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SportsAnkle sprain: observation and palpation
You look at the foot, ankle and lower leg of the injured side and then palpate structure by structure. Where the ankle swells and where it hurts point to the injured ligaments, and what you see and feel helps tell a sprain from a fracture.
Free to startScenarios
- Minutes or hours after the injury, when the location of the swelling still shows the structures involved.
- Later in recovery, tracking the swelling from one visit to the next.
The steps
- Observe the foot, ankle and lower leg on the injured side.
- Look for deformity: gross deformities are typical of fractures and dislocations, but not every fracture shows one.
- Look for swelling and discoloration, and note where the swelling is: it may show which structures are involved.
- Palpate the ligaments: point tenderness over a ligament is a good indicator of the injured structure.
- Palpate the surrounding muscles and tendons.
- Bone tenderness over the fibular attachment of the anterior talofibular ligament should not raise suspicion of a fracture.
- To track the swelling over the recovery, measure it with a figure-8 girth measure or water volumetrics.
Safety rules that stop the station
- Point tenderness does not test the integrity of a ligament: the special tests still follow.
- The amount of swelling does not match how well the athlete says the ankle works.
To pass
- Deformity, swelling and discoloration checked on the injured side.
- Ligaments, muscles and tendons palpated, and the tender structures named.
Official source
Athletic trainers · NATA position statement
National Athletic Trainers' Association Position Statement: Conservative Management and Prevention of Ankle Sprains in Athletes (J Athl Train, 2013)
The National Athletic Trainers' Association position statement on ankle sprains (Journal of Athletic Training, 2013), free on PubMed Central: recommendation 1 and its literature review.
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