Post-operative rehabilitation program for lateral collateral ligament ligament reconstruction of the ankle

  1. 1 day after surgery – before cast removal: 1) Straight leg raising exercises and quadriceps isometric contraction exercises should be performed to avoid muscle atrophy.  2) Strengthen toe flexion and extension exercises.  3) Walk on the affected limb without weight-bearing with the help of crutches, the time should not be too long, and it is enough to complete the daily life such as going to the toilet.  2.3/4–5 weeks after surgery: 1) Wear a rigid ankle brace after removing the cast until 6-8 weeks after surgery.  2) Continue to walk on the affected limb without weight-bearing with the help of crutches for not too long, and just complete the necessary daily activities such as going to the toilet.  3) Continue to perform straight leg raising, knee and hip flexion and extension exercises to strengthen the muscle strength.  4) Passive ankle activities should be performed daily, including only flexion and extension of the ankle joint, but not active movement of the ankle joint and inversion. 2 times/day, 10-15 minutes/time. Apply ice immediately after the exercise.  3. 6 weeks after surgery: 1) Start partial weight-bearing walking on the affected limb with the help of crutches, the time should not be too long. Do not take walking as a training program, but gradually extend the walking time according to your own condition, and make sure that the swelling and pain of the ankle joint are not obvious the next day.  2) Continue to perform straight leg raising, knee and hip flexion and extension exercises to strengthen muscle strength. Perform isometric contraction exercises of the calf muscles.  3) Perform active ankle flexion and extension exercises, but not active ankle inversion and valgus exercises. Adhere to the maximum joint angle passive ankle movement once a day and maintain it at a tolerable angle for 5-8 minutes, only once a day. Apply ice immediately after the exercise.  4. 8-10 weeks after surgery: 1) Start to walk with full weight on the affected limb with the help of crutches, and gradually extend the walking time according to your condition, ensuring that the swelling and pain of the ankle joint are not obvious the next day.  2) Squatting exercises: legs apart, the distance between the two feet is slightly wider than the shoulders, the body remains upright, not leaning forward, the back is reliably on the wall, the heel is one and a half feet away from the wall, the toes and knees are forward, not “inside and outside the eight”, at this time both knees begin to bend and squat. The bending angle of both knees varies according to the patient’s physical condition and muscle strength. If the patient’s body is good, good thigh muscle strength, squatting angle can reach 90 degrees; if the patient’s body is poor and thigh muscle strength is weak, both knees can be lightly flexed, this time the patient squatting position is higher, the patient more effort, with the practice of muscle strength and then increase the angle of knee flexion to 90 degrees, 2-5 minutes / time, 30 seconds interval, 5 -10 consecutive times/group, 2-3 groups/day.  3) Begin resistance ankle exercises, gradually increasing resistance.  4) Active ankle movement, including active ankle inversion, can be performed. Insist on one passive ankle movement at maximum joint angle once a day and maintain it for 5-8 minutes at a pain tolerant angle, once a day only. Apply ice immediately after the exercise.  5) Begin proprioceptive and balance training (intermittently begin unilateral balance training, unilateral balance training with the aid of visual feedback, single leg balance training and ball gripping exercises); skateboarding (increase distance); lateral double leg jump (progress to single leg); anterior-posterior double leg jump (progress to single leg); diagonal double leg jump; jogging; internal and external ankle rolls.  6) Dancers should perform the peroneal long and short muscles in the full plantarflexion position; early hydrotherapy training; dancers should perform plantarflexion or valgus training under resistance (2-20 pounds).  7) Exercise or dancing is allowed if the peroneal long and short muscles are normal and the affected leg can perform single leg hopping without pain.