Phase 2 Post Op Ankle Rehab

Finally, I made it to “Phase 2” of my rehab, which means I can start progressing into these things:

5-8 weeks:

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

Scar mobilizations

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:

This is a picture of the tear in the peroneus brevis tendon
And this is what it looked like after he stitched it up

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

Ankle ROM:

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!

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