Ankle sprain 012701002 611 physical therapy calf stretch sitting place a towel around the ball of your foot. A thorough clinical evaluation is necessary to ensure an accurate diagnosis and appropriate treatment prescription. If improperly treated, they can develop into a chronic problem. Rehabilitation protocol grade iii lateral ankle sprain.
Ankle sprain rehab exercises sydney sports medicine. Poor rehabilitation after an initial sprain increases. If ankle sprain is suspected, the clinician should investigate risk factors such as prior history of ankle sprains or ankle instability, specific sport or activity during which the injury occurred, playing surface, footwear and the use of bracing or taping. A doctor may immobilize or splint your sprained ankle. Ankle sprains are very common injuries, usually the result of the foot turning in. It is important to rewrap the ace bandage on a regular basis starting at the toes and finishing well above the ankle. B, in the grade ii sprain, the anterior talofibular ligament tears partially, and the calcaneofibular ligament stretches. Relatively few studies have been performed to examine the effectiveness of different methods of treatment for the inversion ankle sprain. Grade 2 sprain some partial tearing of the ligament. However, i dont think ive ever heard of a grade 3 ankle sprain that had very little swelling or discoloration, but i suppose its possible. In this study, restoration of function following a grade ii inversion sprain was compared among 34 subjects who received one of three methods of treatment, each of which incorporated an airstirrup brace. When this occurs there is immediate pain, swelling and difficulty walking. Grade ii large spectrum of injury, mild to moderate instability, complete tearing of. Grade 3 is the most severe sprain and classifies injuries with complete disruption of all ligaments of the lateral ligamentous complex.
May 28, 20 interestingly, malliaropoulos found that low grade acute lateral ankle sprains result in a higher risk of reinjury than high grade acute lateral ankle sprains. This video is a quick run down of rehabilitation techniques you can use on a grade 2 ankle sprain from time of injury to returning to play. Aug 20, 2019 a high ankle sprain is a tear of the anterior tibiofibular ligament at the top of the ankle. It causes a significant amount of pain, swelling, and coloring of the lateral side of your ankle. Ankle sprain rehabilitation orofino physical therapy. An ankle sprain occurs when a ligament connecting the ankle bones is stretched or torn. The high rate of failure after ankle sprain treatment might be explained by overlooked associated lesions, such as.
Although difficult to assess initially without an anesthetic block due to pain and swelling, the drawer and talar tilt tests and stress xrays are often useful in determining. Microsoft word general ankle rehab protocol author. Rehabilitation rehab exercises are critical to ensure that the ankle heals completely and reinjury does not occur. Persistent ankle pain from prior injury often localized to the anterolateral aspect of the ankle andor a history of recurrent sprains. A grade 3 ankle sprain is a complete tear of the anterior talofibular ligament. For a grade 2 sprain, a removable plastic device such as a castboot or air stirruptype brace can provide support. A simpler approach is to divide these injuries into two groups.
An ankle sprain is where one or more of the ligaments of the ankle are partially or completely torn. When these ligaments are overstretched, it is referred to as an ankle sprain. A grade ii ankle sprain is more severe partial tearing of the ligament. R rest further injury can be prevented by taping or bracing your ankle. Brigham and womens hospital department of rehabilitation.
Decrease pain and swelling, increase pain free range of motion, begin strengthening, begin nonweight bearing proprioceptive training and provide protective support as needed. If treated quickly and properly, however, ankle sprains can heal well, allowing safe return to activity. The high rate of failure after ankle sprain treatment might be explained by overlooked associated lesions, such as syndesmosis or cartilage injuries 17. Grade iii ankle sprains are complete tears of the ligaments.
Ankle sprain and strain treatment options sportshealth. Recurrent sprains are common, so it is important to. Ankle sprain rehab exercises sydney sports medicine centre. A grade 3 sprain is a complete tear of the ligament. Management of ankle sprains american family physician. Do as frequently as possible for the first 310 days. If treated quickly and properly, most ankle sprains heal completely, allowing a safe and early return to activity.
You should be able to easily put two fingers under the wrap. This protocol for grade iii lateral ankle sprain is designed to provide the rehabilitation professional with a general guideline for patient care. Ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. If this swelling is allowed to consolidate it can produce excessive scar tissue and structural changes, which seriously lengthens the rehab period. Sprained ankle treatment with 2 exercises grade 1, 2 or 3. There is usually more significant swelling and bruising caused by bleeding under the skin. The incidence of ankle sprain is highest in sports populations. Please check with your doctor to make sure that you dont have a fracture. These three bones are connected by several ligaments that help stabilize the joint. 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. A high ankle sprain is likely to be more severe and difficult to treat.
A grade iii ankle sprain generally involves the complete tearing of the ligament or ligaments with resulting pain and swell and generally some loss of joint stability. Following a wellstructured conditioning program will also help you return to sports and other. Total rupture of a ligament there is a loss of motiongross instability of the joint joint function is lostsevere pain initially followed by no pain severe swelling usually extensive bruising return to activityfunctional phase in 36 weeks with proper ankle sprain treatment. Without proper treatment and rehabilitation, a severely injured ankle may not heal well and could lose its range of motion and stability, resulting in recurrent sprains and more downtime in the future. For grade 1 and grade 2 sprains, most doctors recommend the rice protocol, which stands for rest, ice, compression, and elevation. Inversiontype, lateral ligament injuries represent approximately 85% of all ankle sprains. Dorsiflexors ankle plantar flexors ankle invertors ankle evertors ankle length of program. Sit with your knee straight and hold the foot position as long as possible. 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. Here we outline examples for mild grade 1, moderate grade 2 and severe grade 3 ankle sprains.
Athletes who suffer an ankle sprain frequently go on to develop persistent symptoms, resulting in significant resources spent toward treatment, rehabilitation, and prevention. With a first degree injury, you can expect to be back to sports within 1 to 3 weeks. A grade 3 ankle sprain is the most severe and serious of the 3 different grades of sprained ankle. 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. Tapingcompression wrap ankle bracing, crutches if needed active range of motion in all planes alphabet, circles, calf pumping. May 08, 2018 this video is a quick run down of rehabilitation techniques you can use on a grade 2 ankle sprain from time of injury to returning to play. Abnormal looseness of the ankle joint is found if moved in certain directions when tested grade 3 sprain complete tear of the ligament.
Ankle sprains account for 85% of ankle injuries and 85% of sprains involve lateral structures. On the lateral portion of the ankle there are three ligaments which. The swelling is caused by bleeding in the tissue and a leaking of cellular fluid secondary to tissue damage. Some of the authors may have been financially compensated for the case study. The recovery time of a grade 2 ankle sprain is usually 24 weeks. A high ankle sprain is a tear of the anterior tibiofibular ligament at the top of the ankle. This foot and ankle conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. Lateral ankle sprains are thought to be suffered by men and women at approximately the same rates. Keep the injured leg back, the uninjured leg forward, and the heel of. This level of sprain causes severe pain, swelling and bruising. The most common type of ankle sprain is an inversion injury, or lateral ankle sprain. They are often immediately and severely painful and incapacitating. During the early phase of healing, it is important to support your ankle and protect it from sudden movements.
This guideline is intended to provide the treating clinician a frame of reference for rehabilitation. Almost all authors have concluded that grade i or ii ankle sprains recover quickly with nonoperative management and with a good prognosis. Patients usually have pain with walking, but can take a few steps. A the grade i sprain is characterized by stretching of the anterior talofibular and calca neofibular ligaments.
You may have heard a popping sound when it happened. C compression place an ice bag on the ankle for 15 to 20. Ankle sprain rehabilitation guideline sanford health. The injury occurs when one or more of the ligaments in the ankle are stretched or torn, causing pain, swelling, and difficulty walking. With appropriate exercises, it can take about 2 weeks before returning to activities. Symptoms of a high ankle sprain include pain on tibiofibular ligament as well as swelling or bruising.
If necessary, use crutches until you can walk without pain or limping. Usually, the other ligaments on the lateral side of your ankle are also. 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. Do the standing stretch instead if you can stand without an increase in your. Grade 1 sprain slight stretching and some minor damage to the fibers of the ligament. Jan 01, 2001 ankle sprains range in severity from grade i to grade iii table 1 5 and figure 1. If the examiner pulls or pushes on the joint in specific movements, gross instability occurs. Rehabilitation after ankle sprain center for sports medicine.
Ankle sprains are common injuries that can result in lifelong problems. Treating a sprained ankle can help prevent ongoing ankle problems. You should ice the ankle for 2030 minutes 3 to 5 times. After the examination, your doctor will determine the grade of your sprain to help develop a treatment plan. Others have used these two sets of categorical terms in a synonymous manner ie. Some people with repeated or severe sprains can develop longterm joint pain and weakness. The aim of rehabilitation is to restore normal function to the ankle and surrounding tissues.
Most ankle sprains involve the ligaments on the lateral outside aspect of the ankle. Tapingcompression wrapankle bracing, crutches if needed. Ankle sprains affect athletic populations at high rates. After your recovery, these exercises can be continued as a maintenance. You should start this straight away for a simple sprain. An ankle sprain is one of the most common musculoskeletal injuries in people of all ages, athletes and couch potatoes alike. These grades are typically only assessed through imaging, although a full tear can be assessed by a trained physical therapist or orthopedist. Understand, however, that most ankle sprains do not require imaging.
As such, it should be stressed that this is only a protocol and should not be. Subacute stage ankle sprain treatment grade 1 sprain. Chattanooga, tn 423 6242696 the injury ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Loosen the wrap if your toes start to turn blue or feel cold. A grade 3 severe sprain puts you at risk for permanent ankle looseness instability.
When you sprain your ankle you will typically have pain and swelling located around the. Your physician may also prescribe physical therapy, antiinflammatory medications, a walking boot or ankle. A swollen ankle is a sign of a significant ankle sprain. Rehabilitation after ankle sprain brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. Elevate the ankle above heart level until swelling subsides. Lateral ligament injuries are perhaps one of the most common sportsrelated injuries seen by physiotherapists. A brief course of physical therapy may lessen the likelihood of residual. Gait training with various ads progressing to no ad based on pain level. Lateral ankle sprain grade iii nonoperative protocol. I ice rest from all activities that cause pain or limping. Rehabilitation of the ankle after acute sprain or chronic.
Grade 3 sprains may require a short leg cast or castbrace for 2 to 3 weeks. 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. A lot of times with grade 3 ankle sprains, the person will feel instant pain followed by no pain at all. Sep 27, 2010 ankle sprain part 1 how they occur, what ligaments are injured and initial treatment part 1 duration. Rehabilitation protocol the antigravity treadmill has been cleared by the fda for rehabilitation following injury or surgery of the lower extremity. On rare occasions, surgery may be needed to repair the damage, especially in competitive athletes. High ankle sprain syndesmosis sprain anatomy and biomechanics. Grade 1 sprain mild slight stretching and microscopic tearing of the ligament fibers. Ankle sprain part 1 how they occur, what ligaments are injured and initial treatment part 1 duration. Sprains are graded based on how much damage has occurred to the ligaments. Know the causes, symptoms, treatment by watching 3d video. It can mean significant tearing or possibly a complete rupture of the ligaments in the ankle. 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.
1083 1072 78 597 594 791 1168 967 456 186 125 466 1021 280 1327 568 1589 75 669 203 1189 1083 24 254 1495 308 967 212 1376 959 175 849 523 666 1252 1011 1141 361 283