Ankle Rehabilitation By: Luke Kasper & Dave Schuber
Ankle Anatomy ► Bony Tibia (medial malleolus) Fibula (lateral malleolus) Talus Calcaneous Cuboid Cuneiforms Navicular
Ankle Anatomy (continued) ► Ligaments Lateral ► Anterior Talofibular Ligament (ATF) Most commonly injured ligament ► Calcaneofibular Ligament (CF) ► Posterior Talofibular Ligament (PTF) Medial ► Deltoid Ligament Anterior ► Anterior Tibiofibular Ligament
Ankle Anatomy (continued) ► Lateral Ligaments ► Medial Ligaments
Common Mechanisms of Injury (MOI) ►I►I►I►Inversion DDDDamages the lateral ankle ligaments MMMMost common type of ankle injury ►E►E►E►Eversion DDDDamages the medial ankle ligaments ►E►E►E►Extreme Dorsiflexion DDDDamages the anterior ankle ligaments
Rehabilitation Sequence ► Range of Motion (ROM) Range of Motion (ROM) Range of Motion (ROM) Passive (PROM) Active (AROM) ► Strengthening Strengthening Basic to advanced Isometric to Isokinetic Open versus Closed kinetic chain ► Next Stages Next Stages Next Stages
Rehabilitation Sequence (continued) ►P►P►P►P rrrr oooo pppp rrrr iiii oooo cccc eeee pppp tttt iiii oooo nnnn BBBBalance CCCCoordination AAAAgility ►P►P►P►P llll yyyy oooo mmmm eeee tttt rrrr iiii cccc ssss ►F►F►F►F uuuu nnnn cccc tttt iiii oooo nnnn aaaa llll E E E E xxxx eeee rrrr cccc iiii ssss eeee ssss ►R►R►R►Return to Play
ROM ► Decreased ROM following injury ► Must increase ROM to prevent any gait abnormalities. Exercises ► Towel Stretch ► ABC’s Ankle Alphabets Ankle AlphabetsAnkle Alphabets ► Slant Board ► Stationary Bike ► Back to Sequence Back to Sequence Back to Sequence
Strengthening ► Increase strength to help with stability of joint and return to prior strength levels Exercises ► 4 way Theraband ► 4 way ankle weights ► BAPS board ► Towel curls ► Marble Pickups ► Calf Raises ► Back to Sequence Back to Sequence Back to Sequence
Proprioception ► Proprioception is lost due to the damage to the sensory nerves in the ankle. ► Body loses the ability to determine where it is without sight Exercises ► Single leg balance ► Single leg balance on different surfaces ► PNF patterns ► Jogging on trampoline ► Back to Sequence Back to Sequence Back to Sequence
Plyometrics ►I►I►I►Incorporates strength and proprioception ►P►P►P►Power, quick movements EEEExercises ►H►H►H►Hopping ►B►B►B►Box jumps ►D►D►D►Dot Drills E E E E E xxxx aaaa mmmm pppp llll eeee V V V V iiii dddd eeee oooo ►B►B►B►B aaaa cccc kkkk t t t t oooo S S S S eeee qqqq uuuu eeee nnnn cccc eeee
Functional Exercises ► These drills should mimic the athletes sport, but in a controlled environment. ► Drills should be sports specific. Examples ► Football- running, cutting, blocking ► Volleyball- agility, jumping, sliding ► Soccer- running, cutting, kicking ► Return to Play Return to Play Return to Play
Return to Play ► Once the athlete has been cleared by the physician and team athletic trainer they are able to return to play. ► They may have to wear some support or brace once they have returned. Donjoy Mueller Ankle Tape