Introduction:
Ligaments, the tenacious bands of fibrous tissue that hold two bones together in your joints, can be stretched or torn during a sprain. The first course of treatment for a sprain is rest, cold, compression, and elevation. After that, at-home treatments for minor sprains are effective. Surgery to mend damaged ligaments is occasionally necessary for severe sprains. Strain and sprain are injuries different although used interchangeably. An injury to the muscle or to the band of tissue that joins a muscle to a bone is called strain injury. A sprain involves an injury to the bands of tissue that connect two bones. Sprains are most frequently associated with the ankle.
An injury to the lateral ligament complex of the ankle joint results in an ankle sprain. One may grade the injury's degree of severity.
-
Grade I: Refers to a minor stretching of the ligament complex without joint instability.
-
Grade II: Refers to a partial rupture of the ligament complex with mild joint instability.
-
Grade III: Refers to complete rupture of the ligament complex with joint instability.
When people excessively strain a joint and overextend or tear a ligament, they get a sprain. Sprains frequently happen during any athletic activity, fall, or injury. For instance, walking or exercising on an uneven surface can result in an ankle sprain, as can twisting the ankle from a jump.
What Is a Syndesmotic Ankle Sprain?
An ankle syndesmosis injury is referred to as a syndesmotic ankle sprain. Syndesmosis is a fibrous connection connecting two bones held together by membranes and ligaments. Any ankle motion can result in injuries, although the most frequent ones are talus dorsiflexion i.e., severe external rotation. Because the dome of the talus is wider in the anterior than in the posterior, these movements force apart the medial and lateral parts of the ankle joint, which correspond to the tibial and fibular malleolus. If the distal fibula is sufficiently separated from the tibia, the anterior inferior tibiofibular ligament, superficial posterior inferior tibiofibular ligament, transverse tibiofibular ligament, interosseous membrane, and inferior transverse ligament interosseous ligament can all become strained or torn.
Compared to a lateral ankle sprain, the syndesmotic will manifest with much less edema, a loss of full plantar flexion, and an inability to bear weight. Due to the interosseous membrane's damage, a bruise may manifest several days after the injury. In addition, inability or difficulty toe walking is frequently observed. Chronic pain, long healing times, repeated sprains, and the development of heterotopic ossification within the interosseous membrane is all part of the chronic symptoms of a syndesmotic ankle sprain.
What Is Physiotherapy Assessment?
Physical therapists base their treatment decisions on the diagnosis of particular illnesses. Clinicians obtain information through the physiotherapy exam to analyze and make clinical decisions. The first step in the diagnostic process is getting pertinent information from the history and physical examination.
Certain information may be utilized to narrow the examination scope to a particular area of the body, identify a specific pathology, and decide on the best course of action. The objective assessment (clinical testing) confirms or disproves the hypothesis generated by the subjective interview, making the subjective assessment (history taking) by far the most significant component of the evaluation.
However, a physiotherapist must determine the severity, irritation, and nature of the condition before any objective testing is done. Therefore evaluations such as determining the amount of activity necessary to increase the symptoms, their severity, and the length of time it takes for the symptoms to decrease, irritability are done.
What Is a Kleiger Test?
The Kleiger test is also called the external or lateral rotation stress test. In a hospital, the Kleiger test assesses any damage to the ankle syndesmosis. The therapist uses this clinical test during the assessment's examination phase when the patient complains of ankle pain.
How Is the Kleiger Test Done?
As a patient is being tested, they are seated when the test begins. The patient sits with one leg hanging over the exam table and the other kneeling at 90°. Assisting with one hand, the examiner steadies the leg. Next, the examiner administers passive lateral rotation stress, also known as external rotation, to the ankle and foot while holding the foot in plantigrade (90°) with the aid of the other hand. When compared bilaterally, increased pain over the ligament specifies a positive test for an ankle sprain.
What Conditions Are Diagnosed With Kleiger Test?
1. Medial Internal Ankle Sprain
- A medial ankle sprain is caused by excessive stretching of the deltoid ligament on the inside (medial side) of the ankle joint.
- Sprains are classified according to their severity, from mild strain to moderate partial to severe complete tear; they could need more time to recuperate.
- An abrupt twisting, turning, or rolling inward of the ankle frequently results in medial ankle sprains.
- A fall or a clumsy step onto an uneven surface may cause a medial ankle sprain.
- Another potential factor is the degeneration of the deltoid ligament.
- A hard kick to the ankle during a sporting event such as soccer, tennis, football, trail running, or basketball, medial ankle sprains are the most typical.
- Common symptoms include swelling, bruising, and soreness to the touch at the inner aspect of the ankle, pain at the inner aspect of the ankle joint with movement, and pain on weight-bearing at the inner aspect of the ankle joint.
- Rest and avoiding weight bearing on your ankle are typically part of the treatment.
2. Syndesmotic Sprain of the Inferior Tibiofibular Ligament
- Sports-related injuries and ankle fractures are frequently linked to ankle syndesmosis injuries.
- The inferior tibiofibular transverse ligament, interosseous ligament, anterior inferior tibiofibular ligament, and posterior inferior tibiofibular ligament make up the syndesmosis.
- Depending on the degree of the injury, syndesmosis injuries can be treated either conservatively or surgically.
Conclusion:
When an ankle ligament is stretched beyond its normal capacity, it results in an ankle sprain. It usually occurs during an athletic activity, fall, or injury due to twisting or ankle trauma. A therapist will run several tests to diagnose an ankle sprain. The Kleiger test is typically used as the initial test to rule out an ankle sprain. Conservative therapy is started when the possibility of an ankle sprain is ruled out and is frequently the most successful.
