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Excerpt
HISTORY: A 16 year old high school punter injured his right dominant ankle during a hurdling race when he landed awkwardly after striking a hurdle. Although ambulation was unaffected, he experienced unpredictable pain in the posterior aspect of his right ankle when performing activities of daily living, or with wrestling activity. Due to this persistent pain, he eventually sought care from his primary care doctor. Although no treatment had been attempted, he found that he could not punt a football without substantial pain.
PHYSICAL EXAMINATION: The patient was found to be 6'1» tall, 185 pounds. His right ankle demonstrated no edema or erythema, but had some mild tenderness in the retrocalcaneal area posteriorly. Range of motion was found to be full, equal to his unaffected left side, but painful in full plantarflexion. Stress testing of the ankle revealed no ligamentous laxity. He was found to have pain with great toe plantarflexion. No strength limitation was detected.
