Methods of ankle functional rehabilitation training
Two of the most important rehabilitation components in the early postoperative period after various ankle surgeries are joint mobility exercises and muscle strength exercises. The following is a brief introduction of the training methods.
I. Joint mobility
The normal ankle joint can move in all directions. In this article, we focus on dorsiflexion (dorsiflexion) and plantarflexion, inversion and valgus movements.
Since many patients are immobilized in a cast for a period of time after ankle surgery, it is inevitable that some limitation of ankle mobility will occur. Then, early after the cast is removed, joint mobility exercises should be performed. Here are some methods of joint angle exercises.
1.Dorsal extension (dorsiflexion)
Dorsal extension is the upward movement of the ankle joint. Because of the presence of the Achilles tendon at the back, this angle is the most likely to have limited movement after surgery and is also a more difficult angle to practice. In the early postoperative period, you can use a towel or any long strip of tape to perform upward stretching.
You can also ask your family to help you practice. During the practice, you can put a small pillow under the knee joint, which will help to keep the calf triceps in a relaxed state.
With time and the increase in intensity that the ankle joint can tolerate, in the future it will be possible to use your own body weight to perform exercises at an angle, such as the following methods.
”Lunge”
The affected limb is behind, the toes are naturally forward, the knee is straightened and the ankle is pressed down. This fully stretches the calf triceps and Achilles tendon. Addresses the limited ankle mobility caused by the calf triceps and Achilles tendon.
”Squat”
When squatting, pay attention to the natural forward movement of the toes and do not skew the knees and hips, even if the heels do not hit the ground. The main solution is to address the limited mobility of the joint caused by the internal ankle joint.
There is also a training tool for ankle angle on the market now, which can be searched by searching for “ankle angle training board” on Sompo. The affected limb can directly step on the board for angle exercises, which is very effective and convenient.
2.Plantar flexion
Plantar flexion is the downward movement of the ankle joint, which is an easy angle to practice after surgery.
Later on, as the angle increases, you can use the “kneeling” method to let your hips press down on the ankle joint.
3.Inward turning
If you are a post-operative patient with external ankle ligament injury, it is not recommended to practice inversion in the early stage, but usually in the post-operative review, when the surgeon thinks that the patient’s inversion activity is limited. In the early stage, you can practice the inversion angle by pulling the inversion with your own hands in the stilted leg position.
If the ankle joint is stiff in the later stage, you can also use the “ankle angle training board” mentioned above to assist the practice, but pay attention to safety.
4.Outward turning
Because the structure of the ankle joint itself can limit the valgus, the angle of normal ankle valgus is not too big, and usually the valgus is limited, mainly in the case of inner ankle injury or fracture.
5.Ice application
In the early stage after the joint mobility exercises, there may be swollen and hot joints, then you need to use the ice pack to apply ice, about 20 minutes each time.
Two, muscle strength
The simplest and easiest way to practice muscle strength in the early stage is to use elastic bands to resist, and to control the strength within the range of your pain tolerance.
All directions need to be practiced, eventually forming a “rice” shape.
For patients with external ankle ligament injuries, the lateral muscle strength should be practiced.
When the later can be fully weight-bearing, you can take the heel lift method to practice calf muscles. In the early stage when the strength is not enough, you can use the side of the foot to assist, and in the future when the strength increases, you can practice with one foot.
After the joint angle and muscle strength are restored, most patients can resume their normal daily life.