Finally, I made it to “Phase 2” of my rehab, which means I can start progressing into these things:
Goals: Full weight bearing without boot (hurray to wean out of the boot!), using brace with minimal swelling, Full plantar flexion/dorsiflexion ROM
Progress closed chain exercises- weight shifting
Resisted DF/PF- theraband, seated, double leg standing- avoid end range with resistance
Continue AROM EV/INV
Stationary bike, elliptical, treadmill easy walking
Progress hip and core strengthening to closed chain positions, no side/side activities
Progress upper body strengthening in WB positions
My surgeon was a bit skeptical that I wanted to do my own rehabilitation, but especially after I have seen the bills coming in, the idea of paying someone else to do for me what I get paid to do for others seemed a bit ridiculous. There may be some things I need to get some help with at some point, but right now I am working hard on my own. If it were a different body part, it would be a lot harder to care for, but I think I can manage my ankle.
Speaking of surgeon, I finally got to see a few of pictures of the inside of my ankle, I know you were dying to see these as well. Warning: These were pictures taken of his phone, they aren’t the best quality, but still so cool:
So, since I am doing my own rehabilitation, I figured I needed to take some baseline measurements to get me started, now that I can start working into the range of motion (ROM) and strength.
And in full disclosure to keep me accountable, here are my baseline measurements:
Figure 8 girth: L: 47.5cm; R: 46.5cm
Circumference of malleoli: L: 22.8cm R: 21.2cm
Calf Girth (15 cm below knee joint line): L: 33cm, R: 34 cm
AROM: DF (knee bent): L: 4 degrees R: 17 degrees PF: L: 36 degrees R: 72 degrees INV L: 8 degrees R: 32 degrees EV: L: 9 degrees R: 30 degrees
PROM: DF : L: 4 degrees PF: L: 44 degrees
DF lunge test: L: 3 cm, R: 14 cm
Scar mobility: Fair around lateral malleolus, Good in medial port hole.
Gait: Decreased L foot DF with heel strike on L and in stance phase, mild excess in hip flexion on L with swing phase.
Visible edema around lateral malleolus.
If you don’t have a medical background, some of this may be a little gibberish, but that’s OK. For anyone who is interested, I have included a video for objectifying edema in the ankle joint (figure 8 girth and malleolar circumference):
Next, I am going to describe a few exercises and self mobilization techniques to progress ankle ROM and strength:
Standing dorsiflexion mobilization with belt:
Seated self mobilization for dorsiflexion and plantarflexion:
Seated DF/PF, Inv/Ev:
Theraband resisted ankle plantarflexion/dorsiflexion/inversion/eversion:
All of these exercises are not only important for post-op rehab, but can help regain mobility and strength after any ankle injury. I would love to hear from you if you have any questions or comments!