A CHOP sports medicine physical therapist and a patient demonstrate the second phase in a home program to rehabilitate your foot or ankle following an injury.
Ankle Rehabilitation: Phase 2
Heather Stewart, PT, DPT, SCS: My name's Heather, and I’m a physical therapist in CHOP's Sports Medicine. This home program is designed to help you get started to rehabilitate your foot or ankle following an injury. If you have been prescribed physical therapy by your physician, these exercises are not intended to replace formal physical therapy.
Quinn: My name is Quinn, and I’m rehabbing here at CHOP's Sports Medicine because I fractured my ankle playing basketball.
Heather Stewart, PT, DPT, SCS: The first exercise is called the inchworm. It is a dynamic stretch that focuses on helping increase the flexibility in your calf and legs. Begin with your feet together. Keeping your leg straight, you reach down towards the floor. When you can’t reach down anymore, walk your hands out into a pushup position. Keeping your hands still and your knees straight, slowly walk your feet back up towards your hands.
Quinn: You know you’re doing it right if you feel a stretch in the back of your legs.
Heather Stewart, PT, DPT, SCS: Now, walk your hands back out to the original pushup position and repeat this five times. We are now going to begin the strength section of phase II. Completing these exercises with good form is very important. Go slow and controlled to get better results.
The first exercise is squat to a heel raise. Start with your feet shoulder width apart and make sure your feet are pointing straight ahead and not out. Bend your knees and sit back like you were going to sit down in a chair. Your weight should be shifted back toward your heels. And when you squat, make sure you keep your chest up. Straighten your knees to get back to the starting position.
Quinn: Holding my arms out front helps me keep my balance.
Heather Stewart, PT, DPT, SCS: Now, raise up on the balls of your feet nice and slow and lower back down. Continue to repeat squat to a heel raise for three sets of 10. It’s important that your knees and feet stay straight ahead, and that you remember to raise all the way up on the balls of your feet.
Quinn: If you want to make this harder, try holding a ball.
Heather Stewart, PT, DPT, SCS: Now, Quinn is going to do what we call an eccentric calf raise. Start by standing with your feet shoulder width apart. Now, you’re to raise up on the balls of your feet. At the very top, lift up your good leg and slowly lower the heel down on your injured side. Up with both legs and slow down with one. You should do 15 of these for three sets. If you lose your balance, try hanging on to something with one hand. Once these start to get easy, try single leg calf raises.
Stand on your injured leg Raise the heel off the floor so that you are on the ball of your foot. Slowly lower the heel back to the floor. Do 15 of these for three sets.
The next two exercises are going to work the muscles of your lower legs and your hips. The first one is called lateral toe walking. Step into your TheraBand with both of your legs and place the band slightly above your knees. Standing sideways, you are going to raise up onto the balls of your feet. Start with your feet shoulder width apart. While staying up on the balls of your feet, take a step out sideways and then step back to the starting position. Make sure your feet are shoulder width apart. Take 15 steps to the right and then 15 steps to the left.
Quinn: When I do this exercise, I feel the burn in my hip and my calf.
Heather Stewart, PT, DPT, SCS: The next one is called lateral heel walking. Keep your band above the knees and begin with feet shoulder width apart. Lift your toes off of the ground so that you are standing on your heels. While staying on your heels, take a step out to the side and back to the starting position. Take 15 steps to the right and 15 steps to the left. Your toes should stay off the ground the entire time.
Quinn: For this exercise, I feel the burn in my hip and my shin.
Heather Stewart, PT, DPT, SCS: The next strength exercise is called the forward lunge. Take one big step out, now bring your back knee down towards the ground and return to the starting position. As you’re doing this, make sure your front knee is not caving in, but pointed straight ahead. Your front thigh should be parallel with the ground, and your front knee should not be over your toes. Your toes should be facing forward, and your knee should not be collapsing in. Return to your starting position and repeat with the opposite leg in front. Complete 10 lunges on each side and repeat that twice.
The next exercise is called a side lunge. Start with your feet together, and you’re going to take a big step out towards the side on your injured leg. Then sit back over your injured leg like you were sitting in a chair, while your good leg stays straight. Using your injured leg, push back up to the start position.
Quinn: Doing this exercise, your toes and knees should be pointing straight ahead.
Heather Stewart, PT, DPT, SCS: Complete this exercise in one motion and do three sets of 10.
This next section is called plyometrics, or jumping. Quinn is starting with a double leg jump, which he will do in a few different directions. Start with your feet shoulder width apart and your knees slightly bent. Now, hop forwards and backwards over an imaginary line on the floor. Make sure it’s a soft landing, and don’t let those feet turn out. Make sure your feet are even with each other, so one foot doesn’t not come in front of the other, and don’t let your knees turn inwards. Perform this jump 20 times.
Now, you are gong to jump side to side. Don’t forget to use good form, and watch your knees to make sure they stay inline with your hips and ankles. Repeat the side to side, jumping 20 times.
Quinn: Now, it gets harder.
Heather Stewart, PT, DPT, SCS: As double leg jumping gets easier, you can progress to single leg jumping. Start by standing on your injured leg in a squat position. Hop forwards and then backwards over a short distance like you were jumping back and forth over an imaginary line. As you jump, land on the bent knee and make sure your leg is not caving in or out.
Quinn: And to make this harder, I'm gonna jump side to side.
Heather Stewart, PT, DPT, SCS: Again, watch your knee and ankle making sure that it stays straight inline with the rest of your leg. Make sure you keep a good squat position every time you jump. Try to complete two sets of 10 repetitions for this exercise.
This exercise is called the Y balance. It is a dynamic activity that requires strength, flexibility, and your body's ability to know where it is in space. You are going to place three objects on the ground, one in front of you, one behind you to the right, and one behind you to the left. Start by standing in the middle of the three objects on your injured leg while keeping your hands on your hips. Make sure you keep the weight on your injured leg. Bend the knee of the leg you were standing on and reach your good leg towards the object. Reach out as far as you can without touching that foot to the ground.
When you cannot reach anymore, return to the straight knee position. Repeat this reach to the objects behind you to the right and behind you to the left. Reaching to all three objects counts as one repetition. We are going to complete this activity five times.
Quinn: Once this gets easy, you can make this more challenging by standing on a pillow.
Topics Covered: Sports Medicine Physical Therapy