Ankle sprains comprise 15% of all athletic injuries. The lateral ligamentous complex is most commonly involved in ankle sprains. Majority of patients fully recovery but 20-40% develop chronic symptoms or instability.
The ankle joint (talocrural joint) is a hinge type, synovial joint between the talus and th mortise formed by the fibula (lateral malleolus) and tibia (medial malleolus). Ankle stability dependent on the bony restraints, medial collateral (deltoid) ligament, anterior and posterior talofibular ligaments, calcaneofibular ligament. The talus is the only bone in the lower quadrant that does not have a muscular attachment. The movement of the talus is influenced by the adjacent bones.
MANUAL THERAPY CONSIDERATIONS for the ANKLE/FOOT:
Common Mechanical Dysfunctions that influence the ankle and foot:
Talor restriction will often limit dorsiflexion. Restoring joint play (long axis extension and anteroposterior glide) at the talus will restore dorsiflexion range of motion.
Subtalor (talus-calcaneous articulation) restriction. The talus articulates with the
calcaneous with three facets on the superior surface of the calcaneus. If subtalor
restriction exists, talor restriction always present as well. Restriction will
present with ankle inversion or eversion restriction.
Cuboid subluxation can mimic plantar fascitits. The cuboid is the cornerstone for all three arches of the foot. Also key to the forefoot secondary to itŐs articulation with 4-5th metatarsals. Dysfunctional cuboid is prominent on the plantar surface with pronation and is tender. Normal cuboid mechanics is not prominent and is not tender. Responds well to joint mobilization.
Distal tibiofibular restriction as reported in the knee section.
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