Clinical Pearls for the Movement Specialist

ANKLE SPRAIN ORTHOSIS

U-Shaped Ankle Sprain Orthosis This economical orthosis is made by cutting a U-shaped piece from a high-density foam pad (used to sleep on when camping, Walmart ~ $10.00).  The orthosis applies selective, focal compression (see slide 5 and description, below) which allows for channeling of edema as shown by arrows (see figure on left).  Next, a compression wrap is applied to the ankle.  Since the orthosis will insulate the ankle, it must be removed during cryotherapy. . Ankle Sprain and ATF Tear Cartoon 1.  Interstitial fluid pressure is subatmospheric. Anterior Talofibular (ATF) ligament is suctioned into the vacuum. 2.  Interstitial fluid pressure is equal to atmospheric pressure.  No vacuum. 3.  Interstitial fluid is greater than atmospheric pressure as edema increases. 4.  Interstitial fluid is much greater than atmospheric pressure and increased edema.  If ATF ligament heals in this position--with edema--laxity is probably, along with chronic ankle sprain signs and symptoms. 5.  Selective compression with U-shaped orthosis.  ATF ligament is in position for decreased healing time. References Wilkerson GB.  Treatment of the Inversion Ankle Sprain Through Synchronous Application of Focal Compression and Cold. J Athletic Training, Fall 1991: Vol. 26. Online Articles The Physician and Sportsmedicine: Ankle Sprains The Physician and Sportsmedicine: Persistent Pain After Ankle Sprain: Targeting the Causes The Physician and Sportsmedicine: Managing Ankle Sprains: Keys to Preserving Motion and Strength The Physician and Sportsmedicine: Foot Injuries of the Recreational Athlete The Physician and Sportsmedicine: Common Fractures of the Foot and Ankle: Part 2 The Physician and Sportsmedicine: Refining Rehabilitation With Proprioception Training The Physician and Sportsmedicine: How to Steer Patients Toward the Right Sport Shoe The Physician and Sportsmedicine: Athletic Shoes: Finding a Good Match The Physician and Sportsmedicine: Giving Injuries the Cold Treatment The Physician and Sportsmedicine: Pain Relief for Acute Soft-Tissue Injuries The Physician and Sportsmedicine: Bracing

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