Physio Edge podcast with David Pope19 Jul 2018

081. How to treat ankle syndesmosis injuries with Chris Morgan

Ankle syndesmosis injuries following forced ankle dorsiflexion and lateral rotation of the foot require very specific management and rehabilitation to achieve great treatment outcomes. If you approach management of ankle syndesmosis injuries in the same manner as a lateral ankle ligament injury it will likely result in long term pain and dysfunction for your patients.

In the previous episode of the Physio Edge podcast - How to assess ankle syndesmosis injuries, Chris Morgan and David Pope explored how to assess and diagnose ankle syndesmosis injuries (ASI).

In this new Physio Edge podcast - "How to treat ankle syndesmosis injuries with Chris Morgan (Arsenal 1st Team Physiotherapist in the English Premier League), you will discover how to manage different grades of ASI, including:

Grade 1 syndesmosis injury management

Initial injury management
How long should you immobilise a Grade 1 injury for?
What weight bearing should be allowed in the initial stages?
Taping techniques that can be utilised during return to running, training and play
Rehab - initial exercises and progressions
How much pain is acceptable during return to training?
Return to sport timeframes & how you and your athlete can decide when RTP is appropriate
When can contact be initiated?

Grade 2 syndesmosis injuries

Grade 2 injury management and immobilisation
Which players are likely to require arthroscopy to confirm instability, and subsequent stabilisation surgery?
Why rehabilitation of stable grade 2 injuries is different from grade 1 injuries
Which movements you need to restrict
How to maintain lower limb musculature and minimise muscle atrophy should be performed
Additional general conditioning your patient should perform during the early phase of rehab
How to incorporate an Alter G treadmill into rehab
Occlusion training for lower limb conditioning
How to modify rehab if you do not have access to an Alter G
Timeframes and criteria to assess when your patient can remove their immobilisation boot
Tests to perform at each stage of rehab
When and how should dorsiflexion range be improved?
Timeframes and criteria to meet prior to return to running
Exercise progressions and variations
Return to play markers and tests you can use
What to do when a player still reports a 'nipping' at the front of the ankle after 6 weeks and is having difficultly achieving full dorsiflexion

Unstable injuries - Grades 2b, 3 and 4

Management of unstable injuries
Post-surgical immobilisation and management
Common return to play timeframes

To accurately grade your patients ASI and prescribe the most appropriate rehab I strongly recommend listening to Physio Edge podcast episode 80 – How to assess ankle syndesmosis injuries with Chris Morgan prior to this podcast.

Free webinar - Medial knee injuries with Chris Morgan

Medial knee injuries often occur in snow sports, or other sports when landing or being tackled. Different areas of the medial knee can be injured, including the deep, superficial, proximal or distal fibres of the MCL and medial knee. Depending on the injured structures, patients will either cope with a more aggressive treatment approach and early return to sport, or require a more conservative approach. How can you know the rehab approach your individual patient requires?

In this free webinar with Chris Morgan (1st Team Physiotherapist with Arsenal FC), you will explore:

Applied anatomy of the medial knee
Mechanism of injury, presentation and diagnosis of medial knee injuries
How you can differentiate between deep, superficial, proximal, distal and Grade 1, 2 and 3 clinical injuries
How imaging findings correlate with your clinical findings
MRI grading (radiological versus clinical)
How you can perform an objective assessment
How function, pain and instability impact your treatment
Accelerated vs more conservative treatment - how can you choose the ideal approach for your patient?
Are PRP injections appropriate?
Rehabilitation principles you can use with your medial knee injury patients
Ligament loading
Which bracing and weight bearing regime should you utilise?
What should you do when your patient has joint laxity?
Is pain during rehab acceptable?
Should you overload OR "under load to overcome"?

You can CLICK HERE to access this free webinar

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