Ankle Sprain - South Shore Hospital

Recommended Exercises/Treatment• Continue general LE strengthening• Continue ankle strengthening in all planes of motion• Continue aerobic activity, return to weightbearing activity (running) as tolerated• Progress proprioceptive/weightbearing/single leg exercises• Initiate agility drills• Initiate functional bracing if needed for sport/workCriteria for discharge• Full functional strength, balance and proprioception• Painfree return to sports• Knowledge of injury prevention/use of functional brace as neededSouth Shore Hospital Orthopedic, Spine and Sports Therapyin Clinical Collaboration with South Shore OrthopedicsPage 6

Phase Goals Precautions Recommended Exercises Criteria to Progressto Next Phase• Decrease swelling• Full pain-free ROM• Muscle re-education• Normal gait patternPhase 1 –Acute Phase• Use assistive device ifgait is painful or if anabnormal gait patternpresent• Splint or brace may beneeded for ambulation• Do not move footthrough a painful rangeof motion• PRICE• Modalities as indicated todecrease swelling and pain• Manual therapy to increaserange and decrease pain asappropriate• Massage for edema control• Pain-free active ROM in allplanes• Towel scrunch and/ormarble pick up• Isometric anklestrengthening• Open chain hipstrengthening• Minimal swellingand pain• Near or full painfree range onmotion• Normal gaitpattern withoutcrutchesPhase 2 –Strengthening(Early)• Full AROM• Normal gait at higherspeeds• Brace may be used withactivity if needed• Avoid exercise thatcauses more thanmoderate pain• Continue modalities tomanage pain andinflammation as needed• Joint mobilization asindicated• Resisted ankle exercises inall planes• Initiate proprioception/balance exercises• Aerobic/enduranceactivity with minimalweightbearing (i.e. biking,swimming…)• Continue hip/knee/corestrengthening• Minimal pain withactivity• Minimal swelling• Pain free AROMand higher levelgaitPhase 3 –FunctionalStrengthening• Pain free functionalweightbearingactivity• Advancestrengthening• Initiate sportspecific exercise/agility• Avoid activity that causespain greater than 3/10on VAS• Continuing bracing asneeded for activity• Continue general LEstrengthening and anklestrengthening in all planes• Continue aerobic activity,return to weightbearingactivity (running) astolerated• Progressproprioceptive/weightbearing/single leg exercises• Initiate agility drills• Initiate functional bracingif needed for sport/work• D/C to HEP if:• Full functionalstrength, balanceand proprioception• Painfree return tosports• Knowledge ofinjuryprevention/use offunctional brace asneededSouth Shore Hospital Orthopedic, Spine and Sports Therapyin Clinical Collaboration with South Shore OrthopedicsPage 7