CHAPTER 77 • BASKETBALL 469(Sitler et al, 1994). Players do not like wearing ankle
braces but if given a week long break-in period there
is no detriment to athletic performance and players
feel comfortable (Pienkowski et al, 1995).- High top shoes are thought to provide added support
and have been shown in some studies to reduce ankle
injury rates (Garrick, 1973). - Ottawa ankle rules have a sensitivity of 98% for
ankle fractures and should be used. Specificity of
the rules varies greatly from 10 to 70% (Bachmann
et al, 2003). The rules state that an ankle X-ray is
needed if:- There is any pain in the malleolar zone (defined
from the tibia and fibula 6 cm above the articula-
tion with the talus, to the bones of the midfoot) and
any of these findings:
a. Bone tenderness at the posterior edge or tip of
the lateral malleolus
b.Bone tenderness at the posterior edge or tip of
the medial malleolus
c. Inability to bear weight both immediately and in
the emergency room - A foot X-ray series is required only if there is any
pain in midfoot and any of these findings:
a. Bone tenderness at the base of the 5th metatarsal
b.Bone tenderness at the navicular
c. Inability to bear weight both immediately and in
the emergency room.
- There is any pain in the malleolar zone (defined
- Ankle sprains should be treated with relative rest,
NSAIDS, weight bearing as tolerated, ice, bracing,
and physical therapy with a focus on regaining pro-
prioception that helps prevent repetitive injury.
•Navicular stress fractures are the most common
stress fractures seen in jumping athletes and present
with foot pain that is activity related and may persist
to a lesser degree out of activity. Bone scan or MRI
is needed for diagnosis as plain films are inadequate.
Treatment involves immobilization and nonweight-
bearing until the navicular is nontender (Khan,
1994).
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