Lesson 1Acute management (first 72 hours): PRICE vs POLICE, analgesia options, when to use immobilization or controlled ROMCovers evidence-based care in first 72 hours post-injury, comparing PRICE and POLICE protocols, suitable pain relief, when to immobilise or start gentle movement, and weight-bearing guidelines for soccer players.
PRICE versus POLICE principlesCryotherapy, compression, and elevation useAnalgesia and anti-inflammatory optionsIndications for immobilization devicesEarly controlled ROM and weight bearingLesson 2On-field immediate management protocols: safe removal, immobilization options, and documentationStep-by-step on-pitch handling of suspected ankle twists, covering safety checks, assessment, safe player removal, splinting choices, weight-bearing calls, initial notes, and updates to coaches.
Primary survey and scene safetyRapid ankle assessment on the fieldCriteria for assisted or stretcher removalOn-field immobilization and supportInitial documentation and handover notesLesson 3Prevention strategies for teams: balance/proprioception programs, external supports/taping protocols, footwear and load managementTeam prevention for ankle sprains using balance drills, position sense training, taping/bracing methods, boot choices, and workload control suited to Botswana soccer training and matches.
Designing balance and proprioception circuitsProgressive single-leg stability trainingTaping techniques for lateral ankle supportBrace selection and fitting for soccerFootwear, surfaces, and load monitoringLesson 4Indications for specialist referral or surgical consideration: chronic instability, large avulsion fractures, syndesmotic involvementWhen to send for expert review or surgery, like ongoing wobbliness, big bone chips, ligament bundle issues, cartilage damage, or failed non-surgical care in competitive soccer.
Indicators of chronic ankle instabilityLarge avulsion fractures and loose bodiesSuspected syndesmotic or high ankle injuryOsteochondral lesions and cartilage damageFailure of rehab and return-to-play issuesLesson 5Clinical presentation and grading of lateral ankle sprains (I–III): signs, symptoms, and functional limitationsSigns and grading of side ankle sprains grades I to III, including injury how, pain spots, swelling, bruising, looseness, and daily limits to aid diagnosis and planning for soccer players.
Typical history and injury mechanismsGrade I clinical signs and functionGrade II clinical signs and functionGrade III clinical signs and functionFunctional impact on soccer performanceLesson 6Red flags indicating fracture or high-risk injury: Ottawa Ankle Rules, persistent instability, neurovascular compromiseWarning signs for breaks or serious harm, using Ottawa checks, big swelling, no weight-bearing, ongoing shake, bad pain, or nerve/blood issues needing quick specialist referral.
Key elements of Ottawa Ankle RulesSigns of fracture and gross deformityInability to bear weight or severe painNeurovascular assessment and compromiseUrgent referral and emergency pathwaysLesson 7Communication with coaching staff and player: delivering prognosis, RTP timelines, documentation templatesClear talks with players and coaches on diagnosis, outlook, return timelines, repeat risk, joint decisions, and standard record forms for smooth care in Botswana teams.
Explaining diagnosis in clear languageDiscussing prognosis and RTP timelinesManaging expectations with coachesShared decision making and consentInjury reports and RTP documentationLesson 8Anatomy of the lateral ankle: ligaments, bones, tendons, and neurovascular structuresKey side ankle parts: bones, bands, sinews, nerves, vessels, focusing ATFL, CFL, PTFL, outer leg tendons, their stability role, common damages, exam and rehab links.
Bony anatomy of ankle and hindfootATFL, CFL, and PTFL structure and rolesPeroneal tendons and dynamic stabilizersRetinacula and joint capsule supportNeurovascular structures at riskLesson 9Rehabilitation phases for ankle sprain: range-of-motion, proprioception, progressive strength, plyometricsStep-by-step rehab from protection to top play, blending motion recovery, balance training, strength build-up, jumps, and soccer drills while watching pain, puffiness, function.
Acute phase goals and protection strategiesRestoring dorsiflexion and plantarflexion ROMProgressive strengthening and endurance workProprioception and dynamic balance retrainingPlyometrics and soccer-specific reconditioningLesson 10Functional testing and objective criteria for return to training and competition: hop tests, Y-Balance, strength ratiosClear return tests post-sprain: jumps, Y-balance, power levels, side-to-side matches, soccer tasks for safe step-up to training and matches.
Single and triple hop test protocolsY-Balance test setup and scoringIsokinetic and handheld dynamometry useLimb symmetry index thresholds for RTPSoccer-specific functional field testsLesson 11Initial imaging and diagnostic choices: indications for X-ray, weight-bearing radiographs, and when to order MRI or ultrasoundImaging guide post-twist: Ottawa for X-rays, standing shots, MRI/ultrasound for bands, sinews, cartilage, hidden breaks.
Applying Ottawa Ankle Rules for X-rayWhen to request weight-bearing radiographsMRI indications for ligament and cartilageUltrasound for ligaments and tendonsTiming and sequencing of imaging testsLesson 12Physical exam maneuvers for ankle: anterior drawer, talar tilt, palpation for ATFL/CFL/Osseous tendernessMain ankle checks: front pull, tilt test, feel for ATFL/CFL/bone sore spots, puffiness, motion range, record for follow-up.
Inspection, swelling, and deformity checkPalpation of ATFL, CFL, and malleoliAnterior drawer test technique and gradingTalar tilt test performance and meaningAssessing ROM and strength at the ankleLesson 13Mechanisms of inversion sprain specific to soccer: landing, contact, and inversion forcesSoccer twist causes: header lands, cuts, tackles, bumps, pitch effects, linking forces to typical tissue harms.
Non-contact cutting and pivoting injuriesLanding from jumps and aerial duelsContact injuries from tackles and collisionsRole of playing surface and weatherFootwear, studs, and traction mechanics
