I. Ankle ligament injuries.
Sports injuries to the ankle ligaments are very common, and what we usually call “sprained foot” usually refers to acute injuries to the ligaments around the ankle. It can be divided into three categories: lateral ligament injury caused by posterior rotation of the ankle; deltoid ligament injury caused by anterior rotation of the ankle; ligament injury between the tibia and fibula caused by external rotation of the ankle.
Treatment of ankle ligament injury.
1. Minor ligament injuries can be relieved by elastic bandage fixation and rest; more serious ligament tears may require plaster fixation for about 3-4 weeks to make them heal.
2.Serious ligament rupture generally requires surgical suturing to treat.
3, old ankle ligament injury if accompanied by joint instability should be damaged to treat and restore the stability of the ankle joint
3. Rehabilitation treatment plan after suture of medial and lateral collateral ligament rupture of ankle joint:
The mechanisms of medial and lateral collateral ligament injuries in the ankle are different, but the surgical approach and clinical management as well as the healing and recovery process are basically the same. The timing of the start of the exercises and the amount and intensity of the exercises differ only by the severity of the injury and the choice of surgical procedure. The start of the exercises should be carried out under the guidance of a professional doctor according to your specific situation.
1.One day after surgery.
(1) Move the toes.
Move your toes vigorously, slowly and as widely as possible. But never cause ankle movement! 5 minutes / group, 1 group / hour.
(2) Quadriceps (anterior thigh muscle group) isometric exercises.
That is, thigh muscle tensing and relaxation. Do as much as possible without increasing pain. Greater than 500 times/day.
2.2-3 weeks after surgery.
(1) Continue the above exercises.
(2) You can walk on your feet without touching the ground with the help of crutches, but only to go to the toilet but necessary for daily activities.
(3) Start straight leg raising exercises.
30 times/group, 30 seconds rest between groups, 4-6 consecutive groups, 2-3 exercises/day. Exercises may not be completed due to excessive weight of the cast rest.
(4) Gradually start the leg muscle strength exercises
To restore the atrophied thigh muscles during the cast fixation period. Exercise the absolute strength of the leg, choose a medium load (the amount of load to complete 20 movements that feel fatigue), 20 times / group, 2-4 groups of continuous exercises, rest 60 seconds between groups, until fatigue.
3.4 weeks after surgery
(1) Start ankle joint active flexion and extension exercises
Slowly, forcefully and maximally tense the toes and hook the toes. Must be within the range of no or minimal pain! Because the early tissue healing is not strong enough, excessive stretching may cause undesirable consequences. 10-15 minutes/time, 2 times/day.
You can soak your feet in hot water for 20-30 minutes before the exercise to increase the tissue temperature to improve the ductility and enhance the effect of the exercise.
(2) Start the passive ankle flexion and extension exercises at the discretion of a medical professional
Gradually increase the force and mobility, 10-15 minutes/time, 2 times/day. The mobility exercises should be performed gradually so that the mobility (i.e. range of motion) of the ankle joint is the same as that of the healthy side within 1-2 months.
(3) You can walk on the ground with a single crutch. Start weight-bearing and weight-shifting exercises, so that the affected leg can gradually bear weight. 5-10 minutes/time, 2 times/day. 2 weeks or so to achieve normal gait walking.
(4) Begin various muscle exercises.
Squatting exercises.
2 minutes/time, 5 seconds rest, 10 times/group, 2-3 groups/day.
Resistance “foot hook”
Resistance to rubber band resistance to complete the “hooked foot (toe upward hook action)” action, 30 times / group, 30 seconds rest between groups, 4-6 sets of continuous, 2-3 exercises / day.
Resistance “taut foot”
Resistance to rubber band resistance to complete the “tense foot (toe down movement)” action, 30 times / group, 30 seconds rest between sets, 4-6 sets in a row, 2-3 exercises / day.
(5) Start functional exercises for the ankle and lower limbs.
Forward striding exercises
20 times/group with 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day. Requires slow, controlled movements and no swaying of the upper body.
Backward stride exercise
20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day. Requires slow, controlled movements and no swaying of the upper body.
Lateral straddle exercise.
After the strength is increased, both hands can carry heavy objects as load or add sandbags at the ankle joint as load. The movement should be slow, controlled and without swaying of the upper body. 20 times/group, 30 seconds interval between groups, 2-4 groups continuously, 2-3 times/day.
4.After 6-8 weeks postoperatively.
If the ligaments heal well after the professional doctor’s review, you can gradually resume the movement.
(1) Internal and external ankle joint mobility exercises.
Slowly, forcefully and maximally turn the ankle joint inward and outward. It must be within the range of no or minimal pain, and gradually increase the angle and intensity of movement! The excessive stretching may cause adverse consequences because the tissue healing is not yet strong enough. 10-15 minutes/time, 2 times/day.
You can soak your feet in hot water for 20-30 minutes before the exercise to increase the tissue temperature to improve ductility and strengthen the exercise effect.
(2) Comprehensive restoration of ankle joint muscle strength and control.
Heel lifting exercises.
That is, stand on the toes, 2 minutes / time, rest 5 seconds, 10 times / group, 2-3 groups / day.
Sitting drop leg “hook foot” exercise (see Chapter 13, Section 4: Illustration 036).
Resistance sandbags and other heavy weights for resistance to complete the movement, 30 times / group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 exercises / day.
Resistance inversion exercises.
Resistance rubber band resistance to complete the action, 30 times / group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 exercises / day.
(3) Strengthen the function of the lower limbs.
Protect the lower full squat.
Equal distribution of weight between the legs, as far as possible, so that the buttocks touch the heel. 3-5 minutes / time, 1-2 times / day.
Begin single knee squat exercises.
Requires slow, controlled movements and no swaying of the upper body. Lift weights with both hands if necessary to make the exercise more difficult. 3-5 minutes/reps, 2-3 reps/set, 2-3 sets/day.
Downward exercise in front of the step
After the strength is increased, you can lift weights with both hands as a load or add sandbags at the ankle joint as a load. 20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day.
Conservative treatment and rehabilitation program for medial and lateral collateral ligament injury of ankle joint:
1.Plaster fixation period (may need to be fixed for 4-6 weeks depending on the injury and surgery)
One day after surgery.
(1) Move the toes.
Use force, slowly, as wide as possible to move the toes. But never cause ankle movement! 5 minutes/group, 1 group/hour.
(2) Quadriceps (anterior thigh muscle group) isometric exercises
That is, thigh muscle tensing and relaxation. Do as much as possible without increasing pain. Greater than 500 reps/day.
2 days – 4 weeks post-op.
(1) Continue the above exercises.
(2) You can walk with your feet off the ground with the help of crutches, but only to go to the toilet but necessary for daily activities.
(3) Start straight leg raising exercises.
30 times/group, 30 seconds rest between groups, 4-6 consecutive groups, 2-3 exercises/day. Exercises may not be completed due to excessive weight of the cast rest.
(4) Gradually start the leg muscle strength exercises
To restore the atrophied thigh muscles during the cast fixation period. Exercise the absolute strength of the leg, choose a medium load (complete 20 movements that is the amount of fatigue load), 20 times / group, 2-4 sets of continuous exercises, rest 60 seconds between groups, until fatigue.
4 weeks after injury
At this time, the cast has been removed. If the cast is still not removed, the following exercises can be delayed.
(1) Start ankle active flexion and extension exercises
Slowly, forcefully and maximally tense the toe and hook the toe. Must be within the range of no or minimal pain! Excessive straining may have adverse consequences because early tissue healing is not yet strong enough. 10-15 min/time, 2 times/day.
You can soak your feet in hot water for 20-30 minutes before the exercise to increase the tissue temperature to improve the ductility and enhance the effect of the exercise.
(2) Start the passive ankle flexion and extension exercises at the discretion of a medical professional
Gradually increase the force and mobility, 10-15 minutes/time, 2 times/day. The mobility exercises should be performed gradually so that the mobility (i.e. range of motion) of the ankle joint is the same as that of the healthy side within 1-2 months.
(3) You can walk on the ground with a single crutch. Start weight-bearing and weight-shifting exercises, so that the affected leg can gradually bear weight. 5-10 minutes/time, 2 times/day. 2 weeks or so to achieve normal gait walking.
(4) Begin various muscle exercises.
Squatting exercises.
2 minutes / time, rest 5 seconds, 10 times / group, 2-3 groups / day.
Resistance “foot hooks”.
Resistance to rubber band resistance to complete the “hook foot (toe up hook action)” action, 30 times / group, 30 seconds rest between groups, 4-6 sets of continuous, 2-3 exercises / day.
Resistance “taut foot”.
Resistance to rubber band resistance to complete the “tense foot (toe down action)” action, 30 times / group, 30 seconds rest between sets, 4-6 sets in a row, 2-3 exercises / day.
(5) Start functional exercises for the ankle and lower limbs.
Forward striding exercises.
After the strength is increased, you can lift heavy objects with both hands as load or add sandbags at the ankle joint as load. 20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day. Requires slow, controlled movements and no swaying of the upper body.
Backward straddle exercise.
After the strength is increased, both hands can carry heavy objects as load or add sandbags at the ankle joint as load. 20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day. Requires slow, controlled movements and no swaying of the upper body.
Lateral straddle exercise.
After the strength is increased, both hands can carry heavy objects as load or add sandbags at the ankle joint as load. 20 times/group, 30 seconds interval between groups, 2-4 groups in a row, 2-3 times/day.
8 weeks after injury
When the ligaments have healed according to the professional physician’s examination, the following training can be continued.
(1) Internal and external ankle joint mobility exercises.
Slowly and vigorously turn the ankle joint in and out to the maximum. It must be within the range of no or minimal pain, and gradually increase the angle and intensity of movement. The excessive stretching may cause adverse consequences because the tissue healing is not strong enough yet. 10-15 minutes/time, 2 times/day.
You can soak your feet in hot water for 20-30 minutes before the exercise to increase the tissue temperature to improve ductility and strengthen the exercise effect.
(2) Comprehensive restoration of ankle joint muscle strength and control.
Heel lifting exercises.
That is, stand on the toes, 2 minutes / time, rest 5 seconds, 10 times / group, 2-3 groups / day.
Sitting leg “hook foot” exercise.
Resistance sandbags and other heavy weights for resistance to complete the action, 30 times / group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 exercises / day.
Resistance inversion exercises.
Resistance rubber band resistance to complete the movement, 30 times / group, 30 seconds rest between groups, 4-6 groups in a row, 2-3 exercises / day.
(3) Strengthen the function of the lower limbs.
Protect the lower full squat.
Equal distribution of weight between the legs, as far as possible, so that the buttocks touch the heel. 3-5 minutes / time, 1-2 times / day.
Begin single knee squat exercises.
Requires slow, controlled movements and no swaying of the upper body. If necessary, lift weights with both hands to increase the difficulty of the exercise. 3-5 minutes / time, 2-3 times / group, 2-3 groups / day.
Step front down exercise.
After the strength is increased, you can lift weights with both hands as a load or add sandbags at the ankle joint as a load. Requires slow, controlled movements, no swaying of the upper body. 20 times/group, 30 seconds between groups, 2-4 groups in a row, 2-3 times/day.