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Common Sports Injuries of the Ankle
A British and an American physician, both sports injury experts, discuss and illustrate the complex anatomy, action and importance of injury to the ankle in sports. Drawing from their vast clinical experience as medical officers to professional soccer and rugby teams and director of the sports medicine program at Graduate Hospital in Philadelphia the authors discuss the types of injury to the ankle as well as their relative frequency, anticipated duration and treatment. The commonest of these injuries are lateral ankle sprains, which account for 15% of all time lost from sport. While inversion injuries are the most common cause of ankle injury, the authors describe the causes and manifestations of others such as eversion injury, footballer's ankle (especially seen in soccer players), os trigonum, plantar fasciitis, and achilles tendonitis, which often occurs in running sports. Initial tests such as the "anterior drawer" are detailed and the authors graphically describe how to properly perform this important study. They note that it is best to remove the injured player from the site of injury and that it is always advisable to compare the injured ankle with the "good" one in order to rule out congenital ligamentous laxity. They also provide guidance on when and how x-rays should be performed, and when the results of these call for surgery. In managing the injury, rest, ice, compression, and elevation (RICE) are fundamental. NSAIDS are advocated for minimizing pain and swelling … and the importance of proper rehabilitation, which is too often incomplete and incorrect, is reviewed. As an example, casts can delay rehabilitation and should be used only for the severest cases. As a final note the authors discuss the use of crutches, and also touch upon therapies that are either unproven or even detrimental. |
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