On physical examination, the lower extremity is inspected
and palpated while noting any existing hindfoot varus. The
hindfoot motion should be recorded and peroneal muscle
strength should be tested. Signs of generalized ligamentous
laxity should be elicited. Stability testing consisting of the
anterior drawer and talar tilt test should be performed. Proprioception
is often abnormal in these patients as grade III
ankle sprains have been noted to have up to 86% and 83% of
peroneal nerve and tibial nerve stretch injury, respectively.37
The modified Romberg test is used to examine proprioception
as the patient stands on the normal ankle with their eyes
open and then closed and is repeated for the injured ankle.