Physical Therapy Haven

Acute Phase: Days 1-3

Goals: Decrease pain and swelling, protect from further injury

• Pain and swelling management (RICE)
• Protection of injured ligaments (taping, splints, casting, walking boot etc.)
• Gait-WBAT

Sub-Acute Phase: 2-4 days to 2 weeks

Goals: Decrease/eliminate pain, increase ROM, decrease swelling, increase strength

• Continue pain and swelling management
• Subtalar and talocrurcal joint mobilizations
• ROM with pain-free range: DF/PF/EV/IV AROM, calf stretching
• Increase weight bearing of affected extremity during gait
• Isometric strengthening

Rehabilitative Phase: 2-6 weeks

Goals: Regain ROM and strength, increase endurance and proprioception

• Continue joint mobilizations and stretching
• Progress to pain-free concentric and eccentric strengthening exercises (both open chain and closed chain)
• Proprioception exercises (balance board, BAPS board, single leg stance etc.)
• Gait training-promote equal weight beraing and weaning of assistive devices
• Endurance activities (stationary biking, swimming, walking, etc.)

Functional Phase: 6 weeks

Goals: Return to full activity and function

• Continue strengthening exercises
• Coordination and agility training-depends on patient's prior level of function, recreational activities, and goals 

Standard of Care: Ankle Sprain. Brigham and Women's Hospital Web site. http://www.brighamandwomens.org/patients_visitors/pcs/rehabilitationservices/physical%20therapy%20standards%20of%20care%20and%20protocols/ankle-%20ankle%20sprain.pdf