For grade 1, 2 and 3 for grade 1 and 2 the rehabilitation protocol is generally faster than grade 3. An ankle sprain of grade 2 is slightly more severe than an ankle sprain of grade 1. Here are some things to consider when rehabilitating your ankle. Tapingcompression wrapankle bracing, crutches if needed. Your ankle will probably feel sore and may be slightly swollen.
The rehabilitation guidelines for a grade 2 lateral ligament sprain can be split into 4 phases. Apr 10, 2017 high ankle sprain, is also known as, syndesmotic ankle sprain. These three bones are connected by several ligaments that help stabilize the joint. Continue to ice 24 times per day as long as your ankle is warm, painful or swollen. Depending on how many ligaments are injured, your sprain will be classified as grade 1 mild, 2 moderate, or 3 severe. Place a cold pack on your ankle for 1520 minutes several times per day. An ankle sprain is one of the most common musculoskeletal injuries in people of all ages, athletes and couch potatoes alike. Epidemiologic data suggest that syndesmotic ankle sprains account for 11% to 17% of the ankle sprains in athletic populations.
Strengthening the muscles that support your lower leg, foot, and ankle will help keep your ankle joint stable. You may have heard a popping sound when it happened. Taping or bracing the ankle may be necessary depending on the grade severity of the sprain. An ankle sprain involves stretching andor tearing of one or more ligaments in the. An ankle sprain is where one or more of the ligaments of the ankle are partially or completely torn. In fact, many athletes have sprained their ankle at one point or another in their careers, even if its a minor injury from a simple. It is not intended to substitute clinical judgment regarding the patients post injury care, based on examtreatment findings, individual progress, andor the presence of concomitant injuries or complications. This guideline is intended to provide the treating clinician a frame of reference for rehabilitation. It is designed for rehabilitation following high ankle. High ankle sprain syndesmosis sprain anatomy and biomechanics. Ankle sprains are common injuries that can result in lifelong problems. Functional rehabilitation is more effective than immobilization in managing grade i and ii ankle sprains. The aim of rehabilitation is to restore normal function to the ankle and surrounding. Treating a sprained ankle can help prevent ongoing ankle problems.
General romstrength present at the beginning of rehabilitation is highly variable patient is at risk for recurrent ankle sprains and development of chronic ankle instability rule out fracture andor need for further imaging through utilization of the ottawa ankle rules exclude children under 6 or pregnant women 1. Chattanooga, tn 423 6242696 the injury ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. A grade ii sprain is a moderate injury and can result in partial tearing of one or two of the ankle ligaments. Slowly move your knee side to side while keeping your foot pressed flat. For grade 2 are more severe and require a slower and longer rehabilitation program.
Treating lateral ankle sprain in basketball playersa. Here we outline examples for mild grade 1, moderate grade 2 and severe grade 3 ankle sprains. Sprained ankle treatment with 2 exercises grade 1, 2 or 3. Syndesmotic ankle sprains high ankle sprains are a challenging lower extremity injury for athletes and sports health clinicians. 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. An ankle sprain occurs when a ligament connecting the ankle bones is stretched or torn. Ankle sprains are the most common musculoskeletal injury, accounting for 1030% of all musculoskeletal injuries in the athletic population. With a first degree injury, you can expect to be back to sports within 1 to 3 weeks. Ankle sprain and strain treatment options sportshealth. Ankle sprains affect athletic populations at high rates. Elevate the ankle above heart level until swelling subsides. Many ankle sprains and strains heal on their own within four to six weeks if the patient rests the ankle and avoids strenuous activity until the healing process has completed. Testing of the ligamentous structures will help identify the type and grade of injury and highlight. Strategies for prevention of recurrent sprains and return to play considerations also are discussed.
A thorough clinical evaluation is necessary to ensure an accurate diagnosis and appropriate treatment prescription. Ankle sprains account for 85% of ankle injuries and 85% of sprains involve lateral. An ankle sprain is a stretch or a tear of the ligaments bands of tissue that hold. Your physical therapist can teach you the best way to tape your ankle depending on which ligaments were. Rehabilitation rehab exercises are critical to ensure that the ankle heals completely and reinjury does not occur. Manual strengthening program is progressed with modified daily adjustable resistance. Grade iii sprains should be immobilized for at least 10 days. Ankle sprains need to be rehabilitated properly to prevent reinjury or a chronic problem from developing. Ankle sprain rehabilitation guideline general guidelines. 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. Patients with a grade ii sprain have significant swelling and pain.
The most commonly injured part of the lateral ligament complex is the anterior talofibular ligament atfl. Nonoperative treatment with early functional rehabilitation is the treatment of choice inversion injuries of the ankle ligament are among the most common injuries, accounting for about 25% of all injuries to the musculoskeletal system. You should start this straight away for a simple sprain. It is a common medical providers experience to examine a patient with a chief complaint of ankle pain after sustaining an ankle sprain. This evidencebased high ankle sprain guideline is criterionbased. If this swelling is allowed to consolidate it can produce excessive scar tissue and structural changes, which seriously lengthens the rehab period. Inversiontype, lateral ligament injuries represent approximately 85% of all ankle sprains. The swelling is caused by bleeding in the tissue and a leaking of cellular fluid secondary to tissue damage.
For grade 3 lateral ankle sprains also mobilization should be started as soon as the pain permits 10. High ankle sprain rehabilitation guideline sanford health. Keeping these muscles strong can relieve foot and ankle pain and prevent further injury. In a grade 1 sprain, there is stretching of the ligaments with little or no joint instability. Do as frequently as possible for the first 310 days. C compression place an ice bag on the ankle for 15 to 20. After the examination, your doctor will determine the grade of your sprain to help develop a treatment plan. Ankle sprains need to be rehabilitated properly to prevent re injury or a chronic problem from developing. Ankle sprain rehabilitation guideline sanford health. High ankle sprain exercises should be started once the initial phase of the injury has passed and the pain and swelling due to high. There are a number of treatment goals and objective measurements which will guide the speed and intensity of the treatmentrehabilitation plan.
A more effective way to rehab your ankle sprain breaking muscle. High ankle sprain, is also known as, syndesmotic ankle sprain. Sit with your knee straight and hold the foot position as long as possible. A sprained ankle is one of the most common sports injuries. Management of the sprained ankle british journal of sports. A swollen ankle is a sign of a significant ankle sprain. This foot and ankle conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. Treating your sprained ankle properly may prevent chronic pain and looseness. On the lateral portion of the ankle there are three ligaments which. Abnormal looseness of the ankle joint is found if moved in certain directions when tested grade 3 sprain complete tear of the ligament. Jul 23, 2018 a grade ii sprain is a moderate injury and can result in partial tearing of one or two of the ankle ligaments.
These ligaments and many others are essential for stabilizing the major bones of the ankle, including the talus, tibia, and fibula. Brigham and womens hospital department of rehabilitation. The incidence of ankle sprain is highest in sports populations. Grade i mild stretch, no instability, single ligament involved usually atfl, minimal. Rehabilitation of the ankle after acute sprain or chronic instability. It can mean significant tearing or possibly a complete rupture of the ligaments in the ankle. When these ligaments are overstretched, it is referred to as an ankle sprain. Decrease pain and swelling, increase pain free range of motion, begin strengthening, begin nonweight bearing proprioceptive training and provide protective support as needed.
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. Loosen the wrap if your toes start to turn blue or feel cold. Place a thin towel between your skin and the cold pack to prevent a rash or burn. Treatment and rehabilitation of an ankle sprain can begin after the initial ankle sprain diagnosis. Blood entering the joint causes the staining of your foot. E elevation wrap an elastic bandage from the toes to mid calf, using even pressure. It causes more pain than an ankle sprain of grade 1, more swelling, and sometimes a bit of discoloration. Ankle sprain rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Sprains are graded based on how much damage has occurred to the ligaments. Rehabilitation after ankle sprain brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. Each day, an estimated 23 000 ankle sprains occur in the united.
Elevating the ankle in your down time can help decrease swelling and speed up the recovery process. When this occurs there is immediate pain, swelling and difficulty walking. Rehabilitation protocol grade iii lateral ankle sprain. The injury occurs when one or more of the ligaments in the ankle are stretched or torn, causing pain, swelling, and difficulty walking. After initial management for pain and swelling of the grade 1 sprain, rehabilitation can often be started immediately.
It is designed for rehabilitation following ankle sprain. Patients can bear weight but do so with a sense of instability and a visible limp. Modifications to this guideline may be necessary dependent on physician. Increase pain free range initial stage rehabilitation 2 5 days it. Subacute stage ankle sprain treatmentgrade 1 sprain. Rehabilitation after ankle sprain center for sports medicine. Most physicians familiar with sports medicine will divide the treatment into specific phases.
Ankle sprain rehabilitation orofino physical therapy. Rehabilitation of ankle and foot injuries in athletes. Ankle sprain rehab exercises sydney sports medicine centre. Anterior talofibular ligament, posterior talofibular ligament. A grade 3 ankle sprain is the most severe and serious of the 3 different grades of sprained ankle. In this case, the ligament has been overstretched but not torn.
Ankle sprain is a common injury with a high rate of recurrence usually as a result of landing on a plantarflexed and inverted foot. Management of ankle sprains is based on the grade or severity of the sprain and any associated injuries. This level of sprain causes severe pain, swelling and bruising. Dorsiflexors ankle plantar flexors ankle invertors ankle evertors ankle length of program. Please check with your doctor to make sure that you dont have a fracture. This time there is a slight tear in the talofibular frontal ligament. If you have a grade 3 sprain, the first thing you should do is get an xray to make sure you dont have a fracture. National athletic trainers association position statement.
As such, it should be stressed that this is only a protocol and should not be. After a sprain occurs, it can be classified as grade i, grade ii, or grade iii, depending on the severity of the ligament stretch, strain, or tear. Grade 1 sprain slight stretching and some minor damage to the fibers of the ligament. Microsoft word general ankle rehab protocol author. T he ankle is one of the most common sites for acute musculoskeletal injuries, and sprains account for 75 percent of ankle injuries. After your recovery, these exercises can be continued as a maintenance. Grade 2 sprain some partial tearing of the ligament. Grade iii sprains should be immobilized for at least 10 days with a rigid stirrup brace or belowknee cast and. Athletes who suffer an ankle sprain frequently go on to develop persistent symptoms, resulting in significant resources spent toward treatment, rehabilitation, and prevention.
High ankle sprain exercises should be started once the initial phase of the injury. Increase pain free range initial stage rehabilitation 2 5 days it is found that after ankle sprain, there is restriction of. 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. Phase 1 is directed toward reducing swelling, protecting the injured ligaments, and beginning weightbearing activities. Grade 1 sprain mild slight stretching and microscopic tearing of the ligament fibers. Pain and swelling for a grade 1 sprain are often mild and seldom debilitating. Most ankle sprains involve the ligaments on the lateral outside aspect of the ankle. The treatment is the same for a minor and major sprain, but a major sprain. For grade 1 and grade 2 sprains, most doctors recommend the rice protocol, which stands for rest, ice, compression, and elevation. 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.
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