Unraveling the Mystery
of Ankle Pain #3:
Posterior and Retinaculum
Ligament Sprains
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Instructor: Ben Benjamin, Ph.D.
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1
Instructor: Ben Benjamin, Ph.D.
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Webinar Goals
• Explore the Assessment and Treatment of
Posterior and Retinaculum Ankle Ligament
Sprains
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2
Logistics
• Time: 60 minutes
• Schedule:
• Presentation 30-40 minutes
• Questions 15–20 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
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Pretest
1.
2.
3.
4.
5.
6.
Pain behind the ankle on the posterior lateral aspect indicates a: a.)
calcaneofibular ligament injury, b.) fibularis tendon or tibialis
posterior injury, c.) posterior talofibular ligament injury, or d.) tibialis
posterior tendon injury
The posterior talofibular ligament: a.) doesn’t have an effective
assessment test, b.) never gets injured, c.) doesn’t connect any
bones, or d.) is connected to the anterior talofibular ligament
Posterior ligament sprains are: a.) the least common of the lateral
ligament sprains, b.) the most common of the lateral ligament
sprains, c.) more common than calcaneofibular ligament sprains, or
d.) easy to detect
The cruciate crural ligament or retinaculum holds: a.) the nerves of
the foot in place, b.) the flexor hallucis in place, c.) many of the
extensor tendons of the foot in place, or d.) the ankle joint in place
How many cruciate crural ligaments are there? a.) Five, b.) Three,
c.) Two, or d.) Six
The retinaculum is often injured along with: a.) a deltoid ligament, b.)
a cuboid ligament, c.) a medial ankle sprain or with falling, or d.) a
lateral ankle sprain or with something heavy dropped on the foot
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3
Anatomy
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The Posterior Talofibular Ligaments
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4
The Primary Ankle Ligaments
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Assessment
Posterior Talofibular Ligament
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5
Assessment History and Tests for the
Posterior Talofibular Ligament
1. Posterior Palpation in Dorsiflexion
2. Passive dorsiflexion
3. Passive plantarflexion
4. Heat test
5. Heel raises
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Finding the Posterior Talofibular Ligament
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6
Posterior Palpation in Dorsiflexion
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Passive Dorsiflexion
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7
Passive Plantar Flexion
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Heat Test
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8
Achilles Tendon
Differentiation
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Alignment Check
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Assessment Tests
Extensor Retinaculum/Cruciate Crural Ligament
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Four Toe Resisted Extension
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10
Four Toe Resisted Extension
with Palpation
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Theory
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11
Posterior Talofibular Ligament Sprain
Positive Tests
MI: Posterior Palpation in Dorsiflexion
AUX: Passive Dorsiflexion of the ankle
is painful and often limited
AUX: Passive Plantarflexion of the
ankle is painful and often limited
AUX: Heat Test is positive. The injured
ankle is often hot or at least warmer
then the other one
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Posterior Talofibular Ligament
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12
Posterior Ankle Sprains
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Persistent Swelling
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What to watch out for confusion
Fibularis Tendon
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Persistent Swelling
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Treatment
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15
Posterior Talofibular Ligament Friction
Friction Therapy
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Friction Therapy of Crucial Crural Ligament
Extensor Retinaculum Ligament Friction
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16
Myofascial Therapy
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Massage Therapy
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17
Exercise Therapy
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Exercise Therapy
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18
Exercise Therapy
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Exercise Therapy
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19
Exercise Therapy
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Exercise Therapy
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20
Exercise Therapy
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Exercise Therapy
Lateral Stretch
Medial Stretch
Anterior Stretch
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21
Questions
Facebook.com/DrBenBenjamin
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Post-test
1.
2.
3.
4.
5.
6.
Pain behind the ankle on the posterior lateral aspect indicates a: a.)
calcaneofibular ligament injury, b.) fibularis tendon or tibialis
posterior injury, c.) posterior talofibular ligament injury, or d.) tibialis
posterior tendon injury
The posterior talofibular ligament: a.) doesn’t have an effective
assessment test, b.) never gets injured, c.) doesn’t connect any
bones, or d.) is connected to the anterior talofibular ligament
Posterior ligament sprains are: a.) the least common of the lateral
ligament sprains, b.) the most common of the lateral ligament
sprains, c.) more common than calcaneofibular ligament sprains, or
d.) easy to detect
The cruciate crural ligament or retinaculum holds: a.) the nerves of
the foot in place, b.) the flexor hallucis in place, c.) many of the
extensor tendons of the foot in place, or d.) the ankle joint in place
How many cruciate crural ligaments are there? a.) Five, b.) Three,
c.) Two, or d.) Six
The retinaculum is often injured along with: a.) a deltoid ligament, b.)
a cuboid ligament, c.) a medial ankle sprain or with falling, or d.) a
lateral ankle sprain or with something heavy dropped on the foot
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