Physical Therapy Guidelines for Ankle Fracture with Surgery This was written and developed by the therapists of MGH Physical Therapy Services. Chiropractic Therapy. Specific Instructions: Do not perform activities that increase pain and/or swelling Goals of Phase: 1. 2 0 obj For patients who are recovering from ankle or foot surgery, please refer to the following protocols as advised by your physical therapist. You will likely also be advised to move your toes while the foot is in a cast. Weight-bearing as tolerated with the knee locked in extension. Physical therapy can be used to expedite return to function when appropriate. Specific changes in the program may be made by the physician as appropriate for the individual patient. Detailed recovery / rehabilitation protocol: Safe non weight bearing crutches /knee-walker. The plan of care should be based upon the patients clinical exam and individual goals. To improve muscular flexibility around your ankle after a fracture, you can perform a few different exercises. Of all ankle sprains, approximately 85% are inversion (roll in) sprains and are commonly graded based on severity of the … Next to the fibula bone is the tibia, which is thicker. 3 0 obj Ankle fracture treatment is offered at New West Sports Medicine & Orthopaedic Surgery in Kearney, Nebraska. Physical therapist performs a full evaluation of the ankle to give the proper and effective treatment and exercises for early recovery from sprained ankle. ORIF means the patient will have hardware (plate and screws) to stabilize the fracture. May use Roll-a-bout for community ambulation. Detailed Physical Therapy Post Op Protocol The following post-operative rehabilitation protocol is adapted from the one used at the Brigham and Women’s Hospital and the Hospital for Special Surgery (HSS), where the modified Brostrom-Gould procedure is the preferred anatomical surgical procedure for the treatment of lateral ankle instability. Towel calf stretching can improve the flexibility of the muscles on the back of your lower leg. Maintain ankle motion with toe crunches; ankle alphabet; inversion eversion; ankle pumps, Increase safe ADL (activities of daily living), Sutures or staples removed at 14 to 21 days, FWB involved LE in walker boot after 4 weeks, 50% AROM all planes involved ankle and subtalar joint, Maintain optimal bone and soft tissue healing environment, Gait training level surfaces with proper tibia advancement, quads activation, symmetrical weight-bearing, Grade 1-2 joint mobilizations ankle and subtalar joints, Manual resistance in open chain for DF/PF/inv/ev and multiplanar motion, Leg extension, curl, press, wall stretch with knee flexed and extended, Full ankle and subtalar AROM, flexibility, Restore gait on level surfaces, hills, stairs, CKC theraband exercises (stand on involved leg and perform hip flex/ext/abd/add with uninvolved LE). This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. D. Summary Digital fractures are common in the workplace and often result from blunt trauma caused by a falling object or stubbing of the toe. Physical Therapy. ANKLE/SYNDESMOSIS ORIF PHYSICAL THERAPY Philosophy This protocol is to be utilized as a guideline. RETURN TO WORK PROTOCOL: ANKLE & FOOT FRACTURES 0-2 Weeks  No work. If your injury is left untreated to become more injured (or is severe enough from the start) you might even be forced to partake in a surgical procedure to reposition your bone fragments back in place, which involves the high possibility of screws, metal plates, and rods placed into your ankle … 1. <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Physical therapists can help patients begin putting weight on the injured leg and gradually progress to full weight. x��\Yo�F~�����AD�/v30�a'J�X��xFƲ��XG���ߪ��C�P#)43$������������b~>;]/^l�,��˳���퓛�߷O�ޞm�.�׳���z:-v���ݓ͍�W�`��eqr�����c�h 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. Ankle sprains are common injuries that can result in lifelong problems. When comfortable with two legs progress to alternating unilateral hopping on the right and left leg. This is a sample surgical protocol that we typically use. There will always be individual differences amongst patients regarding progression and tolerance of specific activities. Lateral Ankle Reconstruction Protocol Weeks One And Two Weeks Two To Six Initial Evaluation Evaluate Patient is NWB w/ assistive device/s while in Robert Jones splint Patient in WB cast x 4 weeks Gait progression from TDWB at week 2 to full WB by week 6 Patient Education Patient Education Support Physician prescribed meds Reinforce NWB w/ assistive device/s Elevation as tolerated for … Ankle Fracture Post-op Rehabilitation Protocol. These impairments can make performing your normal everyday activities difficult or impossible. It is not intended to be a substitute for one’s clinical decisionmaking. JUMPING ROPE Start with two legs, and do small jumps slowly, gradually increase height and speed. Take immobilizer off only for physical therapy sessions. This instability may occur via repetitive ankle sprains or even progress to the ankle giving way with routine daily activities. After 6 weeks time and depending on factors such as gait, strength and stiffness you may require formal physical therapy.  No driving. REMEMBER: It can take up to a year to make a full recovery, and it is not unusual to have intermittent pains and aches during that time! Lacey WA 98516 (360) 456 - 1444; Inquire Today; Work With Us; Services. Manual test are performed to find out how unstable your ankle is following a sprain and in some cases, x-rays might be required to determine whether there is a broken bone.  Cast or cast boot on at all times. Can WBAT in boot after 6 weeks. When dealing with an ankle fracture, physical therapy is paramount to recovery. endobj This painful injury can cause loss of lower extremity strength, range of motion, and pain. - Boot discontinued at 8 weeks Therapeutic exercise is one of your main treatments to help you … A broken ankle can severely limit your ability to perform basic functional tasks like running and walking. Specific physical therapy activities to expect following a fibula fracture or any other broken ankle bone typically include: Walking instruction.  Must use crutches or knee roller at alltimes.  May need to elevate foot to control swelling. Progression through the protocol will depend on successful accomplishments of set milestones as assessed by the physician and the physical therapist/athletic … Articular cartilage transplantation to the ankle rehab protocol Some people with repeated or severe sprains can develop long-term joint pain and weakness. If concern of wound, please take a picture and call Dr. Vora’s office. Some of the authors may have been financially compensated for the case study. Rehabilitation Protocol: Ankle Open Reduction Internal Fixation Name: _____ Date: _____ Diagnosis: _____ Date of Surgery: _____ Week 0-4: - Patient non weightbearing in splint with ankle in equinnus (toes toward ground) - At 2 weeks, splint removed, wound checked, and placed into a cast Week 4-8: - Cast removed - Patient placed into a boot - PWB in boot from 4-6 weeks. endobj Ankle dislocation rehab protocol Distal fibular fracture and deltoid ligament repair Patient will be walking with crutches and touchdown (toe-touch) weight bearing on the surgical leg for 4 - 6 weeks post-op. Shockwave Therapy. Physical therapists can give specific instructions and exercises to help restore a normal walking pattern. If you have suffered a broken ankle, you may benefit from the skilled services of a physical therapist to help you return to optimal function once your fracture has healed.Your physical therapist (PT) may use various treatments and modalities to help control your pain or swelling or to improve the way your ankle moves. 4 0 obj However, up to 20% of lateral ankle sprains can lead to chronic pain and instability. - Patient non weightbearing in splint with ankle in equinnus (toes toward ground) - At 2 weeks, splint removed, wound checked, and placed into a cast Week 4-8: - Cast removed - Patient placed into a boot - PWB in boot from 4-6 weeks. ****Please fax initial assessment and subsequent progress notes directly to IBJI at 847-234-2090***. Custom Braces for Rehabilitation. At 12 weeks begin gentle running / higher impact activities. Most ankle sprains involve the ligaments on the lateral (outside) aspect of the ankle. Massage Therapy. ankle, and to describe a functional rehabilitation program that progresses from basic to advanced, while taking into consid- eration empirical data from the literature and clinical practice. POST-OPERATIVE PROTOCOL Patella Fracture – ORIF, Rehabilitation or Non-Operative Treatment. Physical therapy is not always required after surgery for an ankle fracture and is highly dependent on each individual patient and injury. Knee Immobilizer – wear at all times. DRIVING: You may begin driving when you are fully weight bearingon right foot without crutches if right ankle. This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. A physical or occupational therapist can show you how to exercise your ankle. Pain Management; Surgical Rehabilitation; Injury Rehabilitation; Specialty Therapy. <> 3-8 Weeks  Seated work only. ANKLE/SYNDESMOSIS ORIF PHYSICAL THERAPY Philosophy This protocol is to be utilized as a guideline. Reconstruction after Foot and Ankle Fractures. … Treating a sprained ankle can help prevent ongoing ankle problems. -U՘��js�..���͍�����8�qs�%�/����ݛ���j�h^4U�$�Y��༪���Vn�� When to start physiotherapy after a broken ankle depends on the seriousness of the injury. endobj Ankle instability rehab protocol. We will always communicate with your surgeon on your surgery and their preferred protocol. Shower boot or saran wrap with showers until closed. Ankle Sprain Rehabilitation. Workplace Injuries. Aggressive … Gait training. ANKLE FRACTURE Treatment Guidelines Last Modified: Oct 2012 General This protocol is for patients who have had a stable open reduction internal fixation (ORIF) or a stable closed reduction and casting. Boot can only be removed for bathing and therapy exercises. Therapy at 2-3 wks post op: Progression with boot to WBAT (per tolerance, no pain with WBAT) with use of crutches, cane, walker, etc. Then press your good foot against the band. 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 Anti-Gravity Treadmill. Ankle Fracture Physical Therapy Protocol This protocol provides you with general guidelines for progression of rehabilitation according to specific time frames. Concussion Rehabilitation. Physical therapy exercises for the knee and hip can help a person from losing strength and prevents or limits atrophy of the muscle group while the ankle fracture heals. PHYSICAL THERAPY: start between 2-6 weeks post injury, focus on motion and swelling at first, then gait training and strengthening. High ankle sprains, also known as a Syndesmotic injury, are much less common but far more disabling than traditional ankle sprains. <>>> While this may seem minor, movement of the toes can keep blood clots and adhesion of the tendons from forming. Diminish pain and inflammation 2. 3. We find best results with orthotics, bracing and offloading following removal of the cast. Ankle dislocation rehab protocol. Phase 1: 0-2 Weeks Post-op. Physical therapy When your bones start to heal, your doctor might have you do physical or occupational therapy. Resisted ankle inversion Sit on the floor with your good leg crossed over your other leg. %���� NWO Therapy Department Rehabilitation Guidelines for A nkle ORIF . REHABILITATION PROTOCOL The Anti-Gravity Treadmill has been cleared by the FDA for rehabilitation following injury or surgery of the lower extremity. This is normal and does not mean there is anything wrong with your ankle. Get Directions. <> Rehabilitation Protocol: Ankle Arthroscopy WITH Talus OCD Microfracture Phase I - Post-operative Period (Weeks 0-1) • NON-weightbearing • Splint immobilization • Daily icing, compression and elevation home program Phase II (Weeks 1-3) • Weightbearing: Contine NON-weightbearing for 6 … Injuries range from simple non-displaced fractures to open intraarticular injuries which require surgical treatment. v��V���@]�nUeK���9��A2U���������SXMn꒵U��An. There will always be individual differences amongst patients regarding progression and tolerance of specific activities. Knee Immobilizer will be converted to a hinged knee brace at the first post-op visit. stream CAM boot is to be worn all times, including sleep, until 6wks post op. When comfortable with unilateral hopping, start using a jumping rope. Achilles tendon repair rehab protocol. Broken ankle rehab can take up to 6-12 months to regain your flexibility and normal walking from the time of the fracture. tY�rr\�)���e�%&��[z�S���8>�xI��JcG!� ��.�8�����<+�-�'�o�$ �@&qFu��[�o�JS�� �+�#�P�۟�-Y���=)@���Cq�����Y�D���PQ�ji(����~e��L���+���0�