Term Paper on "Ankle Injury"

Term Paper 12 pages (3360 words) Sources: 1+

[EXCERPT] . . . .

Ankle injuries - Athletes

Sports-Medicine

Ankle-Injury

Lateral Inversion Sprain

Medial Eversion Sprain

Syndesmosis Sprain

Achilles Tendon Rupture

Other Ankle Injury Classifications

Sports-Medicine

Ankle-Injury

One of the most common types of injuries occurring during sports events is that of ankle injuries. The ankle is susceptible to injury in practically every sport that exists. "There is a broad spectrum of intra- and extra-articular pathologies that may result in chronic pain and loss of function after an ankle sprain in an athlete. Multiple concurrent intra- and extra-articular pathologies are common. The complex anatomy in the ankle and foot may result in overlap of the clinical features of these various conditions. Contemporary imaging modalities facilitate accurate diagnosis and appropriate and timely management. This review focuses on the particular mechanisms of injury in individual sports, the imaging manifestations of ankle ligament injuries, posttraumatic ankle synovitis, meniscoid lesions, soft-tissue impingement, and ankle joint chondral and osteochondral lesions, with an emphasis on their clinical relevance in athletes." (Uyar et al. 2004) The objective of this work is to research and explore ankle injuries and possible preventative measures that would effectively end losing athletes due to injuries of the ankle.

Sports-Medicine

Ankle-Injury

Objective

The objective of this work is to research and explore ankle injuries and possible preventative measures that would effectively end losing athletes due to injuries of the ankle.

Introduction

Athletic coaches, trainers and athletes alike know that sustaining an injury during the course of a competitive sport, or in practice is a reality that practically every athlete will deal with varying degrees of injury experienced. Many athletes have had their athletic career vanish in a moment of an injury occurring that affects them the rest of their life, rendering them incapable to participate I the athletic career they had hoped to pursue. One of the most common types of injuries occurring during sports events is that of ankle injuries. The ankle is susceptible to injury in practically every sport that exists.

Literature Review

In the work entitled 'Long-Term Outcomes of Inversion Ankle Injuries' stated is that: "Ankle Sprains are common sporting injuries generally believed to be benign and self limiting. However, some studies report a significant proportion of patients with ankle sprains having persistent symptoms for months or even years." (Barnsley et al. 2005) This work reports a study conducted toward the determination of "the proportion of patients presenting to an Australian sports medicine clinic who had symptoms after a sports-related inversion ankle sprain." (Barnsley et al. 2005) In the study the control group that was matched as to age and sex. Data collection was via interview/surveys with questions related to current ankle symptoms, disability related to ankle injury and present health status.

The mean age of the 19 patients in the study was 20 (range 13-28). Twelve male patients (63%) with follow-up averaging 29 months. Out of the 19 patients only five (26%) had fully recovered and had no pain, swelling, giving way, or weakness reported at the follow-up. This study states that findings are that: "Most patients who sustained an inversion ankle injury at sport and who were subsequently referred to a sports medicine clinic had persistent symptoms for at least two years after their injury. This reinforces the importance of prevention and early effective treatment." (Barnsley et al. 2005)

Stated in the work entitled 'Closed poste medial dislocation of the tibiotalar joint without fracture in a basketball player' is: "There is a broad spectrum of intra- and extra-articular pathologies that may result in chronic pain and loss of function after an ankle sprain in an athlete. Multiple concurrent intra- and extra-articular pathologies are common. The complex anatomy in the ankle and foot may result in overlap of the clinical features of these various conditions. Contemporary imaging modalities facilitate accurate diagnosis and appropriate and timely management. This review focuses on the particular mechanisms of injury in individual sports, the imaging manifestations of ankle ligament injuries, posttraumatic ankle synovitis, meniscoid lesions, soft-tissue impingement, and ankle joint chondral and osteochondral lesions, with an emphasis on their clinical relevance in athletes." (Uyar et al. 2004)

The long-term debilitating effect of an undiagnosed ankle injury is stated in the work entitled 'Traumatic foot and ankle injuries in the athlete': "Unrecognized and inappropriately managed foot and ankle injuries can lead to significant long-term functional disability. As many of the above injuries are frequently diagnosed late or not even considered because of the benign appearance of the foot or radiograph, it behooves the sports medicine physician to carefully assess the foot and obtain appropriate radiographs, including stress views as needed.

Although quick return to athletic play is among the goals of treatment for the elite athlete, this must be tempered by the fact that certain injuries require significantly greater time for complete recovery. A functional rehabilitation program is the best means to rapidly return the player to competition and while prolonging the athletic career." (Title & Katchis, 2004)

The work entitled 'Stress fractures of the foot and ankle' states: "When developing a treatment plan for the runner, the sports medicine physician must keep the athlete informed as to the nature of the injury and the necessity of the treatment. A fitness plan must be developed with the runner to ensure that strength, flexibility, and cardiovascular conditioning are maintained during this period. Ideally the physician should develop this plan with the runner and not dictate the type of activity that is used to obtain these goals." (Haverstock, 2001)

Wilkerson (1992) states in the work entitled "Ankle Injuries in Athletes" that "the most frequent cause of physician evolution in a sports-oriented environment" is that of ankle injuries. Further stated is "With a detailed history, physical and radiographic examination to avoid missing underlying pathology, the primary care physician can diagnose and treat the majority of ankle injuries. Occasionally, stress radiographs, arthograms, or magnetic resonance imaging (MRI) is needed.

The vast majority of ankle sprains can be treated with adhesive tape strapping or semirigid orthotics and nonsteroidal anti-inflammatory medication followed by rehabilitation. Key points of rehabilitation are control of pain and swelling acutely with nonsteroidal anti-inflammatories and RICE (rest, ice, compression, and elevation), then restoring normal range of motion, strengthening muscle groups, and retraining proprioception of the ankle joint." (Wilkerson, 1992)

Martin & Martin (2002) state the fact that "Sports play an integral part in the lives of many students, both male and female, making the need for sports medicine universal. The ratio of school-aged female to male athletes has increased from 1 in 27 athletes in 1972 to 1 in 3 today." Stated as well is the important factor as related by Martin & Martin (2002) as to bone strength: "Several factors make injuries to the immature skeleton different than those of the mature skeleton. Immature bone is less dense and more porous than adult bone due to the abundant vascular channels and lower mineral content. This accounts for the lower modulus of elasticity and bending strength found in the bones of growing athletes, resulting in fractures occurring after less significant trauma. The periosteum that surrounds the bone is thicker and stronger than that found in the adult. It is attached firmly in the metaphyseal and ephiphyseal regions of the long bones to help stabilize the physis. This thicker, stronger, more biologically active periosteum helps young bones heal quicker and more reliably than their adult counterparts. Growth plates (physes) located at the ends of the long bones (epiphyses) and at the insertion of certain muscle-tendon units (apophyses) may be subject to injury when exposed to excessive force. Damage to these specific physes can lead to temporary or permanent disturbances of growth." (Martin & Martin, 2002)

Ankle injuries are usually due to "excessive inversion" (Trojan & Mckeag, 1998) However, it is important to make the differentiation between a "simple inversion sprain and a potentially disabling injury."(Trojan & Mckeag, 1998) The method of assuring expedient diagnosis is through screening for any deformity and running tests specific to this type injury. Assessment is best performed during the "preswelling period on the sidelines" according to Trojan and McKeag (1998) The most common injury experienced by athletes is that of ankle sprains. Facts stated by Trojan & McKeag (1998) in relation to ankle injuries are: (1) Most involve injury to the lateral supporting ligaments from an inversion incident; (2). The risk of ankle injuries varies by sport; they make up 45% of all injuries in basketball, 31% in soccer, and 25% in volleyball; (3). In professional, college, and high school football, ankle sprains account for 10% to 15% of all time lost to injury. Yet these injuries are often minimized. (Trojan & Mckeag, 1998) The avoidance of "chronic ankle pain, laxity, or arthritis can be accomplished through "appropriate treatment." Ankle injuries are usually due to "excessive inversion" (Trojan & Mckeag, 1998) However, it is important to make the differentiation between a "simple inversion sprain and a potentially disabling injury."(Trojan & Mckeag, 1998) The method of assuring expedient diagnosis is through screening for any deformity and running tests… READ MORE

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