Ankle injury rehabilitation protocol the following exercises may be used to rehab ankle ligament injuries and fractures. Immediate treatment of a sprained anklethe immediate treatment for a sprained ankle. The ankle joint is designed to adapt to uneven terrain, but a sudden or forceful twisting motion can result in damage to the ankle ligaments and in severe sprains, the ligaments can be torn. An ankle sprain involves stretching andor tearing of one or more ligaments in the ankle. This treatment is typically followed by exercises that can be performed at home. A more effective way to rehab your ankle sprain breaking. Recovering from an ankle sprain generally requires 46 weeks of treatmentrehabilitation. Chattanooga, tn 423 6242696 the injury ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Rehabilitation after ankle sprain center for sports medicine. Foot and ankle rehabilitation exercises orthoinfo aaos. Rehabilitation after ankle sprain center for sports.
Ibuprofenadvil 4 times a day for 3 days only if no allergies phase ii restore range of motion 24 days for grade i. These principles, together with expert input from a healthcare professional can help you recover safely and quickly. Begin and end each exercise session with application of ice. The cast is typically worn for two or three weeks and followed by rehabilitation. Ankle sprain the first 48 hours rest from weight bearing but start trying to move your ankle straight away. The principles of rehabilitation apply to all ankle sprain injuries, regardless of the sport. Ankle sprain rehabilitation guideline sanford health. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Usually, people are told to rest, elevate the foot, apply ice, and use an elastic wrap to reduce swelling. Besides management of the common inversion sprain, conditions such as severe sprains see pp 28, deltoid sprains see pp 29, high ankle sprains see pp 30, and chronic ankle pain or instability. However, the accuracy, sensitivity and specificity of this imaging technique to diagnose ligament injury in acute ankle injuries is inconsistent, particularly when comparing studies of acute injury vs chronic ankle instability.
Rehabilitation is used to help to decrease pain and swelling and to prevent chronic ankle problems. In addition to the primary care, your doctor may recommend a short leg cast or a castbrace system for a grade three sprain. A number of musclestrengthening exercises employ a length of surgical. These three bones are connected by several ligaments that help stabilize the joint. Rehabilitation protocol the antigravity treadmill has been cleared by the fda for rehabilitation following injury or surgery of the lower extremity. Medial ankle sprain is an injury caused by an eversion trauma. Simply put, proprioception is the ability to know where your extremity is in. E elevation wrap an elastic bandage from the toes to mid calf, using even pressure. Use crutches to take weight off your ankle if you are having trouble walking. Management programs are generally divided into acute care and functional rehabilitation phases.
The general goals of acute interventions are to reduce pain and swelling. High ankle sprain rehabilitation guideline sanford health. Management of ankle sprains american family physician. Ice apply to the injured area for 15minutes every 2 hours.
Incomplete rehabilitation is the most common cause of chronic ankle instability after a sprain. If a patient stops doing the strengthening exercises, the injured ligaments will weaken and put the patient at risk for continued ankle sprains. Loosen the wrap if your toes start to turn blue or feel cold. Proprioception, your ability to tell the precise position of a joint, is also impaired when your ankle is sprained. Rehabilitation after ankle sprain ankle sprain the injury. But the major component of any ankle injury rehabilitation protocol should include a focused, strategic plan to fortify the proprioception of the ankle.
Decrease pain and swelling, protect from further injury pain and swelling management rice protection of injured ligaments taping, splints, casting, walking boot etc. Rehabilitation of a sprained ankle needs to begin right away. An ankle sprain is a stretch or a tear of the ligaments bands of tissue that hold bones together supporting the ankle joint. Rehabilitation procedures for a sprained ankle hsc pdhpe. Physical therapy management of medial ankle complex sprain. While few randomized control trials exist on the rehabilitative process of a syndesmotic injury, some protocols have been developed via case studies and expert opinion. Ligaments are strong bands of tissue that connect bones at the joint.
The athletes, who followed the prescribed rehabilitation protocol in full detail comprised group a na101, whereas group b nb31 consisted of the noncompliant athletes. In patients with grades i or ii sprains, emphasis should be placed on accurate diagnosis, early use of rice. To outline rehabilitation concepts that are applicable to acute and chronic injury of the ankle, to provide evidence for current techniques used in the rehabilitation of the ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consideration empirical data from the literature and clinical practice. Ankle sprain treatment protocol early treatment week one postinjury early treatment is directed at minimizing the swelling which will help decrease pain and speed up healing. All cases were classified in four 4 grades i, ii, iiia and iiib, according to our classification criteria. Ease off the exercise if you have more than mild pain. Applying an ace bandage can help decrease the swelling and help the healing process. Ankle sprains are very common ankle injuries, usually the. Physical therapy management of a high ankle sprain. The most common ankle sprain is an inversion ankle spraincontinue reading. An ankle sprain is an injury that causes a stretch or tear of one or more ligaments in the ankle joint.
Phase i control inflammation 12 days for grade i sprain, 23 days for grade ii goals. Rehabilitation is helpful to decrease pain and swelling and to. If treated quickly and properly, most ankle sprains heal completely, allowing a safe and early return to activity. The doctor may need to move your ankle in various ways to see which ligament has. Ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Acromioclavicular sprain rehabilitation program angelfire. For grade 3 lateral ankle sprains also mobilization should be started as soon as the pain permits 10. After an injury or surgery, an exercise conditioning program will help you return to daily. Rehabilitation after ankle sprain brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. Foot and ankle conditioning program orthoinfo aaos. Use a damp cloth layer, such as a towel, between the ice and your skin.
They have a high rate of recurrence, often due to inadequate rehabilitation and an early return to sport. You should be able to easily put two fingers under the wrap. Foot and ankle rehabilitation exercises to ensure that this program is safe and effective for you, it should be performed under your doctors supervision. In evaluating your injury, the podiatrist will take your history to learn more about the injury. Ankle sprains often occur when running, walking on uneven ground, or jumping. Rehabilitation protocol grade iii lateral ankle sprain. Sprains may be graded i, ii, or iii depending on their severity. Ankle sprains are among the most common of all sportsrelated injuries. Simple exercises can be done using elastic to create resistance fig. Start each exercise slowly and use your pain level to guide you in doing these exercises. High ankle sprain syndesmosis sprain anatomy and biomechanics.
This ankle rehabilitation programme is an example of the progression followed by a professional footballer with a sprained ankle. Eversion trauma an occur from running downstairs, landing on uneven surfaces, or other activities involving rotation. Recovering from an ankle sprain generally requires 46 weeks of treatment rehabilitation. For fractures in which weight bearing is prohibited until the bone heals, perform steps 15 while out of the aircast walker between 26 weeks after surgery. Increase pain free range initial stage rehabilitation 2 5 days it is found that after ankle sprain, there is restriction of. First degree sprains involve a partial tear to the medial ligaments. Use of a standardized protocol enhances the management of ankle sprains. You can begin healing by walking or bearing some weight, while using crutches if needed, if you can do so without too much pain. It is designed for rehabilitation following high ankle sprain. Interferential stim can be used with ice at the same time 3 nsaids a. The protocol may be advanced according to the severity of the injury. If rehabilitation is delayed, the injury may be less likely to heal properly. Most ankle sprains result from the ankle turning inwards during an activity. Either immerse it in an ice bucket, or wrap it in a bag of ice for 20 minutes on, 20 minutes off.
The rehabilitation procedures for a sprained ankle include immediate treatment, stretching to increase rom, conditioning, total body fitness, training, and the use of heat and cold. It is not intended to serve s a substitute for clinical decisionmaking. When these ligaments are overstretched, it is referred to as an ankle sprain. How to do rehabilitation exercises for an ankle sprain. Some of the authors may have been financially compensated for the case study. It is very important to follow the guidelines recommended by your health care provider, which may include the following steps below in the acute phase of your injury. The following exercises will strengthen the ankle muscles and redevelop the reflexes of. The emphasis is on stopping any bleeding in the joint and. Phase 1 is the initial acute phase and begins as soon as possible after injury and continues at least until you can walk pain free. Decreaseeliminate pain, increase rom, decrease swelling, increase strength continue pain and swelling management. An ankle sprain may be accompanied by a foot injury that causes discomfort but has gone unnoticed thus far. Do not perform exercises that increase pain andor swelling. Progression through each phase of rehabilitation is based on clinical criteria and time frames as appropriate.
Patients with ankle sprains stretching, partial rupture, or complete rupture of at least one ligament constitute a large percentage of these injuries. The use of orthotics shows promise in the treatment of ankle instability, particularly in response to improving balance after injury 39 or fatigue, 40 when rearfoot motion is altered, 41 and in normal subjects. Jan 01, 2001 without adequate care, acute ankle trauma can result in chronic joint instability. Ankle sprain rehabilitation protocol the intent of this protocol is to provide guidelines for progression of rehabilitation. Breitenseher et al found that mri could detect lateral collateral ligament disruption. Rehabilitation rehab exercises are critical to ensure that the ankle heals completely and reinjury does not occur. Phils ankle sprain rehabilitation program is based around 4 phases with an additional 5th phase designed to prevent your anke sprain recurring. Ankle stability and movement coordination impairments. Although the pain and swelling usually improve quickly, more than 70% of people. Elevate the ankle above heart level until swelling subsides. General ankle rehabilitation protocol phase 1 dr michael bahk. This can be caused by a fall, a sudden twist, or landing on the side of the foot.
Depending on the severity of your injury, you may receive a shortleg cast, a walking boot, or a brace to keep. Ankle sprain rehabilitation guidelines ankle sprains particularly those affecting the lateral ligaments are one of the most common forms of soft tissue injury experienced in sports involving sprinting and rapid changes of direction. Ankle injuries are among the most common injuries presenting to primary care offices and emergency departments. Rehabilitation of the ankle after acute sprain or chronic. Treating lateral ankle sprain in basketball playersa. Control inflammation and pain reduce swelling rehab. Gently stretching after strengthening exercises can help reduce muscle. Following are some examples of typical rehabilitation rehab exercises. C compression place an ice bag on the ankle for 15 to 20. Multiple phases exist for the rehabilitation of a high ankle sprain, with the most accepted number of phases being three. You can use surgical tubing, theraband, or a bike inner tube for the resistance. Start rehab with rangeofmotion exercises in the first 72 hours after your injury. A sprained ankle can come in any of the three classifications for a sprain levels 1,2 and 3. Yo ur foot and ankle surgeon may recommend one or more of the following treatment options.
Clinicians should recognize the increased risk of acute lateral ankle sprain in individuals who 1 have a history of a previous ankle sprain, 2 do not use an external support, 3 do not properly warm up with static stretching and dynamic movement before activity, 4 do not have normal ankle dorsiflexion range of motion, and 5. Treatment of these more proximal structures are outside the scope of this protocol, although a number of the ankle rehabilitation exercises will. For grade 1 and 2 the rehabilitation protocol is generally faster than grade 3. It is important to rewrap the ace bandage on a regular basis starting at the toes and finishing well above the ankle.
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