Ankle rehabilitation

Primary stage-ROM (range of motion)

ROM

Whirlpool - abc's with foot and ankle

Rolling towel up

Picking up marbles

Ankle boards - Forward, Sideways, Clockwise, Counter clockwise

Thera Band or Thera tubing

Walking - concentrate on maintaining a normal gait with good heel to toe movements.

Proprioception standing. This is a critical early part of the rehabilitation process and should not be over looked. The ability to balance with the patients eyes opened and then progressing to closed is most important.

Proprioception ball / slant board exercises are the more advanced portion. Play catch with a roll of tape, a "hackey sack" or "stress ball" with the athlete while they are balancing.

Once an athlete has built up to one minute in each position of balance, then increase the difficulty of the activity by bouncing or throwing a tennis ball to them to now make the patient do two things, balance and catch the ball. The degree of difficulty can then be increased via the use of a slant board or balance board.

Water rehabilitation exercises can be undertaken using a ski vest and water deep enough to "run" in without touching the bottom. The time or duration of the exercise should equate to the timing of a "dry land" workout. Example, if the workout calls for the patient to run a 800 meter warm up, then the water workout timing should be approximately 90 seconds. The time in the water activity equals the time that the running event and rest would take on dry land.

Secondary stage- endurance, strength, & flexibility

Power Walking - walking at 3 to 4 mph produces a good cardio vascular response and yet does not subject the joints of the lower extremity to the impact that jogging will produce.

Light jog

Stationary bike

Swimming - the hydrostatic pressure of the water is good for helping to eliminate swimming the resistance and non weighted movements of the foot and ankle help maintain normal joint function as well as conditioning. Start the star hop and weight bearing exercises in the water. This reduces the weight of the patient and lets the health care provider transition the patient to full weight bearing activities faster.

Star hop (5) Hop to marks on the floor in the design of a star. The pattern should not exceed approximately 30".

Slant heel cord stretcher boards

Toe/heel raises (start with 4 sets of 15 reps and build to repetitions of 25. Then add a set and once again reduce the reps and start the progression again. )

Add weight for resistance

Third stage- coordination

Sprint

Start/stop

Cutting - zig zag

Figure 8's

Backtrack

Hill walking and running

Sport Specific Activities

Criteria for return

Pain free, no swelling, no discoloration, full rom, bilateral strength and measurements.

Final criteria - Doctor's approval