Rehabilitation procedures for a sprained ankle hsc pdhpe. The incidence of ankle sprain is highest in sports populations. An ankle sprain occurs when a ligament connecting the ankle bones is stretched or torn. Ankle circles help you regain range of motion in your ankle. Phase i maximum protection weeks 0 to 4 as directed by the physician ice and modalities to reduce pain and inflammation compression wrap to reduce swelling crutches, splint, boot or cast as instructed elevate the ankle above the heart active range of motion pfdf gentle inversioneversion as instructed. On the lateral portion of the ankle there are three ligaments which. The rate of progress from one stage to the next depends upon the amount of pain and swelling present and whether an elastic bandage, tap, and brace or cast was used to stabilize the ankle. Subtalar arthrodesis postoperative protocol rosenberg. High ankle sprain syndesmosis sprain anatomy and biomechanics. Ankle sprain rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Applying an ace bandage can help decrease the swelling and help the healing process. Rehabilitation protocol grade iii lateral ankle sprain.
The goal of our research is to present the protocol for rehabilitation in acute and subacute conditions with the effects of treatment in ankle sprain. A complete rehabilitation program for lateral ankle sprains can mean the difference between a fully healed ankle and a more serious sprain down the road. An ankle sprain involves stretching andor tearing of one or more ligaments in the ankle. Rehabilitation protocol the antigravity treadmill has been cleared by the fda for rehabilitation following injury or surgery of the lower extremity. After an injury or surgery, an exercise conditioning program will help you return to daily. In the ankle joint, ligaments provide stability by limiting sidetoside movement. If improperly treated, they can develop into a chronic problem. A lateral ankle sprain las is a frequently incurred musculoskeletal injury, with a high prevalence among the general population and individuals who participate in sports.
Phase i maximum protection weeks 0 to 4 as directed by the physician ice and modalities to reduce pain and inflammation compression wrap to reduce swelling crutches, splint. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Total rupture of a ligament there is a loss of motiongross instability of the joint joint function is lostsevere pain initially followed by no pain severe swelling usually extensive bruising return to activityfunctional phase in 36 weeks with proper ankle sprain treatment. Simply circle your toot slowly, five times in each direction, making each circle as large as you can. Physical therapy for sprained ankle 12 exercises for. Manual therapy treatment for an acute inversion ankle sprain is primarily palliative in nature and aimed at decreasing swelling and inflammation and relieving associated muscle spasm that might be occurring. Ankle sprain rehabilitation the following protocol is designed to strengthen and increase the flexibility of the muscles surrounding the ankle, which should decrease the chances of incurring another ankle sprain. Modifications to this guideline may be necessary dependent on physician. 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. The surgical and conservative management options can be very much developed by indepth knowledge of the. The following postoperative rehabilitation protocol is adapted from the one used at the hospital for special surgery hss, where the modified. Ankle sprains are very common injuries, usually the result of the foot turning in. You should be able to easily put two fingers under the wrap.
This rehabilitation program is designed to return the individual to their activities as quickly and safely. Protocol for treatment of ankle sprain article pdf available. The rate of progress from one stage to the next depends upon the amount of pain and swelling present and whether an elastic bandage. Here are some things to consider when rehabilitating your ankle. In general, ankle ligament injuries are classified into three grades representing increasing injury severity. Modifications to this guideline may be necessary dependent on physician specific instruction, specific tissue healing timeline. Breitenseher et al found that mri could detect lateral collateral ligament disruption. 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 see pp. The lateral ligaments of an ankle are most likely to be damaged in sprained ankles. An ankle sprain is where one or more of the ligaments of the ankle are partially or completely torn. 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.
It is designed for rehabilitation following high ankle sprain. It is important to rewrap the ace bandage on a regular basis starting at the toes and finishing well above the ankle. These three bones are connected by several ligaments that help stabilize the joint. Modified brostromgould repair for chronic lateral ankle. Ankle syndesmosis repair and rehabilitation in professional. Microsoft word general ankle rehab protocol author. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related. Ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Keeping these muscles strong can relieve foot and ankle pain and prevent further injury. Recovering from an ankle sprain generally requires 46 weeks of treatmentrehabilitation. Lateral ankle sprain grade iii nonoperative protocol. C compression place an ice bag on the ankle for 15 to 20.
Typically, high ankle sprains can be treated conservatively with physical therapy. Osborne m, chou l s, laskowski e r, smith j, kaufman k r. Decrease pain and swelling, protect from further injury pain and swelling management rice protection of injured ligaments taping, splints, casting, walking boot etc. Ankle sprain non operative recovery and rehab protocol. Ligamentous ankle injuries are the most common sports trauma, accounting for 1030% of all sports injuries. First degree sprains involve a partial tear to the medial ligaments. An ankle sprain is a stretch or a tear of the ligaments bands of tissue that hold bones together supporting the ankle joint. Total rupture of a ligament there is a loss of motiongross instability of the joint joint function is lostsevere pain initially followed by no pain severe swelling usually extensive. Ice pack applied for 20 minutes every 12 hours to numb the area and to decrease painful swelling i. Epidemiologic data suggest that syndesmotic ankle sprains account for 11%. Functional rehabilitation exercises for ankle sprains. Rehabilitation rehab exercises are critical to ensure that the ankle heals completely and reinjury does not occur.
Recovery is different in each case, but high ankle sprains generally take longer to resolve than lateral ankle sprains. This can be caused by a fall, a sudden twist, or landing on the side of the foot. A n ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Pdf protocol for treatment of ankle sprain researchgate. Medial ankle sprain is an injury caused by an eversion trauma. Functional exercises are used before returning to sport, to ensure that the ankle is strong enough to play again, these exercises are usually sport specific and very specific to each individual. Sports injury medicine department 9250 sw hall blvd. Ankle ligament reconstruction rehabilitation protocol. 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. High ankle sprain rehabilitation guideline this rehabilitation program is designed to return the individual to activity as quickly and safely as possible. Ankle sprains are common injuries that can result in lifelong problems. A number of musclestrengthening exercises employ a length of surgical. Eversion trauma an occur from running downstairs, landing on uneven surfaces, or other activities involving rotation. Ankle sprain rehab protocol treatment is divided into four stages.
When it comes to immediately treating an ankle sprain, the rice protocol is the most common method used by athletic trainers, coaches, and parents everywhere to quickly treat mild injuries. Backgroundaim the distal tibiofibular joint is described as a syndesmosis. Ankle sprain rehabilitation guideline general guidelines. Rehabilitation after ankle sprain center for sports. With appropriate exercises, it can take about 2 weeks before returning to activities. Eversion trauma an occur from running downstairs, landing on uneven surfaces, or other activities involving. Rehabilitation of the ankle after acute sprain or chronic. E elevation wrap an elastic bandage from the toes to mid calf, using even pressure.
Unlike acute ankle sprain, chronic ankle instability might require surgical intervention. Inversiontype, lateral ligament injuries represent approximately 85% of all ankle sprains. 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 see pp 35, require additional consideration. Rehab protocols list of protocols click here to download pdf. Syndesmotic ankle sprains high ankle sprains are a challenging lower extremity injury for athletes and sports health clinicians. After your injury, your physician will work with you to determine a personalized course of treatment.
Google scholar kerkhoffs g m, rowe b h, assendelft w j, kelly k d, struijs p a, van dijk c n. Ankle sprains university health services university of california. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Cycling adjust the seat so that your lower leg is only slightly bent. The following postoperative rehabilitation protocol is adapted from the one used at the brigham and womens hospital and the hospital for special surgery hss, where the modified brostromgould procedure is the preferred anatomical surgical procedure for the treatment of lateral ankle instability. Chattanooga, tn 423 6242696 the injury ankle sprains are very common ankle. This foot and ankle conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. It is designed for rehabilitation following ankle sprain. Laceup ankle braces are not recommended due to their negative impact on strength as well as performance and range of motion. How do we treat an ankle sprain with manual therapy. Chattanooga, tn 423 6242696 the injury ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Dorsiflexors ankle plantar flexors ankle invertors ankle evertors ankle length of program.
Physical therapist performs a full evaluation of the ankle to give the proper and effective treatment and exercises for early recovery from sprained ankle. Ankle sprain rehabilitation orofino physical therapy. Nov 23, 2010 functional exercises are used before returning to sport, to ensure that the ankle is strong enough to play again, these exercises are usually sport specific and very specific to each individual. Jun 26, 2018 ankle sprains are very common ankle injuries, usually the higharch foot as an exercise to increase the ankle motion, rest your heel on the floor and write recovery is different in each case, but high ankle sprains generally take longer to specific exercises performed should be based on each individual patients pdf treatment of. Rehabilitation after ankle sprain brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. The ligaments are basically likes ropes that hold the bones together. The following postoperative rehabilitation protocol is adapted from the one used at the brigham and womens hospital and the hospital for special surgery hss, where the modified brostromgould. Ligaments are bands of tissuelike rubber bandsthat. Most ankle sprains involve the ligaments on the lateral outside aspect of the ankle. Some people with repeated or severe sprains can develop longterm joint pain and weakness. Foot and ankle rehabilitation exercises to ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Epidemiologic data suggest that syndesmotic ankle sprains account for 11% to 17% of the ankle sprains in athletic populations. When these ligaments are overstretched, it is referred to as an ankle sprain. 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.
If treated quickly and properly, however, ankle sprains can heal well, allowing safe return to activity. Early diagnosis and appropriate management of ankle injuries is. It is important to rewrap the ace bandage on a regular basis starting at the toes and finishing well above. Traditionally, severe syndesmotic injuries with diastasis have been treated surgically with screw fixation. If treated quickly and properly, most ankle sprains heal completely, allowing a safe and early return to activity. Athletes with moderate to severe lateral ankle ligament sprains should wear a semirigid or. Some of the authors may have been financially compensated for the case study. Advanz health programs for getting the best out of your health and fitness. The effect of ankle disk training on muscle reaction time in subjects with a history of ankle sprain. Protocol based analgesic treatment was nonexistent in ed. They are often immediately and severely painful and incapacitating. Rehabilitation exercises reduce reinjury post ankle sprain.
Start plantarflexion downward movement of the foot and dorsiflexion upward movement of the foot motion 45x per day out of the brace 4. After your recovery, these exercises can be continued as a maintenance. Simple exercises can be done using elastic to create resistance fig. Loosen the wrap if your toes start to turn blue or feel cold. Atf ankle sprain rehab protocol linkedin slideshare. Specific changes in the program will be made by the. Gently stretching after strengthening exercises can help reduce muscle. Sports ankle injuries assessment and management pdf. Functional rehabilitation exercises for ankle sprains youtube. Ligaments are bands of tissuelike rubber bandsthat connect one bone to another and bind the joints together. Certain exercises to work on moving the joint, strengthening the ankle and rebuilding balance are a very important part of the treatment of ankle sprains.
Lateral ligament repair with internal brace protocol. A complete rehabilitation program for lateral ankle sprains can mean the difference between a fully healed ankle. Foot and ankle rehabilitation exercises orthoinfo aaos. Treating a sprained ankle can help prevent ongoing ankle problems. Chronic lateral ankle pain can develop after a sprain as well. Physical therapy management of medial ankle complex sprain. Most ankle sprains result from the ankle turning inwards during an activity.
766 572 1221 1049 491 1216 682 916 1346 859 290 671 975 568 496 1076 239 1110 1064 764 157 390 1151 436 1341 94 908 652 643 420 1218 543 663 1361 861 397