This protocol provides you with general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement. Specific changes in the program will be made by the physician as appropriate for the individual patient.
****Please fax initial assessment and subsequent progress notes directly to IBJI at 847-234-2090***
REMEMBER: It can take up to a year to make a full recovery, and it is not unusual to have intermittent pains and aches during that time! Swelling may be on-going for 6 months following surgery.
FOR PATIENTS
Recovery at a glance:
- No casting during recovery
- Non-weight bearing 4 weeks in a boot, followed by 2 weeks of protected weight bearing in a boot.
- At 6 weeks progression to regular shoe wear
- At 8 weeks progression to sports specific strengthening and return to
activity as tolerated
FOR PHYSICAL THERAPISTS
Detailed recovery / rehabilitation protocol:
Phase I: Week 1-2
Goals
- Control pain and swelling
- ADL (activities of daily living)
- Non weight bearing crutches /knee-walker
Guidelines
- NWB (non weightbearing)
- Elevate to control swelling
- AROM hip and knee
- Sutures removed 14 days
Phase II: Week 4-6
Goals
- Normal gait
- Strength motion restoration
Guidelines
- Progressive wt bearing in boot or regular shoe based upon surgeon recommendation
- Strengthening and ROM ankle
Phase III: Week 6-10
Goals
- Full ROM (range of motion)
- Full strength and endurance
- Good proprioception
Guidelines
- Wean from boot as tolerated
- Massage for edema
- AROM (active range of motion) and PROM (passive) in all directions:
- Gait retraining
Manual mobilization if required - Progress to WB exercises
- Single heel rises
- Proprioception retraining
- Dynamic training: hopping skipping running
- Progress to plyometrics
Phase IV: Week 10 +
Goals
- Return to work +/or activity
Guidelines
- Full activity as tolerated
- Work or sport specific retraining
