DJO Managing Ankle Sprains User Guide

DJO Managing Ankle Sprains User Guide

COMMON ANKLE INJURIES

ACUTE ANKLE SPRAIN
An ankle sprain occurs when the foot suddenly twists or rolls and forces the ankle out of its normal position. In addition to pain, you may experience swelling, bruising, and additional discomfort when you try to put weight on your foot.

There are several levels of ankle sprain:

Grade I Sprain (Mild)

• Slight stretching and microscopic tearing of the ligament fibers
• Mild tenderness and swelling around the ankle

Grade II Sprain (Moderate)

• Partial tearing of the ligament
• Moderate tenderness and swelling around the ankle
• When the ankle moves in certain ways, there is an abnormal looseness of the ankle joint

Grade III Sprain (Severe)

• Complete tear of the ligament
• Significant tenderness and swelling around the ankle
• When the ankle moves in certain ways, substantial instability occurs

CHRONIC ANKLE INSTABILITY

Chronic ankle instability is usually caused by multiple ankle sprains.

Symptoms include:

• Pain on the lateral (outer) side of the ankle
• Constant dull ache
• Difficulty walking
• A feeling that the ankle will “give way” (instability)
• Swelling
• Stiffness
• Tenderness

If you have signs or symptoms of an ankle injury, seek medical care right away. In addition to doing a physical exam of your ankle, joint function and range of motion, your doctor may order tests to assess the severity of the injury, including x-rays, an ultrasound exam or an MRI.

MANAGING YOUR ANKLE SPRAIN

Immediately after injury, discontinue activity, elevate your ankle and apply cold therapy to the injured area to help reduce swelling and pain. Don’t try to “tough it out” or limp through the pain, as this may cause more serious problems. An ankle sprain can take from a few days up to several weeks to heal. Treatment depends on the severity of the injury. You can use non- prescription medications like anti-inflammatories to help manage your pain; do not exceed the recommended dosage.

See your doctor if:

• You cannot put any weight on your foot
• The pain is severe, does not improve or becomes worse
• Swelling and tenderness does not improve or becomes worse

For several days following injury, follow the RICE treatment:

Rest
If it’s painful to walk or put weight on your foot, stay off your feet as much as possible. Rest your ankle and use crutches to support your weight if you need to get around.

Ice
Ice your ankle for 48 to 72 hours after injury to help reduce pain and swelling; apply ice or cold therapy for 20 minutes at a time every two to three hours.

Compression
A wrap can be applied around the ankle at the site of the sprain to help decrease swelling.

Elevation
Raise the injured ankle above the level of the heart for at least two to three hours a day, and while you sleep, for the first 24 to 36 hours to help reduce swelling and bruising.

ANKLE SPRAIN TREATMENT PLANS

Most ankle sprains can be treated without surgery.
Even a complete ligament tear can heal without surgical repair if it is immobilized appropriately.

A three-phase program guides treatment to aid all ankle sprains- from mild to severe:

• Phase 1 includes resting, protecting the ankle and reducing the swelling.
• Phase 2 includes restoring range of motion, strength and flexibility.
• Phase 3 includes simple ankle exercises to help strengthen ligaments and muscles while working on range of motion and flexibility. You may gradually return to activities that do not require turning or twisting the ankle. When you are ready, you may be cleared to return to activities that require sharp, sudden turns (cutting activities), such as tennis, basketball, or football – often with the support of a brace.

This three-phase treatment program may take just two weeks for minor sprains, or up to 12 weeks for more severe injuries.

COLD THERAPY TREATMENT

Cold therapy can help manage pain and reduce swelling. Our motorized cold therapy units and compression devices combine the therapeutic benefits of cold with controlled compression.

DonJoy® IceMan® CLEAR3

The IceMan® CLEAR3 cold therapy unit helps reduce pain and swelling, speeding up rehabilitation and recovery. The Ice Man helps provide extended cold therapy to aid in a variety of indications and protocols as directed by a medical professional.

Aircast® Ankle Cryo/Cuff™

Helps reduce ankle swelling and pain with compression and cold therapy. The cuff is anatomically designed to completely fit the ankle, and the detachable cooler allows for uninterrupted treatment.

WARNING! THESE DEVICES CAN BE COLD ENOUGH TO CAUSE SERIOUS INJURY. Please read and understand all warnings and Instructions For Use before using the device. DO NOT use this device without a prescription and direction from a physician. Your prescription must state how long and how often the device should be used and the length of breaks between uses.

BRACING

Whether you play sports or need something for daily wear, an ankle brace can help stabilize the affected ankle and help prevent further injury. Consult your doctor or physical therapist about prescribing these products.

GRADE I

Injury involves only a mild stretch of the ligament.
Patients are usually able to bear weight on the ankle immediately following injury.

GRADE II

Injury involves some ligament tearing and patient generally presents with more significant swelling. They can usually bear some weight.

GRADE III

Injury involves a complete tear of one or more ligaments. Significant swelling and bruising are usually present. The patient will demonstrate clinical as well as functional instability.

CHRONIC ANKLE INSTABILITY (CAI)

Usually caused by multiple ankle sprains. Symptoms include ankle pain, instability, swelling, and weakness.

ACTYFOOT™

TAKE CONTROL OF STABILITY.

The ActyFoot™ ankle support’s modular design allows the user to control the level of ankle stability as required.

Its removable lateral stay offers increased immobilization and protection to aid recovery following injury or for added confidence during activity.

Without the stay, the unique strap system provides sufficient support for sports and daily activities while allowing greater freedom of movement.

Features and Benefits:

• Removable semi-rigid lateral stay
  Helps provide additional support and protection by limiting ankle inversion (lateral twisting). Can be removed as the patient progresses through rehabilitation.

• Cross strap
  Non-elastic diagonal strap further helps to stabilize the ankle and prevent supination of the foot.

• Forefoot strap
  Allows the wearer to adjust the level of compression as required.

• Calf strap
  Adjustable strap with elastic and nonelastic sections provides additional stability to the ankle joint.

• Semi-rigid foot plate
  Enhances control of ankle to help prevent inversion upon landing.

Please consult your healthcare professional prior to use.

SURGICAL TREATMENT

Severe or chronic ankle sprains may require surgery. Surgical options may include:

Arthroscopy
During arthroscopy, your doctor uses a small camera, called an arthroscope, to look inside your ankle joint. Miniature instruments are used to remove any loose fragments of bone or cartilage, or repair parts of the ligament that may be caught in the joint.

Reconstruction
Your doctor may be able to repair the torn ligament with stitches or sutures. In some cases, they will reconstruct the damaged ligament by replacing it with a tissue graft obtained from other ligaments and/or tendons found in the foot and around the ankle.

ANKLE EXERCISES

Exercise is an important part of the recovery process. Your doctor or physical therapist will provide you with specific exercises to help regain strength, flexibility and range of motion.

Immobilize (1st – 7th day)
ActyFoot™ with lateral stay

out the injured leg. You can also stretch out or bend the healthy leg. Slowly flex the injured foot upwards, then slowly stretch it down again. Hold each position for 10 seconds at a time.
Exercise 2| Repetitions| Description
---|---|---
| 3 times daily| Lie on your back and keep the injured foot at a 90° angle. Slowly move the injured leg in the air as if you were riding a bicycle. Do the movement for 15 seconds, pause for about 10 seconds, and repeat the movement in the other direction.

Stabilize (8th – 28th day)
ActyFoot™ with lateral stay

lower legs parallel to one another. Steady yourself by holding onto a sturdy object.
Shift your weight onto your healthy foot.

Bend your knees slightly without getting into a knock-kneed position.
Hold this position for about 3 seconds before straightening up again.

Upwards: Place the injured foot on the step above and slowly bring your entire body weight forward.
Downwards: Place the injured foot on the step below and slowly bring your entire body weight forward and onto the foot, bending your knee as you are doing so. Always hold on tight when you stand on your injured foot!
Exercise 3| Repetitions| Description
---|---|---
| 2 times daily 10 repetitions per side| Sit on the floor and extend your injured leg. Bend your healthy leg toward your torso.
With your toes stretched, statically press the outside of your foot against a sturdy object (e.g. against a wall or a door frame). Then do the same with the inside of the foot. Hold each position for 3 seconds at a time.

Mobilize (from the 29th day onward)
ActyFoot without lateral stay

take a sidestep on a folded towel, so that the affected leg is on slightly unstable ground. Shift your body weight onto the injured leg and squat. Be careful to prevent evasive movements and move slowly. To increase the degree of difficulty, you can turn your head to the side, increase the distance between your legs, close your eyes, choose different surfaces or do the exercise while standing on the tips of your toes.
Exercise 2| Repetitions| Description
---|---|---
| 10 times daily| Place an object that you can grasp with your feet (e.g. a towel) on the floor in front of you. Put your weight on your healthy foot and stand on your leg.
Try to grab the object with the toes of the injured foot, then bend the leg. Now move your leg up and down. You can then change your standing leg and grab the object with your healthy foot.
Exercise 3| Repetitions| Description
---|---|---
| 10 repetitions, 2 times daily| Lie with your back on a mat and bend your feet up with the load on your heel. Push your bottom up, keeping your feet straight.

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Copyright © 2022 DJO, LLC, a subsidiary of Enovis Corporation
MKT-000-00011783-EN – Rev A

Individual results may vary. Neither Enovis, DJO, LLC or any of their subsidiaries dispense medical advice.
The contents of this document do not constitute medical, legal, or any other type of professional advice.
Rather, please consult your healthcare professional for information on the courses of treatment, if any, which may be appropriate for you.

References

• DJO Incorporated - Index

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