10/11/09

20-year-old male with right ankle sprain

20-year-old male with right ankle sprain

Clinical Features:

A 20-year-old male, who has been playing football, had suffered from right ankle

sprain yesterday. He went to see a medical doctor and radiographs didn't indicate

any sign of fracture. Pharmaceutical procedures was given to him in order to

reduce inflammation, and referred to our clinic.

Clinical findings:

・Observation - Swelling was found on the symptomatic site.

・ Palpation - Pain was located anteriorly over the anterior tibiofibular ligament

and lateral aspect of ankle soft tissue (peroneus tertius muscle)

・ Orthopedic exam - Pain was elicited through a variety of tests designed to

stress ankle articulation through diastatic forces.

Intervention and Outcome

Treatment plan included chiropractic manipulation, active release technic,

physiotherapy modalities, and rehabilitation was offerd. Care must be taken to

avoid stressing the supporting ligaments during the early course of therapy. Initial

treatment is aimed at reducing pain and inflammation using modalities such as

microcurrent and P.R.I.C.E. principles. Treatment over subsequent weeks

involves progressive resistance exercises, proprioceptive challenges, plyometric

exercises and sport-specific agility drills, while maintaining cardiovascular fitness.

Conclusion

The most common mechanism of ankle sprain is forced external rotation in a

dorsiflexed foot. Practitioner should also be cognizant of the indolent nature of

this injury and possibility for sequelae. Anterior ankle pain and pain with a deep

squat or during the push-off phase of gait are typical of this injury. Radiographs

to rule out fracture and evaluate the extent of the injury may be necessary.

Conservative therapy involving chiropractic manipulation, active release technic,

physiotherapy modalities, and rehabilitation was effective for this case of Grade I

and II injuries, while Grade III injuries require a surgical intervention.

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