Episode 23: Not so Simple Ankle Injuries

Ready to Run

While most runners return to sport following an acute ankle sprain without complications, not all ankle sprains are simple. In this episode, we'll discuss an example case to demonstrate several important considerations for someone with chronic ankle instability. This includes a discussion on the most common causes of persistent ankle pain including cartilage injuries, peroneal tendinopathy, posterior tibialis tendinopathy, and recurring sprains. We'll break down some of the alterations in movement patterns seen after ankle sprain, physical exam pearls, and rehabilitation plan. If you've ever had an ankle injury that has taken a long time to heal then you'll want to check out this episode and explore the main reasons why runners can end up with ankle instability and what you can do to break the cycle of injury.Show notes:

• 3:30 - What is chronic ankle instability?
• 4:00- Key findings from 2016 consensus statement on lateral ankle sprains
• 6:40- Common causes of persisting ankle pain
• 11:10- Why is it important to manage ankle sprains early on?
• 25:50- Pathomechanical impairments following an ankle sprain
• 30:30- Alterations in joint forces and movement patterns
• 31:50- Effect of loss of range of motion
• 38:00- Too much supination on landing
• 42:00- Assessment and physical exam pearls
• 45:00- Rehab programming

References:

• Cho JH, et al. Value of stress ultrasound for the diagnosis of chronic ankle instability compared to manual anterior drawer test, stress radiography, magnetic resonance imaging, and arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1022-8.Delahunt E, et al. Clinical assessment of acute lateral ankle sprain injuries (ROAST): 2019 consensus statement and recommendations of the International Ankle Consortium. Br J Sports Med. 2018 Oct;52(20):1304-1310.
• Hertel J, Corbett RO. An Updated Model of Chronic Ankle Instability. J Athl Train. 2019 Jun;54(6):572-588.
• Palmieri RM, et al. Arthrogenic muscle response to a simulated ankle joint effusion. Br J Sports Med. 2004 Feb;38(1):26-30.
• Roemer FW, et al. Ligamentous Injuries and the Risk of Associated Tissue Damage in Acute Ankle Sprains in Athletes: A Cross-sectional MRI Study. Am J Sports Med. 2014 Jul;42(7):1549-57.
• Saltzman CL, Salamon ML, Blanchard GM, Huff T, Hayes A, Buckwalter JA, Amendola A. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J. 2005;25:44-6.

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