{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Ep 385: Lateral Ankle Sprains Masterclass","description":"In episode 385 of The Physical Performance Show, host Brad Beer sits down with fellow physiotherapist Lewis Craig for a lateral ankle sprain masterclass. Drawing on material the pair recently presented at a Gold Coast orthopedic evening, Brad and Lewis cover the burden and prevalence of lateral ankle sprains, the three-part clinical assessment process, key differential diagnoses, rehabilitation phases, and preventative strategies including bracing and taping. The episode explores why lateral ankle sprains \u2014 despite their reputation as a minor injury \u2014 carry a significant risk of chronic ankle instability, and why a thorough, structured assessment is essential to a smooth recovery. Brad and Lewis unpack the different ligament and tendon structures that can be involved, the red flags practitioners need to rule out, the impairment categories drawn from Jay Hertel's model of chronic ankle instability, and how rehabilitation should progress from protection through to return to sport and long-term prevention. Show Sponsor: Pogo Physio also offers online Telehealth Consultations for endurance athletes managing bone, tendon, or joint issues \u2014 book online at https:\/\/www.pogophysio.com.au. And... PILLAR Performance is leading a new frontier in the sports nutrition industry through micronutrition innovation. Their Performance Health range is designed to support the crucial hours outside of training and racing, helping athletes return to the start line in peak condition. One of their newest releases is Collagen Repair, developed in collaboration with Gelita Laboratories and featuring the clinically trialled collagen peptide TENDOFORT. For 15% off your first purchase, head to pillarperformance.shop or, for North American listeners, thefeed.com and use the code PHYSICALPERFORMANCE at checkout. Pillar Performance continues to lead the way in sports nutrition through micro-nutrition innovation, now expanding into the Performance Health range. One of their newest releases, Collagen Repair, was developed with Gelita Laboratories (Germany) using a clinically trialled collagen peptide (Tendofort) to support tendon and ligament health in conditions like hamstring tendinopathy, Achilles tendonitis, shin splints, and patellofemoral pain. Head to Pogo Physio also offers online Telehealth Consultations for endurance athletes managing bone, tendon, or joint issues \u2014 book online at https:\/\/www.pillarperformance.shop (or https:\/\/www.thefeed.com for North American listeners) and use code PHYSICALPERFORMANCE for 15% off your first purchase.   Partners \/ links mentioned: Ortho Tools (Cumberland Ankle Instability Tool \/ CAIT): mentioned in-episode as the online questionnaire resource Contact: Lewis Craig \u2014 l.craig@pogophysio.com.au In this episode, you'll hear: Episode context: Lewis Craig's return to the show after being last on around episode 109, and his progress toward finishing his Sports Masters through the University of Queensland The burden of lateral ankle sprains: why they're the most common musculoskeletal injury in sport across field and court sports, contact and non-contact alike Recurrence risk: why roughly 40% of people who sprain their ankle go on to develop chronic instability, and why the one-year mark is a key risk-reduction milestone Early predictors of chronic ankle instability: the Doherty 2016 study on single-leg landing and drop-jump testing at two weeks post-injury The three priorities of assessment: ruling out red flags and fractures, forming an accurate diagnosis, and identifying impairments Screening for fractures: mechanism of injury, the Ottawa ankle rules, weight-bearing ability, and key bony landmarks to palpate Differential diagnosis: ATFL and CFL sprains (70\u201380% of ankle sprains), peroneal tendon injuries, bifurcate ligament sprains, deltoid ligament tears, syndesmosis injuries, and talar dome injuries Why getting a clear mechanism of injury from the athlete is critical to an accurate diagnosis Identifying impairments: the ROAST consensus and Jay Hertel's updated model of chronic ankle instability \u2014 pathomechanical, sensory-perceptual and motor-behavioural impairments Clinical and objective testing: balance progressions, calf raise endurance and strength benchmarks, and power tests including triple hop, crossover hop and timed lateral hop The role of patient-reported outcome tools: the Cumberland Ankle Instability Tool (CAIT) and FAAM, and why they're useful for tracking progress and motivation Rehabilitation framework: protection and appropriate early loading, followed by strength, stability and mobility phases Managing specific injury types: use of moon boots, orthotics, low-dye taping and ASO ankle braces depending on the structures involved Addressing dorsiflexion loss: why regaining ankle range of motion is often one of the hardest parts of rehab, and the Torillin infographic on identifying the source of restriction Late-stage rehab and return-to-sport: hopping, change of direction, and integrating exercises into an athlete's normal training week for ongoing prevention Bracing and taping as secondary\/tertiary prevention strategies to reduce recurrence Long-term consequences of poorly managed ankle sprains, including links to post-traumatic osteoarthritis and eventual ankle surgery The biggest mistake athletes make: assuming rehab is "done" once they can run, despite still having deficits in power, change of direction and stability Lewis's top tip: get every ankle sprain properly assessed, no matter how minor Quotes \/ takeaways: "It's just a simple lateral ankle sprain... and then someone who goes missing for months at a time." "Four out of ten people who have an ankle sprain go on to develop a chronic instability." "The better quality of the assessment, the more likely there's an accurate diagnosis." "It's really hard to sprain your ankle when it's really well strapped or with an appropriate brace." "Once someone gets running... you can run in a straight line really well and have really considerable deficits still." "Get it assessed. Understand what you've done and understand what impairments you might have." Time Stamps: 00:17 \u2013 Episode introduction and breakthrough experience 00:23 \u2013 Episode 385 introduction: lateral ankle sprain masterclass with Lewis Craig 00:50 \u2013 Sponsor: PILLAR Performance and Performance Health 01:15 \u2013 Collagen Repair: formulation, TENDOFORT and collagen health 01:44 \u2013 15% PILLAR Performance discount with code PHYSICALPERFORMANCE 02:19 \u2013 Welcoming Lewis Craig back to the show 02:48 \u2013 Lewis's tenure at Pogo Physio and progress on his Sports Masters at UQ 03:45 \u2013 Introducing today's topic: lateral ankle sprains 04:37 \u2013 How common and burdensome are lateral ankle sprains? 05:36 \u2013 The "she'll be right" attitude and why it's changing 07:02 \u2013 Lewis's personal history with recurrent ankle sprains 08:02 \u2013 Impact on Lewis's own running and trail running 08:28 \u2013 The one-year mark and recurrence risk statistics 09:26 \u2013 Predictors of chronic ankle instability: single-leg landing and drop jump 09:53 \u2013 The Doherty 2016 study explained 10:51 \u2013 The three priorities of assessment 11:21 \u2013 Ruling out red flags and fractures 12:45 \u2013 Why assessment quality drives rehab outcomes 13:14 \u2013 Screening for fractures: mechanism, Ottawa ankle rules, bony landmarks 14:39 \u2013 Deciding on imaging: x-ray or MRI 15:06 \u2013 Differential diagnosis: the many subcategories of ankle sprain 15:35 \u2013 ATFL and CFL: the most common ligament sprains 16:35 \u2013 Peroneal tendon injuries 17:04 \u2013 Bifurcate ligament sprains 18:04 \u2013 Deltoid ligament tears with lateral ankle sprains 18:33 \u2013 Syndesmosis injuries and mechanism differences 19:31 \u2013 Clinical tests for syndesmosis 20:01 \u2013 Talar dome injuries and other easily missed diagnoses 20:30 \u2013 Why getting a clear mechanism from the athlete matters 21:29 \u2013 Identifying impairments: what it means and why it's important 22:51 \u2013 Jay Hertel's model of chronic ankle instability 23:48 \u2013 Balancing patient education without causing fear 24:17 \u2013 Motor outcomes: strength, power and kinetic chain 24:43 \u2013 Assessment time and thoroughness at Pogo Physio 25:08 \u2013 Objective testing: dynamometers, balance and calf tests 25:38 \u2013 Balance test progressions as return-to-sport criteria 26:37 \u2013 Strength testing: inversion, eversion and calf raise endurance 27:07 \u2013 Power testing: triple hop, crossover hop and lateral hop tests 27:33 \u2013 Using objective markers to guide return-to-sport decisions 28:01 \u2013 Patient questionnaires: Cumberland Ankle Instability Tool (CAIT) and FAAM 28:57 \u2013 Coping vs non-coping athletes and objective scoring 29:25 \u2013 Moving into rehabilitation: individualised management 29:54 \u2013 Protection and appropriate early loading 30:20 \u2013 Moon boots and protecting specific structures 31:16 \u2013 ASO ankle braces for lower-grade sprains 31:45 \u2013 The strength, stability, mobility rehab framework 32:14 \u2013 Early loading phase: range of motion, balance and strength 32:43 \u2013 Addressing dorsiflexion loss 33:13 \u2013 The Torillin infographic on restriction sources 33:40 \u2013 Progressing balance and strength exercises 34:10 \u2013 Preventative efforts and integrating rehab into training 34:40 \u2013 Late-stage rehab and return-to-play criteria 35:39 \u2013 Bracing and taping to prevent recurrence 36:08 \u2013 Long-term consequences: osteoarthritis and ankle surgery risk 37:34 \u2013 Lewis's own experience with taping and bracing 38:02 \u2013 The biggest mistake athletes make in managing ankle sprains 39:29 \u2013 Lewis's top tip: get every ankle sprain assessed 40:27 \u2013 Where to reach Lewis Craig for questions 40:52 \u2013 Episode close and sponsor reminder 41:20 \u2013 Pogo Physio Telehealth Consultations and closing details THE TEAM: Join the The Physical Performance Show LEARNINGS membership through weekly podcasts here: https:\/\/www.patreon.com\/TPPShow Our goal is to get you back to your Physical Best. Find out more about Telehealth Consultations and book online. Your Hosts: \ud83c\udfc3 Brad Beer - Instagram & X @Bradbeer and YouTube on @PogophysioAu \ud83d\udcaa Lewis Craig - Physiotherapist and Clinical Lead, Pogo Physio Instagram: @_lewiscraig_ The Physical Performance Show can be found at: Facebook: facebook.com\/thephysicalperformanceshowpodcast X: @tppshow1 Instagram: @physicalperformanceshow Please direct any questions, comments, and feedback to the above social media handles. ","author_name":"The Physical Performance Show","author_url":"https:\/\/physicalperformanceshow.com\/","html":"