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Deroyal Ankle Sprain Guide

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Deroyal Ankle Sprain Guide Self Management Program Ankle Sprains Improving Care. Improving Business. Self Management Program What is an ankle sprain? overstressing the injured ligaments. These Ligaments attach to the ankle bones and ligaments are damaged, weak and sensitive allow for normal movement and help to motion and weight bearing. Too much prevent too much motion within the joint. stress on the ankle can cause further injury Ankle sprains commonly occur during sports and prolong the healing process. Appropriate participation, however frequently occur treatment is critical during the first two with daily activities. The most common weeks following the injury to expedite the ankle sprain results from injury to the return to activity. Mismanagment of the ligaments on the outer aspect of the ankle. injury early on can lead to pain and inactivity The ligaments 1-2 months later. are injured when the heel is forced What should I do about mild to moderate inward resulting in pain? the tissues being Pain can be classified as mild, moderate, overstretched and damaged. Pain is usually and severe. If daily activities cause mild to immediate and can increase over the next moderate pain, you could be causing more 2-3 hours. damage to the ankle ligaments – which can prolong your recovery. During the first 2-3 Let pain be your guide! weeks after the injury, wear a brace during The pain associated with a sprain is due to all weight-bearing activities to control pain, the immediate damage to the ligaments and provide stability and improve function. Early the inflammation Let pain be your guide in your recovery, crutches may be needed that occurs when as you put weight on for pain-free walking. ligaments are your ankle and gradually damaged. During increase activities. ANKLE REHABILITATION PROTOCOL the first 2-3 days, swelling and inflammation In order to recover from your sprained ankle, play an important role in the body’s ability to you may have to progress through several “clean up” the injured site and allow healing. phases of rehabilitation. Immediately after However, to decrease pain and speed up your injury, initiate the PRICE (Protect, Rest, the healing process, you should control the Ice, Compress, Elevate) treatment method amount of swelling as quickly as possible. described in Phase 1 of the rehab protocol. If you have not gained full function of your The amount of pain and swelling you ankle at the completion of Phase 1, then you have is a good indication of the severity may need to continue through all phases of of the injury. Reoccurring pain is due to the rehab protocol. 2 Self Management Program Phase 1 Days 1 - 3 Protect Rest Ice Compress Elevate Improving Care. Improving Business. Self Management Program Protect (Modify Activities) Ice For the first 2-3 weeks, wear an ankle “stirrup 1. While resting, apply ice or cold therapy brace” to protect the ankle when you walk to limit the swelling and reduce the pain. and during all weight- 2. Apply a cold pack. (Depending on the bearing activities. severity of your sprain, you may choose During the first week another form of cold therapy such as a after the injury, you Cold Therapy Wrap or a Cold Therapy Unit should use crutches and Ankle Blanket.) (with the ankle stirrup 3. To apply the ice pack, use the ace wrap brace) until you can provided to wrap the pack snugly, but walk without pain. During this time, you may comfortably around the ankle. progress from two crutches to only one as your ankle begins to heal and it can tolerate Use the following procedures if you do not more of your body’s weight. Walking with a have any cold therapy products. single crutch means you use the crutch on the opposite side of your ankle injury. • Submerge your ankle in ice water (recommended 44-45°F) above ankle Rest level for 20 minutes. Do this 3-4 times Rest is important! Active resting means a day during the first 72 hours (3 days) that you restrict or limit your activity always after the injury occurs. Allow your ankle to using pain as a guide. warm for at least 30-45 minutes between If your ankle Use crutches until you ice treatments. hurts during daily can walk pain-free and or activities or if without a limp. • Apply an ice bag (crushed ice in a zip lock sports activities are resumed too soon, the bag), a frozen freezer ice pack, or a bag healing process is prolonged and the ankle of frozen vegetables (peas or corn) over ligaments may heal in a lengthened position. a moist towel for 20 minutes. Repeat this This can lead to Chronic Ankle Instability procedure 3-4 times a day for the first 72 (and an increased chance of recurring ankle hours (3 days) after the injury occurs. sprains). P h a s e 1 4 Self Management Program Compression elevation when resting and sleeping. Research shows one of 3. Combine elevation with early, but gentle the most effective ways range of motion exercises. Pull the ankle to reduce swelling is toward your knee, push down toward the to apply compression floor, turn the ankle inward and outward to the swollen area as very gently 10 times – using pain as your soon as possible after the guide. Muscle activity helps move fluid injury. out of the ankle and speeds the healing 1. To compress, use a 4-inch elastic wrap. response. 2. To apply the elastic wrap, begin wrapping at the base of the toes and continue WHEN TO DISCONTINUE upward to four Loosen the wrap imme- COLD THERAPY inches above the diately if you experience Swelling usually stops about 3 days after the ankle. Overlap numbness, your toes initial injury. When it does, discontinue the the wrap one- turn blue or the wrap is use of ice. If swelling returns at third to one-half uncomfortable. If the swelling has any time, start ice stopped, the ankle the width of the wrap with each layer as treatments again. it is applied. Larger feet and ankles may will not be warmer require 2-3” wraps. than body temperature. Elevate Moist Heat 1. Raise the ankle above the level of your To improve blood supply to the injured heart. This position allows gravity to help ligaments, apply moist heat or soak your ankle in warm reduce the swelling. If applying heat 2. Keep your ankle elevated (preferably on water (100-103° increases the pain or 2 or 3 soft pillows) when icing, resting, F) for 20 minutes. swelling, discontinue and sleeping. Combine compression with Perform ankle immediately and resume range of motion ice treatments. exercises as you apply moist heat. How Often? 2-4 times a day until the swelling is gone. P h a s e 1 5 Self Management Program Phase 2 Days 4 - 10 Continue protection Begin ROM exercises and muscle strengthening Improving Care. Improving Business. Self Management Program Remember: Continue to use your ankle 2. Put your injured foot and stirrup brace during the first 2-3 weeks for ankle behind you with protection. your knee straight and injured heel down. Bend your ankle RANGE OF Motion (ROM) EXERCISE opposite knee (unaffected Alphabet leg) forward. Use your big toe as your focal point and 3. Keeping your injured heel write the entire alphabet (A-Z) in capital down, bend the opposite letters. Try to aggressively achieve full knee until you feel a stretch in your calf motion of your ankle; again, using pain as and Achilles tendon. Hold for 15-20 your guide. seconds. How Often? 4 times a day until you have How Often? Perform 5 repetitions with full ROM. If you experience pain, reduce the the knee straight and 5 reps with the knee intensity level until the pain resolves. slightly bent, 4 times a day. HEEL CORD STRETCHING ANKLE STRENGTHENING EXERCISES Non-Weight Bearing Plantar Flexion Use this exercise if the ankle is still painful Wrap your exercise band around the sole to stand. Perform the of your injured foot/ankle. With your leg exercise while sitting. straight, slowly point your toes forward, • In a sitting position, pressing your foot down. stretch your calf How Often? Perform and Achilles Tendon 3 sets of 10-15 by looping a towel around your foot and repetitions one time pulling back as far as you can. Hold for a day. 15-20 seconds. How Often? Perform 5 repetitions 4 Dorsi Flexion times a day. Use pain as your guide. Wrap the end of your exercise band around a table or chair to anchor the band. Slip Weight-Bearing Calf and Achilles your injured foot/ankle into the loop of the Stretching exercise band. With your leg straight, slowly Use this exercise if you can tolerate walking pull your toes toward you, pulling your foot up. in your ankle stirrup brace. Perform the How Often? Perform exercise standing. 3 sets of 10-15 1. Place your hands on a wall with your repetitions one time elbows slightly bent. a day. P h a s e 2 7 Self Management Program EVERSION EXERCISES Walking Wrap your exercise band around your You should make walking part of your injured foot and under the sole of your non- rehabilitation program when you can bear injured foot. Move your injured foot/ankle weight on your ankle pain free and without outward away from assistance (crutches). This usually occurs your body performing around day 10 (post injury) as the ligaments three sets of 10-15 continue to heal and get stronger. repetitions each time.
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