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Timing
> Grade 1 sprain: 2-4 days
> Grade 2 sprain: 3-5 days
> Grade 3 sprain: 4-8 days
Main goals:
> Decrease pain
> Increase circulation/decrease swelling
> Increase pain-free ROM
> Strengthening exercises
> Improve neuromuscular control (proprioception)
> Stretching
> Progressive weight-bearing
Decrease pain
> Ice
> Electro Therapy
> Ultrasound
Increase circulation/decrease swelling
> Ankle pump
> Compression
> Hot/Cold contrast baths
> Lymphopress
Increase pain-free ROM within limits of pain:
Passive mobilisation
> Talo crural joint
> Sub talar joint
> Proximal and distal tibiofibular joint
> Foot
Autopassive
> Towel
Active joint mobilisation
> Dorsi-flexion/Plantar-flexion
> Eversion
> Foot circles
> Alphabet
Strengthening exercises
> Isometric in pain-free range/eversion+++
> Toe curl with towel (weight on towel to increase
resistance)
> Pick up objects with toes (tissues, marble)
Improve neuromuscular controle (proprioception)
Progress from 2 legs to one leg and from closed eyes to
open eyes
Mat
> Wobble board
> Ankle disc
> Trampoline
> Biodex balance system
Stretching
> Passive ROM only dorsi flexion and plantar
flexion in pain free-range
> NO: inversion
> Achilles tendon
Weight-bearing
> Progress weight bearing as symptoms permit
> Partial weight-bearing to full weight-bearing if no
signs of antalgic gait are present
Hydrotherapy
> Stretching
> Active mobilization
> Improve gait pattern
> Proprioception
Criteria to progress to the next phase
> Full active ROM
> Minimum or no swelling
> Normal gait pattern
> Adequate proprioception on a stable surface
Single leg stand 30sec
Proprioception
Standing toes
Trampoline
Single leg balance activities
Criteria to progress to the next phase
Full passive ROM
Full strength
Normal biomechanics
Normal muscle length
Good dynamic proprioception
Prevention
Proper shoes
Decent warming up
Decent stretching
Flat surface Prevention
Taping
Consider orthotics if necessary