unraveling the mystery of ankle pain #3: posterior and ...benbenjamin.com/webinars/ankle 3 color...
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Unraveling the Mystery of Ankle Pain #3:
Posterior and Retinaculum Ligament Sprains
Unraveling the Mystery of Ankle Pain #3:
Posterior and Retinaculum Ligament Sprains
Instructor: Ben Benjamin, Ph.D.Instructor: Ben Benjamin, Ph.D.
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Instructor: Ben Benjamin, Ph.D.Instructor: Ben Benjamin, Ph.D.
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Webinar GoalsWebinar Goals
• Explore the Assessment and Treatment of Posterior and Retinaculum Ankle Ligament Sprains
• Explore the Assessment and Treatment of Posterior and Retinaculum Ankle Ligament Sprains
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LogisticsLogistics• Time: 60 minutes
• Schedule:
• Presentation 30-40 minutes
• Questions 15–20 minutes
• Ongoing questions: Use Question box.If I don’t get to your question, ask me on my Dr Ben Benjamin Facebook page after the webinar.
• Get a pen and paper please
• Time: 60 minutes
• Schedule:
• Presentation 30-40 minutes
• Questions 15–20 minutes
• Ongoing questions: Use Question box.If I don’t get to your question, ask me on my Dr Ben Benjamin Facebook page after the webinar.
• Get a pen and paper please
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PretestPretest1. Pain behind the ankle on the posterior lateral aspect indicates a: a.)
calcaneofibular ligament injury, b.) fibularis tendon or tibialis posterior injury, c.) posterior talofibular ligament injury, or d.) tibialis posterior tendon injury
2. The posterior talofibular ligament: a.) doesn’t have an effective assessment test, b.) never gets injured, c.) doesn’t connect any bones, or d.) is connected to the anterior talofibular ligament
3. Posterior ligament sprains are: a.) the least common of the lateral ligament sprains, b.) the most common of the lateral ligament sprains, c.) more common than calcaneofibular ligament sprains, or d.) easy to detect
4. The cruciate crural ligament or retinaculum holds: a.) the nerves of the foot in place, b.) the flexor hallucis in place, c.) many of the extensor tendons of the foot in place, or d.) the ankle joint in place
5. How many cruciate crural ligaments are there? a.) Five, b.) Three, c.) Two, or d.) Six
6. The retinaculum is often injured along with: a.) a deltoid ligament, b.) a cuboid ligament, c.) a medial ankle sprain or with falling, or d.) a lateral ankle sprain or with something heavy dropped on the foot
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AnatomyAnatomy
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The Posterior Talofibular Ligaments The Posterior Talofibular Ligaments
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The Primary Ankle LigamentsThe Primary Ankle Ligaments
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AssessmentPosterior Talofibular Ligament
AssessmentPosterior Talofibular Ligament
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Assessment History and Tests for thePosterior Talofibular Ligament
Assessment History and Tests for thePosterior Talofibular Ligament
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1. Posterior Palpation in Dorsiflexion
2. Passive dorsiflexion
3. Passive plantarflexion
4. Heat test
5. Heel raises
Finding the Posterior Talofibular LigamentFinding the Posterior Talofibular Ligament
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Posterior Palpation in DorsiflexionPosterior Palpation in Dorsiflexion
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Passive Dorsiflexion Passive Dorsiflexion
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Passive Plantar FlexionPassive Plantar Flexion
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Heat TestHeat Test
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Achilles Tendon Differentiation
Achilles Tendon Differentiation
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Alignment CheckAlignment Check
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Assessment Tests Extensor Retinaculum/Cruciate Crural Ligament
Assessment Tests Extensor Retinaculum/Cruciate Crural Ligament
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Four Toe Resisted Extension Four Toe Resisted Extension
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Four Toe Resisted Extensionwith Palpation
Four Toe Resisted Extensionwith Palpation
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TheoryTheory
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Posterior Talofibular Ligament SprainPositive Tests
Posterior Talofibular Ligament SprainPositive Tests
MI: Posterior Palpation in Dorsiflexion
AUX: Passive Dorsiflexion of the ankle is painful and often limited
AUX: Passive Plantarflexion of the ankle is painful and often limited
AUX: Heat Test is positive. The injured ankle is often hot or at least warmer then the other one
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Posterior Talofibular LigamentPosterior Talofibular Ligament
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Posterior Ankle SprainsPosterior Ankle Sprains
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Persistent SwellingPersistent Swelling
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What to watch out for confusionWhat to watch out for confusion
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Fibularis Tendon
Persistent SwellingPersistent Swelling
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TreatmentTreatment
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Friction TherapyFriction Therapy
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Posterior Talofibular Ligament FrictionPosterior Talofibular Ligament Friction
Friction Therapy of Crucial Crural LigamentFriction Therapy of Crucial Crural Ligament
32Extensor Retinaculum Ligament FrictionExtensor Retinaculum Ligament Friction
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Myofascial TherapyMyofascial Therapy
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Massage TherapyMassage Therapy
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Exercise TherapyExercise Therapy
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Exercise TherapyExercise Therapy
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Exercise TherapyExercise Therapy
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Exercise TherapyExercise Therapy
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Exercise TherapyExercise Therapy
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Exercise TherapyExercise Therapy
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Exercise TherapyExercise Therapy
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Exercise TherapyExercise Therapy
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Anterior Stretch
Medial Stretch Lateral Stretch
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QuestionsQuestions
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Facebook.com/DrBenBenjaminFacebook.com/DrBenBenjamin
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Post-testPost-test1. Pain behind the ankle on the posterior lateral aspect indicates a: a.)
calcaneofibular ligament injury, b.) fibularis tendon or tibialis posterior injury, c.) posterior talofibular ligament injury, or d.) tibialis posterior tendon injury
2. The posterior talofibular ligament: a.) doesn’t have an effective assessment test, b.) never gets injured, c.) doesn’t connect any bones, or d.) is connected to the anterior talofibular ligament
3. Posterior ligament sprains are: a.) the least common of the lateral ligament sprains, b.) the most common of the lateral ligament sprains, c.) more common than calcaneofibular ligament sprains, or d.) easy to detect
4. The cruciate crural ligament or retinaculum holds: a.) the nerves of the foot in place, b.) the flexor hallucis in place, c.) many of the extensor tendons of the foot in place, or d.) the ankle joint in place
5. How many cruciate crural ligaments are there? a.) Five, b.) Three, c.) Two, or d.) Six
6. The retinaculum is often injured along with: a.) a deltoid ligament, b.) a cuboid ligament, c.) a medial ankle sprain or with falling, or d.) a lateral ankle sprain or with something heavy dropped on the foot