What is included in physical therapy for ankle sprains?

Updated: Jan 14, 2019
  • Author: Craig C Young, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

The treatment plan during the recovery phase is aimed at the patient regaining full ROM, strength, and proprioceptive abilities. Strengthening is started with isometric exercises and advanced to the use of elastic bands or surgical tubing, as shown below.

strengthening using an elastic band. strengthening using an elastic band.

Strengthening is performed in the following 4 cardinal ankle motions: dorsiflexion, plantar flexion, eversion, and inversion. Strengthening of the peroneals, which act as dynamic stabilizers of the ankle, is critical.

Proprioception rehabilitation begins with single-leg-stance exercises in a single plane and progresses to multiplanar exercises. The patient stands on the injured side with the foot and arch in a neutral position and holds the foot of the uninjured side off the ground. For safety, this exercise should be completed near a wall. Initially, the patient looks at the feet and attempts to hold the position. When the patient can comfortably and easily hold the position for 3 minutes, he/she changes the focus of the eyes to a location in front of the body. When the patient can comfortably and easily hold the position with the eyes looking forward for 3 minutes, the position is then held with the eyes closed. A modified Romberg test may be useful in evaluating the progression of proprioceptive rehabilitation.

Other useful exercises include the use of a balance or tilt board, as shown below; these can be made by attaching a dowel or half of a croquet ball to the bottom of a piece of plywood. The athlete stands on the board and attempts to control balance while touching the board to the floor in a controlled manner to complete various patterns (eg, 4 points of the compass). Finally, the athlete advances to functional drills, jogging, sprinting, and cutting, and then progresses to figure-of-eight and carioca drills. [7]

Tilt board. Tilt board.

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