Sunday, January 17, 2010

Rehab it as you see it-ankle taping

Facilitate good joint mechanics, don't inhibit all of them. Traditional American ankle taping inhibits dorsi/plantar flexion quite a bit & is expensive. In addition, it's very generic. This athlete's ankle sprain was to the posterior talofibular ligament (see the edema?), the distal tib-fib ligs (I believe MOST ankle sprains have a "high" ankle sprain component that causes most of the disability), and the medial fibers of the deltoid lig. In other words, there was more internal rotation to this sprain than inversion.

The first strip of tape is a piece of leukotape applied to the lateral malleolus running posterior/superior & anchored to the anterior/distal tibia. This is the traditional Mulligan style taping for a positional fault of the fibula on the talus. This is effective for most ankle sprains, although it may not have anything to do with a positional fault. I think gliding the distal fib back takes some stress off an injured posterior talofibular lig; and the circular pattern approximates the distal tib/fib joint.

The 2nd strip runs underneath the medial calcaneus & anchors just below the medial malleolus, reducing stress on the deltoid lig. I know you are wondering about the varus angle the tape has created, but don't worry. As soon as the athlete ambulates ground reaction force will cancel that out. This athlete was so comfortable after the taping he practiced the following day & played in next day's game.

Taking the time to do a good traditional & functional evaluation of your athlete's sprain creates more effective rehab strategies.

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