Ankle RehabilitationAnkle RehabilitationBy: Luke KasperBy: Luke Kasper

&&

Dave SchuberDave Schuber

Ankle Anatomy Ankle Anatomy

►BonyBony Tibia (medial malleolus)Tibia (medial malleolus) Fibula (lateral malleolus)Fibula (lateral malleolus) TalusTalus CalcaneousCalcaneous CuboidCuboid CuneiformsCuneiforms NavicularNavicular

Ankle Anatomy (continued)Ankle Anatomy (continued)

►LigamentsLigaments LateralLateral

►Anterior Talofibular Ligament (ATF)Anterior Talofibular Ligament (ATF) Most commonly injured ligamentMost commonly injured ligament

►Calcaneofibular Ligament (CF)Calcaneofibular Ligament (CF)►Posterior Talofibular Ligament (PTF)Posterior Talofibular Ligament (PTF)

MedialMedial►Deltoid LigamentDeltoid Ligament

AnteriorAnterior►Anterior Tibiofibular LigamentAnterior Tibiofibular Ligament

Ankle Anatomy (continued)Ankle Anatomy (continued)

►Lateral LigamentsLateral Ligaments

►Medial LigamentsMedial Ligaments

Common Mechanisms of Common Mechanisms of Injury (MOI)Injury (MOI)

► InversionInversion Damages the lateral ankle ligamentsDamages the lateral ankle ligaments Most common type of ankle injuryMost common type of ankle injury

►EversionEversion Damages the medial ankle ligamentsDamages the medial ankle ligaments

► Extreme DorsiflexionExtreme Dorsiflexion Damages the anterior ankle ligamentsDamages the anterior ankle ligaments

Rehabilitation SequenceRehabilitation Sequence

►Range of Motion (ROM) Passive (PROM)Passive (PROM) Active (AROM)Active (AROM)

►Strengthening Basic to advancedBasic to advanced Isometric to IsokineticIsometric to Isokinetic Open versus Closed kinetic chainOpen versus Closed kinetic chain

►Next Stages

Rehabilitation Sequence Rehabilitation Sequence (continued)(continued)

►Proprioception Balance Balance CoordinationCoordination AgilityAgility

►Plyometrics►Functional Exercises►Return to PlayReturn to Play

ROMROM

► Decreased ROM Decreased ROM following injuryfollowing injury

► Must increase ROM to Must increase ROM to prevent any gait prevent any gait abnormalities.abnormalities. ExercisesExercises

► Towel StretchTowel Stretch► ABC’s Ankle AlphabetsABC’s Ankle Alphabets► Slant BoardSlant Board► Stationary BikeStationary Bike

► Back to SequenceBack to Sequence

StrengtheningStrengthening

► Increase strength to help with stability of Increase strength to help with stability of joint and return to prior strength levelsjoint and return to prior strength levels ExercisesExercises

►4 way Theraband4 way Theraband►4 way ankle weights4 way ankle weights►BAPS boardBAPS board►Towel curls Towel curls ►Marble PickupsMarble Pickups►Calf RaisesCalf Raises

► Back to SequenceBack to Sequence

ProprioceptionProprioception

► Proprioception is lost due to the damage to Proprioception is lost due to the damage to the sensory nerves in the ankle. the sensory nerves in the ankle.

► Body loses the ability to determine where it Body loses the ability to determine where it is without sightis without sight ExercisesExercises

►Single leg balanceSingle leg balance►Single leg balance on different surfacesSingle leg balance on different surfaces►PNF patternsPNF patterns► Jogging on trampolineJogging on trampoline

► Back to SequenceBack to Sequence

PlyometricsPlyometrics

► Incorporates strength and Incorporates strength and proprioceptionproprioception

►Power, quick movementsPower, quick movements ExercisesExercises

►HoppingHopping►Box jumpsBox jumps►Dot Drills Example VideoDot Drills Example Video

►Back to SequenceBack to Sequence

Functional ExercisesFunctional Exercises

► These drills should These drills should mimic the athletes mimic the athletes sport, but in a controlled sport, but in a controlled environment.environment.

► Drills should be sports Drills should be sports specific.specific. ExamplesExamples

► Football- running, cutting, Football- running, cutting, blockingblocking

► Volleyball- agility, Volleyball- agility, jumping, slidingjumping, sliding

► Soccer- running, cutting, Soccer- running, cutting, kickingkicking

► Return to PlayReturn to Play

Return to PlayReturn to Play

►Once the athlete has been cleared by Once the athlete has been cleared by the physician and team athletic trainer the physician and team athletic trainer they are able to return to play.they are able to return to play.

►They may have to wear some support They may have to wear some support or brace once they have returned.or brace once they have returned. DonjoyDonjoy MuellerMueller Ankle TapeAnkle Tape