Ankle injuries 101

Danni is a family physician who also works part-time as the team doc for the Clarington Quakes hockey team. When she’s in her office, she’s often dealing with sports-related injuries. Today she’s sharing some tips for dealing with acute ankle injuries.

The Ottawa ankle rules were developed by a group of physicians in Ottawa, Ontario to help rule out a fracture when a patient presents with the an acute ankle injury. The rules have been tested and validated to help decide whether an injury requires an x-ray. Of course, there are always times when clinical judgement has to supersede the rules, but they’re a really handy guidelines.

The Ottawa ankle rules are as follows:

An ankle x-ray is only indicated for patients who have pain in the malleolar zone AND are tender at the tip of the lateral or medial malleolus (the bony prominences at the sides of the ankle) OR are unable to bear weight (walk) immediately after the injury and for 4 steps at the doctor’s office.

A foot x-ray is only indicated for patients who have pain in the midfoot zone AND are tender at the base of the 5^th toe or at the navicular OR are unable to bear weight (walk) immediately after the injury and for 4 steps at the doctor’s office.

So if a player has an ankle injury and can’t weight-bear or is tender at the bony prominences of the ankle or the base of the 5^th toe, they likely need an x-ray!

Thanks for the tips, Danni!