MUSCLES:
EVERTERS: peroneus longus & brevis, ligments
PLANTER FLEXORS: gastrocnemius, soleus
DORSI FLEXORS: tibialis anterior

COMMENTS: The most common ankle injuries involve talo-fibular and calcaneo- fibular ligament strain and achilles’ tendinitis. Working these injuries consists of frictioning the ligaments, releasing the muscles, and suggesting that the client perform ankle strengthening exercises at home.

INJURY: The ankle joint can respond in two ways to a strain. The ankle ligaments could be stretched, causing the ankle to be unstable and to feel looser than the healthy side. When someone has a loose ankle they should perform exercises to strengthen the ankle. The main muscles of stabilization of the ankle joint are the peroneus brevis, peroneus longus, and the deep ankle flexor such as the tibialis posterior. Trigger points in the muscles will also make the muscles weak and unable to support the joint. The other response is a buildup of scar tissue that causes limited range of motion in the ankle. Ankles that have a restricted range of motion should be loosened by massage, cross-fiber frictioning and stretching.

ASSESSMENT: In order to test the ankle the client should be supine. Take both feet in your hands and turn them towards each other (inversion). This can tell you if the ligaments on the outside have been torn or stretched. Notice which foot is restricted. Use slow stretches to release the restriction.

MASSAGE: Only work on an ankle injury after the initial inflammatory stage (1-3 days) is over. It is contraindicated to do deep massage over an area that is inflamed or puffy. When there is excessive edema (swelling) the appropriate form of treatment is manual lymphatic drainage.