Unraveling the Mystery of Ankle Pain #4: Medial Ligament Sprains

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Opal Ashlie Fisher
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1 Unraveling the Mystery of Ankle Pain #4: Medial Ligament Sprains 1 Instructor: Ben Benjamin, Ph.D. 2 1

2 Instructor: Ben Benjamin, Ph.D. 3 Webinar Goals Explore the Assessment and Treatment of Medial Ankle Ligament Sprains 4 2

3 Time: 60 minutes Schedule: Logistics Presentation minutes Questions 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 5 Pretest 1. How many sections does the deltoid ligament have? a.) Two, b.) Three, c.) Four, or d.) Five 2. Deltoid ligament sprains occur more often in: a.) children, b.) adolescents, c.) adulthood, or d.) old age 3. The deltoid ligament s function is to hold the: a.) lateral ankle together, b.) medial ankle together, c.) anterior ankle together, or d.) posterior ankle together 4. The deltoid ligament is: a.) deep inside the ankle, b.) at the back of the ankle where it is hard to palpate, c.) near the surface of the ankle where it is easy to palpate, or d.) none of the above 5. The deltoid ligaments are attached to: a.) the lateral malleolus, b.) the medial malleolus, c.) the talus, or d.) the cuboid bone 6. The deltoid ligament prevents you from: a.) over supinating, b.) over flexing, c.) over pronating, or d.) over inverting 6 3

4 Anatomy 7 The Deltoid Ligaments Tibionavicular Ligament 8 4

5 The Deltoid Ligaments Anterior Tibiotalar Ligament 9 The Deltoid Ligaments Tibiocalcaneal Ligament 10 5

6 Sustentaculum Tali of the Calcaneus 11 The Deltoid Ligaments Posterior Tibiotalar Ligament 12 6

7 Assessment 13 Assessment Tests 1. Ankle alignment check 2. Passive pronation 3. Passive dorsiflexion 4. Passive plantarflexion 5. Passive plantarflexion in lateral rotation 6. Heat test 7. Palpation of each ligament 14 7

8 Ankle Alignment Check 15 Passive Pronation 16 8

9 Passive Dorsiflexion 17 Passive Plantar Flexion 18 9

10 Passive Plantar Flexion in Lateral Rotation 19 Heat Test 20 10

11 Palpation of the Tibionavicular Ligament 21 Palpation of the Anterior Tibiotalar Ligament 22 11

12 Palpation of the Tibiocalcaneal Ligament 23 Palpation of the Posterior Tibiotalar Ligament 24 12

13 Theory 25 Deltoid Ligament Sprains Positive Tests Ankle Alignment Check MI: Passive Pronation AUX: Passive Dorsiflexion of the ankle is painful and often limited AUX: Passive Plantarflexion of the ankle is painful and often limited 26 13

14 Deltoid Ligament Sprains Positive Tests MI: Passive Plantarflexion in lateral rotation is painful and often limited AUX: Heat Test is positive. The injured ankle is often hot or at least warmer then the other one MI: Palpation of each ligament 27 Tibialis Posterior Tendon 28 14

15 Tibionavicular and Anterior Tibiotalar Ligament Anterior Tibiotalar Tibionavicular 29 Athletic Accidents Fibularis Tendon 30 15

16 Aging and Ligament Collapse Treatment 32 16

17 Friction Therapy of The Deltoid Ligament 33 Friction Therapy of Tibionavicular Ligament 34 17

18 Myofascial Therapy 35 Massage Therapy 36 18

19 Exercise Therapy 37 Exercise Therapy 38 19

20 Exercise Therapy 39 Exercise Therapy Ankle Inverter Stretch 40 20

21 Exercise Therapy Tibionavicular Stretch 41 Questions Facebook.com/DrBenBenjamin 42 21

22 Post-test 1. How many sections does the deltoid ligament have? a.) Two, b.) Three, c.) Four, or d.) Five 2. Deltoid ligament sprains occur more often in: a.) children, b.) adolescents, c.) adulthood, or d.) old age 3. The deltoid ligament s function is to hold the: a.) lateral ankle together, b.) medial ankle together, c.) anterior ankle together, or d.) posterior ankle together 4. The deltoid ligament is: a.) deep inside the ankle, b.) at the back of the ankle where it is hard to palpate, c.) near the surface of the ankle where it is easy to palpate, or d.) none of the above 5. The deltoid ligaments are attached to: a.) the lateral malleolus, b.) the medial malleolus, c.) the talus, or d.) the cuboid bone 6. The deltoid ligament prevents you from: a.) over supinating, b.) over flexing, c.) over pronating, or d.) over inverting 43 22

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Unraveling the Mystery of Cervical Pain #1: Whiplash and Central Ligament Sprains Instructor: Ben Benjamin, Ph.D. 1 Instructor: Ben Benjamin, Ph.D. Webinar Goal Explore the assessment and treatment of