Thursday, April 23, 2009

The enigmatic ankle sprain

I wish more attention was paid to ankle sprains in the professional journals. This is a 4 day old inversion ankle sprain. There was a lot of internal rotation involved, so the deltoid ligament was torn in addition to the posterior talofibular ligament. The “high ankle sprain” is very popular in the media. However, I believe any ankle sprain with a good deal of rotation involves the distal tibiofibular ligaments/interosseous. So, I think it would be safe to say MOST ankle sprains have a high ankle sprain element. A new classification system is seriously in order. So be wary of the cookbook protocol approach. Every ankle sprain is a little different.

Because the sprained ankle is so common, it’s looked at as no big deal. Which makes for a tough sell to coaches when you’re trying to keep this athlete out of competition.

Grade 2 inversion L ankle sprain rehab, day 5:

A.M. session:
3D BLE ankle excursions, 100 each
Rockfit trainer, 5 minutes

P.M. Session:
3D BLE ankle excursions, 100 each
L stagger squats, 3x12
Squats, hip width apart, heels elevated 1.5”, 3x12
Eccentric heel drops, up on 2 feet, down on L, 3x12
RLE pivot lunge, 3x12
Rockfit Trainer, 5 minutes
HVES(-) c/ RICE, 30m


Kev said...

Hey Joe,

What do you have your ankles do on the Rockfit? I have access to the Wave (I know you don't like it as well). I've tried putting concave surface up and place the ankle into a slightly pronated stance and then do some of the balance - reach stuff.

Kevin Moody said...


Can you explain what your BLE ankle excursions & FMR are ?

Thanks, Kevin

Joe Przytula said...

Kev- I use the Rockfit as a close chain frontal/sagittal plane cardio device. I like your idea of balance/reach in pronation. Kind of lets them bail out of the dorsiflexion they don't yet have.

Kevin M- In varying neutral, & narrow stances, they begin by standing on 2 feet, toes pointed straight ahead. Now, they use the appropriate knee drivers to influence the ankle in the direction of their choice. Great early weight bearing, close chain active ROM technique.

FMR= Functional manual reaction (I believe I did a post on the technique sometime around last November.)