Return to play after ankle injury

NewsBot · Oct 17, 2012

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Return to Play in Athletes Following Ankle Injuries
Thomas O. Clanton, Lauren M. Matheny, Hannah C. Jarvis, Anastasia B. Jeronimus
Sports Health: A Multidisciplinary Approach November/December 2012 vol. 4 no. 6 471-474

Background: The decision to return to play following an ankle injury is a multifactorial process involving both physical and psychological parameters. The current body of literature lacks evidence-based guidelines to assist in the decision.

Objective: This article reviews the evidence to support such testing: the dorsiflexion lunge test, star excursion balance test, agility T-test, and sargent/vertical jump test. The importance of psychological factors is also highlighted.

Evidence Acquisition: The primary literature search was conducted using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) with the search terms “ankle AND injury” and the following limits activated: English language. A secondary search was then conducted with the search terms “return to play” and “sport injuries and return to play.”

Results: Various functional tests have been used to determine whether a patient is able to return to play following an ankle injury. This study documented four tests that have been used to assess range of motion, balance and proprioception, agility and strength and the reasoning as to why these tests are used.

Conclusions: Functional testing provides objective measures for gauging an athlete’s progression through the rehabilitation process. Testing balance and proprioception, strength, range of motion, and agility coupled with psychological assessment evaluates readiness for return to play.
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Admin2 · Oct 18, 2012

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NewsBot · Dec 20, 2016

How Knowledge Relates to Confidence in Orthopedics and Emergency Medicine Regarding Return to Sport and Rehabilitation in Foot and Ankle Trauma
Sarah Johnson-Lynn, PhD, FRCS (Tr & Orth), David Townshend, FRCS (TR & Orth)
Journal of Surgical Education; Article in Press

Objective
The aim of this study was to survey the knowledge of registrars in emergency medicine and orthopedics on 5 common injuries to the foot and ankle and compare this knowledge, and self-reported confidence in giving it, with that of consultants and physiotherapists of various levels of experience.

Design
An online survey was used to gather the information using scenario-based open and closed questions.

Participants
A total of 102 health care professionals, who regularly deal with sports injuries, were recruited. These included consultant orthopedic surgeons with a subspecialty interest in foot and ankle surgery, orthopedic surgeons in other specialties, extended scope physiotherapy practitioners (ESPs) in foot and ankle and general musculoskeletal practice, emergency medicine consultants, emergency medicine registrars, orthopedic registrars, senior physiotherapists, and junior physiotherapists.

Setting
The participants were drawn from various health care institutions in the North East of England.

Results
Consultant foot and ankle surgeons and extended scope practitioners in foot and ankle both scored significantly on knowledge of rehabilitation program design than either set of registrars. For 2 of the case scenarios, there was a significant difference in scores between either orthopedic consultants or ESPs and registrars (p < 0.05). For total score, there was a trend for extended scope practitioners to score higher than both sets of registrars, but this did not reach significance.

Correlation coefficients for knowledge and self-reported confidence ranged between 0.009 and 0.33, demonstrating only weak positive linear correlation between scenario score and reported confidence in advice given.

Conclusions
The most significant area of gaps in knowledge among the 2 groups of registrars was in the specifics of rehabilitation programs. There was markedly higher confidence with greater seniority. Registrars in emergency medicine and orthopedics are likely to benefit from case-based teaching in sports injury rehabilitation.
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