Many ankle sprains and strains heal on their own within four to six weeks if the patient rests the ankle and avoids strenuous activity until the healing process has completed. Microsoft word general ankle rehab protocol author. With a first degree injury, you can expect to be back to sports within 1 to 3 weeks. Management of ankle sprains is based on the grade or severity of the sprain and any associated injuries. An ankle sprain is one of the most common musculoskeletal injuries in people of all ages, athletes and couch potatoes alike. Rehabilitation after ankle sprain brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. An ankle sprain is a stretch or a tear of the ligaments bands of tissue that hold.
Functional rehabilitation is more effective than immobilization in managing grade i and ii ankle sprains. Your ankle will probably feel sore and may be slightly swollen. Rehabilitation rehab exercises are critical to ensure that the ankle heals completely and reinjury does not occur. Ankle sprain rehabilitation orofino physical therapy. It is not intended to substitute clinical judgment regarding the patients post injury care, based on examtreatment findings, individual progress, andor the presence of concomitant injuries or complications. Grade 1 sprain mild slight stretching and microscopic tearing of the ligament fibers. Your physical therapist can teach you the best way to tape your ankle depending on which ligaments were. Place a thin towel between your skin and the cold pack to prevent a rash or burn. Testing of the ligamentous structures will help identify the type and grade of injury and highlight. Elevating the ankle in your down time can help decrease swelling and speed up the recovery process. It can mean significant tearing or possibly a complete rupture of the ligaments in the ankle. When this occurs there is immediate pain, swelling and difficulty walking. After your recovery, these exercises can be continued as a maintenance. This time there is a slight tear in the talofibular frontal ligament.
Ankle sprain rehab exercises sydney sports medicine centre. Each day, an estimated 23 000 ankle sprains occur in the united. Ankle sprains need to be rehabilitated properly to prevent reinjury or a chronic problem from developing. In this case, the ligament has been overstretched but not torn. Phase 1 is directed toward reducing swelling, protecting the injured ligaments, and beginning weightbearing activities. After a sprain occurs, it can be classified as grade i, grade ii, or grade iii, depending on the severity of the ligament stretch, strain, or tear. Ankle sprain and strain treatment options sportshealth. Grade i mild stretch, no instability, single ligament involved usually atfl, minimal. Rehabilitation after ankle sprain center for sports medicine. Loosen the wrap if your toes start to turn blue or feel cold.
Rehabilitation protocol grade iii lateral ankle sprain. Depending on how many ligaments are injured, your sprain will be classified as grade 1 mild, 2 moderate, or 3 severe. Ankle sprains need to be rehabilitated properly to prevent re injury or a chronic problem from developing. Ankle sprains affect athletic populations at high rates. Ankle sprains are the most common musculoskeletal injury, accounting for 1030% of all musculoskeletal injuries in the athletic population. As such, it should be stressed that this is only a protocol and should not be. Ankle sprain rehabilitation guideline general guidelines. Treatment and rehabilitation of an ankle sprain can begin after the initial ankle sprain diagnosis.
The incidence of ankle sprain is highest in sports populations. An ankle sprain is where one or more of the ligaments of the ankle are partially or completely torn. The swelling is caused by bleeding in the tissue and a leaking of cellular fluid secondary to tissue damage. It is designed for rehabilitation following ankle sprain. Grade iii sprains should be immobilized for at least 10 days. Abnormal looseness of the ankle joint is found if moved in certain directions when tested grade 3 sprain complete tear of the ligament. Syndesmotic ankle sprains high ankle sprains are a challenging lower extremity injury for athletes and sports health clinicians. The injury occurs when one or more of the ligaments in the ankle are stretched or torn, causing pain, swelling, and difficulty walking. Most ankle sprains involve the ligaments on the lateral outside aspect of the ankle. Grade 2 sprain some partial tearing of the ligament.
Keeping these muscles strong can relieve foot and ankle pain and prevent further injury. This guideline is intended to provide the treating clinician a frame of reference for rehabilitation. Management of the sprained ankle british journal of sports. Patients can bear weight but do so with a sense of instability and a visible limp. Inversiontype, lateral ligament injuries represent approximately 85% of all ankle sprains. Increase pain free range initial stage rehabilitation 2 5 days it is found that after ankle sprain, there is restriction of. It is a common medical providers experience to examine a patient with a chief complaint of ankle pain after sustaining an ankle sprain. Modifications to this guideline may be necessary dependent on physician. E elevation wrap an elastic bandage from the toes to mid calf, using even pressure.
Sprained ankle treatment with 2 exercises grade 1, 2 or 3. For grade 2 are more severe and require a slower and longer rehabilitation program. Treating your sprained ankle properly may prevent chronic pain and looseness. High ankle sprain syndesmosis sprain anatomy and biomechanics. After the examination, your doctor will determine the grade of your sprain to help develop a treatment plan. Ankle sprain is a common injury with a high rate of recurrence usually as a result of landing on a plantarflexed and inverted foot. Ankle sprain rehabilitation guideline sanford health.
Here are some things to consider when rehabilitating your ankle. 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. Rehabilitation of the ankle after acute sprain or chronic instability. The aim of rehabilitation is to restore normal function to the ankle and surrounding. Treating a sprained ankle can help prevent ongoing ankle problems. High ankle sprain exercises should be started once the initial phase of the injury. In a grade 1 sprain, there is stretching of the ligaments with little or no joint instability. Increase pain free range initial stage rehabilitation 2 5 days it.
These three bones are connected by several ligaments that help stabilize the joint. A structured ankle sprain rehabilitation program is important for optimum recovery from an ankle sprain as well as to help prevent future recurring ankle sprains. Blood entering the joint causes the staining of your foot. 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. Strategies for prevention of recurrent sprains and return to play considerations also are discussed. High ankle sprain exercises should be started once the initial phase of the injury has passed and the pain and swelling due to high. Sit with your knee straight and hold the foot position as long as possible. Anterior talofibular ligament, posterior talofibular ligament. High ankle sprain, is also known as, syndesmotic ankle sprain. Grade iii sprains should be immobilized for at least 10 days with a rigid stirrup brace or belowknee cast and. C compression place an ice bag on the ankle for 15 to 20. The most commonly injured part of the lateral ligament complex is the anterior talofibular ligament atfl.
Athletes who suffer an ankle sprain frequently go on to develop persistent symptoms, resulting in significant resources spent toward treatment, rehabilitation, and prevention. This evidencebased high ankle sprain guideline is criterionbased. For grade 1 and grade 2 sprains, most doctors recommend the rice protocol, which stands for rest, ice, compression, and elevation. These ligaments and many others are essential for stabilizing the major bones of the ankle, including the talus, tibia, and fibula. National athletic trainers association position statement. The treatment is the same for a minor and major sprain, but a major sprain. You should start this straight away for a simple sprain. Elevate the ankle above heart level until swelling subsides. A swollen ankle is a sign of a significant ankle sprain. If you have a grade 3 sprain, the first thing you should do is get an xray to make sure you dont have a fracture. Ankle sprains account for 85% of ankle injuries and 85% of sprains involve lateral.
Tapingcompression wrapankle bracing, crutches if needed. Epidemiologic data suggest that syndesmotic ankle sprains account for 11% to 17% of the ankle sprains in athletic populations. This foot and ankle conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. Brigham and womens hospital department of rehabilitation. When these ligaments are overstretched, it is referred to as an ankle sprain. Pain and swelling for a grade 1 sprain are often mild and seldom debilitating. A sprained ankle is one of the most common sports injuries. This level of sprain causes severe pain, swelling and bruising. High ankle sprain rehabilitation guideline sanford health.
Continue to ice 24 times per day as long as your ankle is warm, painful or swollen. Ankle sprain rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Place a cold pack on your ankle for 1520 minutes several times per day. A more effective way to rehab your ankle sprain breaking muscle.
Taping or bracing the ankle may be necessary depending on the grade severity of the sprain. Do as frequently as possible for the first 310 days. It causes more pain than an ankle sprain of grade 1, more swelling, and sometimes a bit of discoloration. For grade 3 lateral ankle sprains also mobilization should be started as soon as the pain permits 10. Subacute stage ankle sprain treatmentgrade 1 sprain. 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. On the lateral portion of the ankle there are three ligaments which.
An ankle sprain involves stretching andor tearing of one or more ligaments in the. Decrease pain and swelling, increase pain free range of motion, begin strengthening, begin nonweight bearing proprioceptive training and provide protective support as needed. A grade 3 ankle sprain is the most severe and serious of the 3 different grades of sprained ankle. Nonoperative treatment with early functional rehabilitation is the treatment of choice inversion injuries of the ankle ligament are among the most common injuries, accounting for about 25% of all injuries to the musculoskeletal system. An ankle sprain of grade 2 is slightly more severe than an ankle sprain of grade 1. Some people with repeated or severe sprains can develop longterm joint pain and weakness. Sprains are graded based on how much damage has occurred to the ligaments. Dorsiflexors ankle plantar flexors ankle invertors ankle evertors ankle length of program. T he ankle is one of the most common sites for acute musculoskeletal injuries, and sprains account for 75 percent of ankle injuries. General romstrength present at the beginning of rehabilitation is highly variable patient is at risk for recurrent ankle sprains and development of chronic ankle instability rule out fracture andor need for further imaging through utilization of the ottawa ankle rules exclude children under 6 or pregnant women 1. Here we outline examples for mild grade 1, moderate grade 2 and severe grade 3 ankle sprains. If this swelling is allowed to consolidate it can produce excessive scar tissue and structural changes, which seriously lengthens the rehab period.
It is designed for rehabilitation following high ankle. After initial management for pain and swelling of the grade 1 sprain, rehabilitation can often be started immediately. In fact, many athletes have sprained their ankle at one point or another in their careers, even if its a minor injury from a simple. A thorough clinical evaluation is necessary to ensure an accurate diagnosis and appropriate treatment prescription. Apr 10, 2017 high ankle sprain, is also known as, syndesmotic ankle sprain. Rehabilitation of ankle and foot injuries in athletes. Ankle sprains are common injuries that can result in lifelong problems. There are a number of treatment goals and objective measurements which will guide the speed and intensity of the treatmentrehabilitation plan. Most physicians familiar with sports medicine will divide the treatment into specific phases. Strengthening the muscles that support your lower leg, foot, and ankle will help keep your ankle joint stable. Manual strengthening program is progressed with modified daily adjustable resistance.
A grade ii sprain is a moderate injury and can result in partial tearing of one or two of the ankle ligaments. Grade 1 sprain slight stretching and some minor damage to the fibers of the ligament. An ankle sprain occurs when a ligament connecting the ankle bones is stretched or torn. Treating lateral ankle sprain in basketball playersa. You may have heard a popping sound when it happened. An ankle sprain typically occurs when the ankle is plantarflexed toes pointing downward and inverted turned inward forcefully causing an over stretch or tear of the ligaments. Slowly move your knee side to side while keeping your foot pressed flat. Jul 23, 2018 a grade ii sprain is a moderate injury and can result in partial tearing of one or two of the ankle ligaments.
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