Rehabilitation of Foot and
Ankle Injuries
One of the most important aspects of foot and ankle injuries
is the rehabilitation of those injuries, and a return to normal activity. This is often done through strengthening,
stretching, and balance exercises. When
combined, these three things can be a powerful means of rehabilitation and the
return to previous mobility.
As an example of how these activities work, let’s look at a
typical ankle fracture that was repaired surgically, and is now being treated
in a rehabilitation center by physical therapy.
For a patient coming in after surgery, the first thing that must be done
is a thorough evaluation of the patient’s current level of mobility, strength,
and balance.
The patient’s mobility is assessed by measuring active
movement and passive movement. Active
movement is the patient’s ability to move their ankle on their own. Passive movement will involve the physical
therapist or the treating physician moving the ankle joint through its normal
range of motion with the patient
relaxed. The patient may experience some
pain with these mtoins, and it is important to let the treating practitioner
know of this pain. If the range of
motion is limited, this will be an area to focus during rehabilitation.
Stretching is the only way to increase the amount of
movement at a joint such as the ankle.
For ankle fractures, calf stretches are used to increase this
motion. However, stretching can be
painful at the beginning of rehabilitation.
During this early period, range of motion exercises may be used instead
in order to maintain the current amount of movement available at the
joint. This may involve the patient
actively moving their foot up and down slowly, in a pain free range. This is opposed to stretching, which is a
prolonged hold at the end of the range of motion.
Strength will also be assessed in the rehabilitation of an
ankle fracture. This is done by the
practitioner applying pressure at the foot and asking the patient to hold and
maintain their foot in the correct position while the practitioner pushes in
the opposite direction. If the patient
is unable to perform this activity, it is seen as a deficit in strength.
To strengthen the muscle groups involved, various exercises
may be used. In physical therapy, this
will often involve the use of resistance bands or manual pressure from the
therapist.
Balance is assessed by asking the patient to stand on one
leg and measuring how long they can stand like that. This may be very difficult for paitients with
a history of an ankle fracture. It also
may be assessed with the eyes closed or by having the patient stand or walk on
an uneven surface. Balance is only
assessed in the beginning in the clinic for safety reasons.
Balance training exercises include the use of a balance
board or wobble board, which forces the patient to balance on an uneven
surface. The ankle plays a critical role
in balance, so restoring this function is a priority. Increasing one’s balance after an ankle
injury can also help prevent a future ankle injury.
Later in rehab, the physical therapist will progress the
patient to their previous activity level, whether that is walking, running,
climbing stairs, or returning to sports.
The physical therapist, therefore, plays an important role in the
rehabilitation of foot and ankle injuries.
Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
www.FLFootandAnkle.com
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