脚踝扭伤的康复性训练

jacky

An ankle sprain is one of the most a common sports injuries. An ankle sprain occurs when the ligaments surrounding the ankle joint are stretched or torn as the ankle joint and foot is turned, twisted or forced beyond it's normal range of motion. The most common cause of an ankle sprain in athletes is a missed step or a missed landing from a jump or fall. Ankle sprains vary in severity and are classified by the degree of severity.

• Grade I - Stretch and/or minor tear of the ligament without laxity (loosening)
• Grade II - Tear of ligament plus some laxity
• Grade III - Complete tear of the affected ligament (very loose)
  

Immediate Treatment of Ankle InjuriesFor immediate relief, follow the R.I.C.E. treatment plan. Rest, Ice, Compression and elevation are the best immediate treatment for all soft tissue injuries, muscle pulls and strains.Ankle Rehab Step One - Assess Joint AlignmentAfter an ankle injury, the ankle joint should be assessed for misalignment or structural defects caused by the sprain. A physician will generally check the joint alignment and test for weakness or deficits in soft tissues (tendons, ligaments, and cartilage). If there are any deficits in these areas, your injury most likely will require taping, bracing or, in severe sprains, surgery. If a fracture or dislocation is suspected, an MRI or an X-Ray will confirm the diagnosis and determine the most appropriate treatment.Ankle Rehab Step Two - Assess Joint StabilityOnce joint alignment is corrected, joint stability is addressed. Specific exercises are prescribed to help restore ankle stability and function. These exercises are progressive and generally prescribed for each of the following areas:

• Range of Motion | Flexibility Exercises
• Balance | Proprioception Exercises
• Progressive Strength Exercises
• Progressive Endurance Exercises
• Agility | Plyometric Exercises
  

Ankle Rehab Step Three - Ankle Sprain Rehab ExercisesThe following exercises can be used to rehab a Grade I ankle sprain. If your sprain is more severe, you should follow the plan prescribed by your physician and physical therapist. You should always work with your own physical therapist to design the best program for your specific injury and your limitations.Ankle Flexibility ExercisesAs soon as you can tolerate movement in the ankle joint and swelling is controlled, you can begin gentle stretching and range of motion exercises of the ankle joint.

• Towel Stretch
• Standing Calf Stretch
• Standing Achilles | Soleus Stretch
  

Ankle Range of Motion Exercises

• Toe Circles
  Move your ankle through it's entire range of motion (up and down, in and out, and in circles). Move only the ankle and not the leg.
• Alphabet Exercise
  With your leg extended, try to write the alphabet in the air with your toes.
  

Ankle Strengthening ExercisesOnce you have good range of motion, joint swelling is controlled and pain is managed, you may begin strengthening exercises.

• Step Ups
  Begin one a short step and slowly step up in a controlled manner while focusing on contracting the muscles of the foot, ankle and leg. Turn around and slowly step down in the same manner. Repeat 20 times several times per day.
• Towel Curls
  While seated and bare foot, place a small towel on a smooth surface in front of you. Grab the towel with your toes. Keep you heel on the ground and curl your toes to scrunch the towel as you bring it toward you. Let go and repeat until you've moved the towel to you. Repeat the action in reverse to push the towel away from you.
• Isometric Exercises
  Gently push against an immovable object in four directions of ankle movement -- up, down, inward, outward. Hold 5 seconds and repeat 10 times, several times a day.
• Tubing Exercises
  Use elastic tubing to create gentle resistance as you move through a full range of motion. Wrap the elastic band around the ball of the injured foot and resist the band as you move your ankle up, down, inward and outward. These exercises incorporate the four movements of the foot: inversion, eversion, plantar flexion and dorsiflexion. Perform 3 sets of 15 repetitions for each movement.
• Toe Raises
  Stand with your heel over the edge of a step. Raise up on the ball of your foot, hold for 3 seconds and slowly lower your heel to the start position. Repeat 20 repetitions several times a day.
• Heel and Toe Walking
  Walk on your toes for 30 seconds. Switch and walk on your heels for 30 seconds. Build up to one minute on toes and heel alternate for 5 to 10 minutes. Perform several times per day.
  

Ankle Balance | Proprioception ExercisesAfter you are able to place your full weight on the injured ankle without pain, you may begin proprioceptive training to regain balance and control of the ankle joint.

• One-leg Balance
  Try to stand on one leg for 10 to 30 seconds. Increase the intensity by doing this with your eyes closed.
• One-leg Squat
• Balance Board Ball Toss
  While balancing on a wobble board, balance board, or Bosu Ball, catch and toss a small (5 pound) medicine ball with a partner.
• Balance Board with Half-squats
  While balancing on a wobble board, perform 10 slow, controlled half-squats.
• Step up onto Balance Board
  Place a balance board (or soft pillow or foam pad) 6 to 8 inches higher than your starting point. Step up 10 times.
• Step down onto Balance Board
  Place a balance board (or soft pillow or foam pad) 6 to 8 inches lower than your starting point. Step down 10 times.
• One-Leg Squat and Reach
  

Ankle Agility | Plyometric Exercises

• Lateral Step Up and Down
  Step up to a step of bench, sideways and then step down sideways.
• Plyometric Exercises:
  • Single Leg Hops
    Hop forward and concentrate on "sticking" the landing.
  • Single Leg Spot Jumps
    Hop from spot to spot on floor.
  • Reactive Spot Jumps
    Place numbered pieces of tape on floor and as a partner calls out a number, hop to that number.
    
• Sports-specific Skills and Drills
  Sports-specific drills can be added as long as return to sports guidelines are followed.
  

Sources:

Anderson, Marcia K., et al. Sports Injury Management. Baltimore: Lippincott Williams and Wilkins, 2002.

Garrick, James MD. Managing Ankle Sprains: Keys to preserving motion and strength. The Physician and Sportsmedicine, March, 1997.

Michael Wolfe M.D., Management of Ankle Sprains. American Academy of Family Physicians. January, 2001.

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