior Talofibular Ligament
  • Syndesmotic Ligament
  • Anterior Talofibular Ligament (correct)

    • What is a typical recovery time for a high ankle sprain?

  • 15 days
  • 1 week
  • 6 weeks
  • 2-7 weeks (correct)

    • Which test is used to assess the integrity of the ATFL?

  • Lateral Hop for Distance Test
  • Talar Tilt Test
  • Anterior Drawer Test (correct)
  • Royal London Hospital Test

    • What is the primary intervention recommended during the acute/protected motion phase of an ankle sprain?

    <p>MICE</p> Signup and view all the answers

    What characteristics define Chronic Ankle Instability (CAI)?

    <p>Recurrent sensations of instability</p> Signup and view all the answers

    What does the Bernese Ankle Rules focus on regarding functional tests?

    <p>90% of uninvolved side performance</p> Signup and view all the answers

    Which of the following is NOT a sign of Achilles tendinopathy?

    <p>Acute swelling</p> Signup and view all the answers

    Which functional test is NOT included in the assessment for ankle injuries?

    <p>Single leg balance test</p> Signup and view all the answers

    Which ankle sprain mechanism of injury (MOI) is typical for a low ankle sprain?

    <p>Inversion and plantar flexion</p> Signup and view all the answers

    Which ligament is known to provide primary restraint to the inversion moment when the ankle is in a plantar-flexed position?

    <p>Anterior Talofibular Ligament</p> Signup and view all the answers

    What is the main distinguishing characteristic of reactive tendinopathy compared to degenerative tendinopathy?

    <p>Increased blood flow and greater vascular density</p> Signup and view all the answers

    Which intrinsic risk factor is associated with Achilles tendinopathy?

    <p>Increased foot pronation</p> Signup and view all the answers

    What is the most common mechanism of injury leading to Achilles tendon ruptures?

    <p>Forceful push-off during athletic activities</p> Signup and view all the answers

    Which symptom is typically associated with midportion Achilles tendinopathy?

    <p>Soreness that worsens after prolonged rest</p> Signup and view all the answers

    Which physical performance measure is not typically used to assess Achilles tendinopathy?

    <p>Upper body strength test</p> Signup and view all the answers

    What is the recommended approach to performing the eccentric phase of rehabilitation for Achilles tendinopathy?

    <p>Controlled slow lowering on single leg</p> Signup and view all the answers

    Which test is commonly used to diagnose plantar fasciitis?

    <p>Windlass test</p> Signup and view all the answers

    What does the presence of a thickened nodule in the Achilles tendon suggest?

    <p>Progression to degenerative tendinopathy</p> Signup and view all the answers

    Which anatomical range of motion (ROM) is needed for a successful lateral step down?

    <p>55 degrees dorsiflexion</p> Signup and view all the answers

    What should be avoided during the rehabilitation of insertional Achilles tendinopathy?

    <p>Stretches that emphasize dorsiflexion</p> Signup and view all the answers

    What is a characteristic of Plantar Fasciitis pain throughout the day?

    <p>Increased pain intensity as the day progresses</p> Signup and view all the answers

    In the progressive resistive eccentric exercise program for Achilles tendon rehabilitation, what is the initial loading weight for the eccentric phase?

    <p>80% of one-repetition maximum (1RM)</p> Signup and view all the answers

    Which biomechanical deficit is likely to exacerbate conditions like Achilles tendinopathy?

    <p>Decreased range of motion at the talocrural joint</p> Signup and view all the answers

    Which of the following is NOT a typical presentation of rheumatoid arthritis?

    <p>Sudden onset of symptoms</p> Signup and view all the answers

    What is a common pathological factor in Femoral Acetabular Impingement Syndrome?

    <p>Abnormal femoral head/neck morphology</p> Signup and view all the answers

    Which rehabilitation intervention is considered beneficial for Gluteal Tendinopathy?

    <p>Strengthening of the gluteal muscles</p> Signup and view all the answers

    Which statement about labral lesions is accurate?

    <p>They serve as shock absorbers and stabilizers in the hip joint</p> Signup and view all the answers

    What is a common symptom of Greater Trochanteric Pain Syndrome?

    <p>Proximal lateral hip pain</p> Signup and view all the answers

    What type of morphology is associated with CAM deformity in Femoral Acetabular Impingement Syndrome?

    <p>Irregularity or aspherical femoral head</p> Signup and view all the answers

    Which test specifically indicates a posterior labral tear?

    <p>EABER test</p> Signup and view all the answers

    Which type of exercise is emphasized for patients with Iliotibial Band Syndrome?

    <p>Increase hip abductor activation</p> Signup and view all the answers

    What is the goal of the conservative treatment for labral lesions?

    <p>To preserve the labral seal effect</p> Signup and view all the answers

    Which is a recognized risk factor for Athletic Pubalgia or Core Muscle Injury?

    <p>Decreased preseason training in sports specific maneuvers</p> Signup and view all the answers

    Which treatment is most suited for Ischemic Necrosis of the Femoral Head?

    <p>Non-weight bearing and potential surgery</p> Signup and view all the answers

    What is the key muscle involved in the pathology of Gluteal Syndrome?

    <p>Piriformis</p> Signup and view all the answers

    Physical therapy for labral tears should primarily focus on which of the following?

    <p>Strengthening of the gluteal muscles</p> Signup and view all the answers

    Study Notes

    Foot and Ankle Sprains

    • Low ankle sprains are more common than high ankle sprains.
    • The most common mechanism of a low ankle sprain is inversion and plantar flexion.
    • Structures involved in low ankle sprains include the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL).
    • Prognosis for low ankle sprains is shorter than high ankle sprains (approximately 1 week).
    • High ankle sprains involve the syndesmotic ligaments.
    • The typical mechanism of a high ankle sprain is external rotation of the tibia and dorsiflexion of the ankle.
    • The prognosis for high ankle sprains is longer than low ankle sprains, approximately 2-7 weeks.

    Chronic Ankle Instability (CAI)

    • Chronic pain and reoccurring sensation of instability are common symptoms of CAI.
    • Some cases of low ankle sprains can develop into chronic ankle instability.
    • 40% of individuals develop persisting symptoms of CAI following an ankle sprain.

    Lateral Ankle Sprain Grades

    • Grade I: minimal loss of function, negative anterior drawer and talar tilt tests, little to no hemorrhaging, and minimal swelling.
    • Grade II: some loss of function, positive anterior drawer test, negative talar tilt test, moderate hemorrhaging, moderate swelling, and moderate pain.
    • Grade III: near total loss of function, positive anterior drawer and talar tilt tests, severe hemorrhaging, severe swelling, and severe pain.

    Ottawa Ankle Rules

    • Used to determine if ankle X-rays are needed.
    • X-ray needed if pain in the malleolar or midfoot zone and bone tenderness at particular points, and/or inability to bear weight both immediately and in the emergency department.

    Bernese Ankle Rules

    • Procedure involves 3 stress tests: Indirect Fibular Stress, Direct Medial Malleolar Stress, and Mid- & Hind-Foot Compression Stress.
    • Radiograph needed if symptoms reproduced from any 1 of the 3 above.

    Hip Examination

    • Hip dysplasia is a shallow acetabulum/decreased coverage of the femoral head.
    • Hip instability is the increased stress on anterior capsul.

    Developmental Dysplasia of the Hip (DDH)

    • The typical presentation of an adult with DDH is an insidious onset of moderate to severe groin or lateral hip pain.
    • Activity restriction, limping, and positive impingement signs are common indicators.

    Slipped Capital Femoral Epiphysis (SCFE)

    • Slippage of the femoral head relative to the femoral neck, often occurring in adolescents.
    • Clinically, there may be gradual or sudden pain in the hip, groin, thigh, or knee.
    • The pain is typically worse with activity but can occur at rest.

    Legg-Calvé-Perthes Disease

    • Idiopathic avascular necrosis of the femoral head, typically affecting children aged 4-10.
    • It's more common in boys.
    • The presence of pain in the groin, thigh, or medial knee along with an antalgic gait and reduced hip abduction/muscle spasms is indicative.

    Osteoarthritis

    • Results from the degradation of the articular cartilage with subsequent osteophyte formation, narrowing of the joint space, and sclerosis of bone.
    • Clinically, there may be moderate to severe anterolateral hip pain during weight-bearing, morning stiffness lasting under an hour, and limited hip IR below 24º.

    Rheumatoid Arthritis

    • A systemic autoimmune inflammatory disease affecting the synovial lining, cartilage, and bone.
    • Common presentation includes symmetrical involvement of multiple joints, pain, swelling, redness, and stiffness.
    • Morning stiffness typically exceeding 1 hour, decreased range of motion, and presence of rheumatoid factor support diagnoses.

    Greater Trochanteric Pain Syndrome (GTPS)

    • A cluster of symptoms including trochanteric bursitis, abductor tendinopathy, and abnormal mechanical loads.
    • Clinically, there may be insidious, chronic, and intermittent pain in the proximal lateral hip radiating to the distal thigh.
    • Positive 30-second single-leg stance test (pain due to, and not necessarily weakness).

    Labral Lesions

    • Labral function includes shock absorption, pressure distribution, joint stabilization, and proprioception.
    • Presentation features include anterior hip/groin pain, clicking, catching, and difficulty with range-of-motion, particularly rotation.

    Iliotibial Band Syndrome

    • Lateral hip or knee pain, weaker hip abductor strength, and a relationship to increased hip adduction and knee internal rotation during stance.

    Avulsion Fractures

    • common in 14-17 years old boys.
    • Typically involve sudden onset pain.
    • Limited active range of motion, weakness, and pain.

    Ischemic Necrosis of the Femoral Head (AVN)

    • Avascular necrosis of the femoral head characterized by interruption of blood supply.
    • Pain in the groin (often worsened by weightbearing and relieved by rest), and limitation in range of motion in the non-capsular pattern.

    Coxa Saltans/Snapping Hip

    • Snapping hip is when various structures snap over the superior portion of the hip joint.
    • Extra-articular snapping hip is more common and is often linked to GTPS.

    Gluteal Syndrome

    • Cluster of pain that may be caused by disorders of the piriformis or hamstrings.
    • Common in those who sit a lot and have buttock pain.
    • Pain often worsens with prolonged sitting or activity; referral to the knee may be common.

    Athletic Pubalgia/Core Muscle Injury (CMI)

    • Chronic pain in the abdominal/groin area radiating into the perineum or proximal adductors.
    • Exacerbation of pain occurs with kicking, cutting, or sprinting.
    • Imbalance between adductor and abductor muscle strength, and decreased ROM are often present.

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    Ortho - Foot and Ankle Exam Breakdown PDF

    Description

    Test your knowledge on foot and ankle sprains, including their mechanisms, common symptoms, and prognoses. Learn about the differences between low and high ankle sprains and the risks of chronic ankle instability. This quiz is ideal for students and professionals in sports medicine and physical therapy.

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