Sports ankle injuries present commonly in the general
practice setting. The majority of these injuries are inversion
and plantar flexion injuries that result in damage to the
lateral ligament complex.
The aim of this article is to review the assessment and
management of sports ankle injuries in the general practice
Assessment of an ankle injury begins with a detailed history
to determine the severity, mechanism and velocity of the
injury, what happened immediately after and whether
there is a past history of inadequately rehabilitated ankle
injury. Examination involves assessment of weight bearing,
inspection, palpation, movement, and application of special
examination tests. Plain X-rays may be helpful to exclude
a fracture. If the diagnosis is uncertain, consider second
line investigations including bone scan, computerised
tomography or magnetic resonance imaging, and referral to a
sports physician. Manage all lateral ligament complex ankle
sprains with ice, compression, elevation where possible and
analgesia. Severe ligament sprains or rupture benefit from
a brief period of immobilisation. After initial management,
the athlete should complete a 6 week guided rehabilitation
program. Athletes with moderate to severe lateral ankle
ligament sprains should wear a semirigid or rigid ankle
orthosis for at least 6 months following injury.
Concussion is a common problem in many sports and recreational pursuits, especially those involving body contact, collisions or high speeds. In general practice, concussive brain injuries may present acutely following head trauma. More commonly, patients present some time after their head injury, either with ongoing symptoms or for medical clearance to allow them to return to play. Clinical management involves confirming the diagnosis, differentiating concussion from structural head injury, estimating the severity of injury and determining when the patient can return safely to competition.
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