REHAB PROGRAMS COMMON INJURIES

Ankle Sprain

• Phase 1: Acute Phase : 

• Pain and swelling around the ankle, difficulty bearing weight on the ankle. Limited movement.

• Protection of the ankle from reaggravation of further injury, resting after the injury, applying ice at intervals of 15 minutes, applying a compression bandage to reduce swelling and oedema, and elevating the ankle to further reduce swelling.

- Goal: Minimise pain and swelling, protect the injured ankle. 

- Strategies: 

- PRICE: Protect, Rest, Ice, Compression, Elevation. 

- The use of non-steroidal anti-inflammatory drugs (NSAIDs) for the initial treatment of the ankle sprain (supported according to a meta-analysis involving 22 studies).

 - Toe Pointing and Circles: Gentle range-of-motion exercises.

 - Isometric Ankle Strengthening: Press the injured foot against a solid surface without moving it (e.g., push foot into the floor).

 Physiotherapy Techniques:

-To increase ankle stability and provide support for the ankle joint during the inflammatory phase, active and passive mobilisation of the foot and ankle is done to reduce pain and prevent venous stasis, and improve local circulation allowing resorption of oedema.

- These mobilisation techniques involve subtalar distraction to reduce pain, medial subtalar glide, and lateral subtalar glide to increase eversion and inversion.

https://youtu.be/1sHwUOBQ5Wk?si=c4gozWathuh9pYJs 

https://www.youtube.com/watch?v=TEjKhf-qDJU

• Phase 2: Subacute Phase 

• Reduced swelling, movement feels limited and unable to bear weight on the ankle

- Goal: The goals of physical therapy during this phase include retrieving ankle function, improving weight bearing capacities on the affected foot, and increasing range of motion, while protecting the joint from recurrence of the injury.

It is important to begin early with the rehabilitation of the ankle. Exercises during the first week should produce significant improvements to ankle function. A brace or tape can also be applied, at the beginning of this phase, to protect the joint. It should be applied as soon as swelling decreases, and depends on the patient's preference.

- Strategies: 

- Ankle Alphabet: Trace the alphabet with the foot while seated.

 ->Resistance Band Exercises: 

- Dorsiflexion: Pull toes toward shin with resistance. 

- Plantar Flexion: Push foot away from shin against resistance. 

- Inversion/Eversion: Rotate the ankle inward/outward with the band.