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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · May 12

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · May 12

I love an article that includes a great infographic.

But there's also more to unpack than just differential diagnosis' to consider.

#achillestendon #achillestendinopathy #tendinopathy #anklepain #sportspodiatry #sportsphysio #physio #podiatry

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Apr 29

We can't think in absolutes.

The more we study the body, the more we'll find things that subvert our theories and expectations.

#anklesprain #lateralanklesprain #lateralankleinversioninjury #sprain #sportspodaitry #sportsphysio #podiatry #physio #ankleinjury #ATFL #CFL

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Apr 28

- Tendinopathy requires long term management.
- It can take > 6/12 for symptom/functional change in some subgroups and >6/12 for all groups to reach criteria for psychological recovery

Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Apr 28

A breakdown of different sub-group characteristics in mid-portion achilles tendinopathy.

There's some key takeaways.
- There are clear sub-groups
- Each group has a typical set of characteristics and different prognosis that impacts how you’ll communicate and plan their recovery.

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Apr 17

The trick is to regularly re-examine your ankle sprain patients.

During the acute phase, it’s easy to miss conditions due to the swelling and general increase in. So sometimes these only become apparent once sub-acute, or maybe when you start progressing rehab.

#anklesprain #ankleinversioninjury

Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Apr 17

‘It’s never just a sprain’ - @liz_bayley_physio were you the original person to say this?

This is an important fact as an estimated 93% of ankle sprains have a comorbid condition alongside ATFL injury!

This could be something that significantly changes your treatment (e.g. fracture),

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Apr 7

The rollercoaster of shockwave and evidence based practice.

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Mar 26

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Mar 26

Foot orthoses.

Great for some conditions, but not all.

#bigtoearthritis #osteoarthritis #footorthoses #1stmtpjpain #bogtoepain #sportspodiatry #podiatry #footpain #forefootpain

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Mar 19

They were struggling to get active again after being sedentary for 2-3 years. Every time they tried walking longer distances or running, they experienced medial arch pain related to midfoot osteoarthritis (related to the previous trauma) and posterior tibial tendon strain.

Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Mar 19

A great example of a patient with historical deltoid ligament injury with an associated loss of medial longitudinal arch height.

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 24

You can read the full blog to find out the general criteria I use for general population clients looking to return to physical activity

Find my blog on my website or substack.

#anklesprain #ankleinjury #anklerehab #podiatry #sportspodiatry #sportspodiatry #sportsphysio #lateralanklesprain

Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 24

♦️ However, it has been shown to be predicted of:
- Whether someone will return to play at 4 months post-injury, and;
- Whether they’ll develop chronic ankle instability at 12 months
 ♦️ I personally use a combination of the Ankle GO score and PAASS framework in my clinical practice.

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 24

♦️ The Ankle Go Score is a new outcome measure designed to help return to play decision making. Currently the score hasn’t been validated for return to play, or an adequate score found for someone to return to play.

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 24

♦️ We have an international consensus on the key attributes someone should have prior to returning to play. However this framework doesn’t provide guidance on specific tests to be performed or to what standard as it’s accepted this will be very different for each person and their sport

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 24

New blog discussing RTP after a lateral ankle sprain.

https://buff.ly/4kfr1wD

🔑 Key take-aways:

♦️Returning someone to play is a criteria based decision, not simply recovery time.

Return to sport decision making following an ankle sprain

Exploring recent research

buff.ly

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 10

2. Imaging Results
Whether the injury is simple or complex sprain on imaging didn’t impact outcomes at 6 months. To me this says there’s so many other potential contributors to a positive or negative outcome that we can’t expect one thing alone to be predictive.

Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 10

What isn't useful at predicting outcomes?

1.Anterior Drawer Testing
Retesting at 6 weeks post injury is not an effective guide to recovery. The goal of therapy is to address strength and balance deficits, not quick decreases in laxity.

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 10

3 weeks post injury:
Effective coping strategies, not the severity of the injury is associated with fewer symptoms.

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 10

2 weeks post injury:
There’s an increased risk of developing chronic ankle instability at 6 months in those who can’t:
- Complete any jumping or landing tasks
- Have poor dynamic postural control (can be measured with mSEBT).
- Lower self reported function

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Alex Murray - The Rehab Podiatrist @therehabpodiatrist.bsky.social · Feb 10

Time based markers:

1 week post injury:
There’s worse outcomes if the patient has significant pain when walking or can’t weightbear due to pain.

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