Rehabilitation protocols ohio state sports medicine. Ankle sprains university health services university of california. It also includes range of motion and strengthening exercises. Ankle sprain rehabilitation protocol the intent of this protocol is to provide guidelines for progression of rehabilitation. While this is common when preparing an athlete to return home. E elevation wrap an elastic bandage from the toes to mid calf, using even pressure.
Treating a sprained ankle can help prevent ongoing ankle problems. Ligaments are the soft tissue structures in the body that give the joints their stability. It is designed for rehabilitation following ankle sprain. Modifications to this guideline may be necessary dependent on physician. High ankle sprains are common in athletes who play contact sports. An ankle sprain is where one or more of the ligaments of the ankle are partially or completely torn. Simple exercises can be done using elastic to create resistance fig. Rehabilitation rehab exercises are critical to ensure that the ankle heals completely and reinjury does not occur. Ankle sprain rehab exercises sydney sports medicine centre. Strategies for prevention of recurrent sprains and return to play considerations also are discussed.
The incidence of ankle sprain is highest in sports populations. If treated quickly and properly, most ankle sprains heal completely, allowing a safe and early return to activity. You may require an ankle brace to return to activity. Ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation.
The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the ohio state sports medicine physical therapy team and. Ankle sprains account for almost 85 % of all acute ankle injuries and are a very common injury in both active and sedentary individuals. As such, it should be stressed that this is only a protocol and should not be. On the lateral portion of the ankle there are three ligaments which. Evidence to support the effectiveness of applying orthotics and ankle braces during the acute and subacute phases of ankle rehabilitation is provid.
The following exercises will strengthen the ankle muscles and redevelop the reflexes of the ankle. It is not intended to serve s a substitute for clinical decisionmaking. C compression place an ice bag on the ankle for 15 to 20. It can be hard for patients to tell if a sprain has healed because even an ankle with a chronic tear can be highly functional because overlying tendons help with stability and motion. Progression through each phase of rehabilitation is based on clinical criteria and time frames as appropriate. You can use surgical tubing, theraband, or a bike inner tube for the resistance. It is a fast moving and aggressive game which requires lot of vertical jumps.
Rehabilitation after ankle sprain center for sports. Rehabilitation after ankle sprain brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. 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. Ankle sprain rehabilitation guideline general guidelines. Lateral ankle sprain protocolbrigham and womens hospital. Lateral ankle sprains are one of the most common injuries in athletes. In this article, we discuss the deleterious effects of ankle injury on anklejoint proprioception and muscular. Either immerse it in an ice bucket, or wrap it in a bag of ice for 20 minutes on, 20 minutes off. It is not intended to substitute clinical judgment regarding the patients post injury care, based on exam treatment findings, individual progress, andor the presence of concomitant injuries or complications. The higher the grade of sprain the longer period of time required for painfree weight.
Once you have sprained your ankle, you may continue to sprain it if the ligaments do not have time to completely heal. Chattanooga, tn 423 6242696 the injury ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Phils ankle sprain rehabilitation program is based around 4 phases with an additional 5th phase designed to prevent your anke sprain recurring. Isometric, eccentric, or concentric exercises in pain free. Poor rehabilitation after an initial sprain increases. To strengthen the evertors or the ankle, for example, the patient seated on a chair places the affected foot inside a loop of tubing that has a long free end, passes. Ankle stability and movement coordination impairments. These three bones are connected by several ligaments that help stabilize the joint. Chad madden, physical therapist, discusses the top 3 exercises for an ankle sprain. An ankle sprain occurs when a ligament connecting the ankle bones is stretched or torn. High ankle sprain syndesmosis sprain anatomy and biomechanics.
Our literature research included electronic databases medline, embase from 1966 to april 2002 using the following subject terms. Pdf the injury occurred at a 16 year old boy, for the second time during physical education class. Most high ankle sprains are treated nonsurgically with a rehabilitation program. Elevate the ankle above heart level until swelling subsides. The acute phase is directed at protecting the joint while minimizing pain.
Keeping these muscles strong can relieve foot and ankle pain and prevent further injury. It is not intended to be a substitute for ones clinical decisionmaking. Applying an ace bandage can help decrease the swelling and help the healing process. Antigravity treadmill grade iii lateral ankle sprain general principles this protocol for grade iii lateral ankle sprain is designed to provide the rehabilitation professional with a general guideline for patient care with the alterg antigravity treadmill. You should be able to easily put two fingers under the wrap. Ankle sprain rehabilitation orofino physical therapy. It is important to rewrap the ace bandage on a regular basis starting at the toes and finishing well above the ankle. Recovering from an ankle sprain generally requires 46 weeks of treatment rehabilitation. Ankle sprains account for 85% of ankle injuries and 85% of sprains involve lateral.
Rachana dabadghav department of physiotherapy, sancheti institute college of physiotherapy, india. Rehabilitation of the ankle after acute sprain or chronic. Rehabilitation of the ankle after acute sprain or chronic instability. Ankle sprains are a common, costly, and potentially disabling problem. Here are a few simple treatment steps to follow for sprained ankle. Rehabilitation after ankle sprain center for sports medicine. The therapist may modify the program appropriately depending on the individuals goals for activity following high ankle sprain. The goal of our research is to present the protocol for rehabilitation in acute and subacute conditions with the. The positive effects of these methods on proprioception have been demonstrated in various studies.
Because the application of an ankle brace has been shown to increase joint position sense, it may be suggested that after an acute ankle sprain, initial exercises and rom should be performed with some prophylactic support in an attempt to improve sensory and proprioceptive feedback. When these ligaments are overstretched, it is referred to as an ankle sprain. We also searched the bibliographies of the identified articles. Treating lateral ankle sprain in basketball playersa. Rehabilitation of lateral ankle sprains in sports intechopen. Ankle sprain rehabilitation guideline sanford health. Progress to pain free concentric and eccentric strengthening exercises both open chain and closed.
For better understanding of ankle sprain treatment, lets first understand an ankle sprain is actually an injury to the ligaments of the ankle joint, which are elastic, bandlike structures that. After you have done this turn the inside of your foot so that. Specific changes in the program will be made by the. When one of these structures are overstretched, it is called a sprain. Pdf protocol for treatment of ankle sprain researchgate. This guideline is intended to provide the treating clinician a frame of reference for rehabilitation.
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. Most ankle sprains involve the ligaments on the lateral outside aspect of the ankle. Ankle sprains are very common ankle injuries, usually the result of the ankle turning. Foot and ankle conditioning program orthoinfo aaos. We then limited the search using such terms as rehabilitation and proprioception. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. Early ankle sprain treatment can help to speed recovery and minimize the symptoms. Ankle sprains are common injuries that can result in lifelong problems. 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.
Madden physical therapy 5425 jonestown road harrisburg, pa. The plan of care should be based upon the patients clinical exam and individual. Rehabilitation protocol grade iii lateral ankle sprain alterg. Clinicianassisted manual resistance performed in pain free. Some people with repeated or severe sprains can develop longterm joint pain and weakness. Tapingcompression wrapankle bracing, crutches if needed. The proper history and physical examination will determine the need for radiological evaluation and treatment. 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. Continue to use ace wrap for compression if swelling persists. Bend and straighten your ankles in a pain free range of movement. Strengthening the muscles that support your lower leg, foot, and ankle will help keep your ankle joint stable. In patients with grades i or ii sprains, emphasis should be placed on accurate diagnosis, early use of rice.
Inversiontype, lateral ligament injuries represent approximately 85% of all ankle sprains. Ankle ligament reconstruction rehabilitation protocol. 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. Continue ankle strengthening 34 days per week indefinitely complete the balance tests and exercises if needed wear an ankle brace during strenuous activity indefinitely balance an ankle sprain can decrease your ability to balance on that foot and makes it easier to roll the ankle again.
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