My idea for this thread is for people to explain common sports med injuries, their treatment and recovery times, as well as talk about big time players that have injuries.

To start it out I'm going to explain high ankle sprains vs. low ankle sprains.

First off let's discuss the ankle joint. The ankle joint (aka talocrural joint) is a synovial hinge joint made up of the tibia (commonly called the shin bone), the fibula (the smaller of the two leg bones), and the talus (the first bone in the foot). The articulation between the tibia and fibula is the only constant syndesmosis in the body. The two bones are held together by three ligaments: the anterior inferior tibiofibular ligament, the posterior inferior tibiofibular ligament (of which the inferior transverse ligament is a part of), and the interosseous ligament of the syndesmosis. A high ankle sprain involves injury (stretching and/or tearing) to these ligaments.

There are 4 ligaments, known as the deltoids, that connect the tibia to the talus, calcaneus, and navicula on the medial (inside) portion of the ankle joint. There are 3 ligaments that connect the fibula to the talus and calcaneus on the lateral (outside) portion of the ankle joint. The lateral ligaments are the ones most often involved in low ankle sprains, but the medial ligaments can also be sprained. The three lateral ligaments are the anterior talofibular ligament (ATFL), the posterior talofibular ligament (PTFL), and the calcaneofibular ligament (CFL). Low ankle sprains have three grades with Grade 1 sprains usually involving the ATFL only. Low ankle sprains often occur when there is extreme plantarflexion (pointing of the foot downward) and inversion (rolling the foot inward), but can involve extreme dorsiflexion (pointing of the foot upward) and eversion (rolling of the foot outward) when the medial ligaments are the ones injured. This is why you often see basketball players get low ankle sprains when they land on another player's foot.

The usual treatment is RICE (rest, ice, compression, elevation). Casting will also be used in some cases. Besides those treatments I'm not sure what else is done. I'm sure Wikipedia or some other site has more information.

3/6/2010 2:26:29 AM

Let's see some torn ACL's, MCL's, PCL,s and minisci.

3/6/2010 12:02:53 PM

RICE has actually been expanded to PRICEM in the last couple of years. P being protection and M being medication

it's pretty easy to diagnose high vs. low. for high, you squeeze the fibula and tibia together higher up near the knee, which will cause separation at the bottom and elicit pain if there's any tearing of the ligament or fracture of the bone. the MOI for high is usually forced dorsiflexion, so that can help determine the diagnosis as well. because the syndesmosis ligament is so strong, a lot of times there'll be an avulsion fracture of the fibula. same with the deltoid ligaments causing avulsion of the tibia. high is usually more severe than a low inversion, so it takes longer to come back from.


if you get just a regular ankle sprain, you'll want to get ROM back as soon as possible, so ankle pumps, spelling the alphabet, etc are good ways to get motion and get rid of swelling. strengthening in all directions in important too, especially the peroneals since they're the ones that get stretched out when you have an inversion sprain and can help stabilize that motion in the future

[Edited on March 6, 2010 at 12:20 PM. Reason : .]

3/6/2010 12:08:30 PM

^ I had not heard about the addendum. Interesting

3/6/2010 12:13:57 PM

I, for one, am recovering from a torn ACL, meniscus, and sprained/strained LCL.

3/6/2010 1:17:11 PM

interesting that it was your LCL and not MCL, since those usually get injured together. how did you do it?

3/6/2010 2:43:50 PM

I'm a really slow healer. They need to invent stem cell injections or something to make people faster healers

3/6/2010 2:53:44 PM

^^^^^ Pro tip: Using a bunch of jargon when talking to a general audience is pretentious.

3/6/2010 3:29:24 PM

what jargon are you referring to? everything i said was already explained in the OP

MOI = method of injury
peroneals = muscles that evert the foot
avulsion fracture = bone breaking where a tendon or ligament inserts

[Edited on March 6, 2010 at 4:20 PM. Reason : better?]

3/6/2010 4:18:57 PM

Quote :

"Let's see some torn ACL's, MCL's, PCL,s and minisci."

Check out http://www.amazon.com/Musculoskeletal-MRI-Clyde-Helms-MD/dp/1416055347 for that.

3/6/2010 4:42:10 PM

The first thing they teach you in medicine/nursing/etc is to learn the language so you can communicate more easily with your other healthcare providers, but when you're talking to a general audience, dumb that shit down. Nobody, especially your average tww tard, is going to understand that shit.

[Edited on March 6, 2010 at 5:43 PM. Reason : ]

3/6/2010 5:43:14 PM

True. I hope that I explained it well enough and the accompanying diagrams helped visualize the ligaments that I talked about.

3/6/2010 5:51:34 PM

another common one is turf toe. shaq was a big name who had it a couple years ago, but basically the big toe is hyperextended and it injures the soft tissues around the joint. it's called turf toe because it typically happens on unforgiving surfaces like artificial turf. it sounds pretty harmless, but it's a real bitch and really prevents you from doing any kind of push off motions. you can PRICEM it, although i don't really think the compression or elevation does a whole lot in this case. you'll want to try to stay off it for at least a few days, up to a couple of weeks. taping may help based on the severity and the need to return to sport quickly.

it's graded from 1 to 3 (like most joint injuries), with 3 being the most severe and usually a complete rupture of the soft tissue

3/6/2010 6:04:18 PM

Well its a good idea for a thread though. You may be better served to post the injured structure, what it does or holds together, treatment, how long said player is going to be out and why...without going into detail of every structure involved.


For example, The ankle is held together by 3 ligaments on the outside that attach to the fibula. The front 2 are generally torn when the ankle turns inward. In additition, the ligament holding the fibula and tibia (the two lower leg bones) together can be strained with bad flexion injuries at the same time, or a longer muscle/ligament that attaches farther down the side of the foot can also be stretched or torn off the bone. Treatment consists of RICE...blah blah blah, and anti-inflammatory medications plus strengthening exercises once the initial inflammation has subsided. Players are generally out "x" weeks but can be as long as "y", longer if bones are broken during the injury. Long term prognosis is "z" and expected return to normal is x% over y period of time.


Prognosis is harder but there are generally return to play guidelines available but everyone has a different variation of the injury and everyone heals differently as well. Thats where it gets complicated, so theres no practical use in knowing the terminology unless you're treating it. Hell, unless you're a surgeon its sometimes not even useful to know the names of the ligaments, just to know that they're there, and can be injured. I mean if you're a doc or PA clearly you have to know it but otherwise no.

3/6/2010 6:07:34 PM

Quote :

"interesting that it was your LCL and not MCL, since those usually get injured together. how did you do it?"

I was playing football and running downfield on a kickreturn. One of my friends shoved me from my left side while I was entirely on my right leg. It tore my ACL, meniscus, and strained the LCL, and I also got a pretty good bone bruise from it.

3/8/2010 10:55:26 PM

ttt

10/7/2011 3:52:12 PM

Thanks ncsuftw1. Thought it might be nice to bring this thread back. I always found it funny when the announcers tone changes and start talking about the concern seen in the trainers because of them running out to the a player with an injured ankle. They aren't running because they are concerned, they are running because they want to be able to palpate the ankle ligaments to see I'd they are intact before the ankle starts swelling up.

10/7/2011 5:12:47 PM