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Dear James,
Rehabilitation of the ankle includes: warm-up, strengthening and probably the most important is regaining propioception/balance through use of tilt board
There are four basic motions of the ankle joint. These are:
Plantar Flexion:
pointing toes down
Dorsi Flexion:
pulling toes upward off the ground
Inversion:
point toes inward
Eversion:
point toes outward
Ankle sprains often occur when there is excessive inversion or pointing the toes inward too much
Start you ankle strengthening program with a warm-up by performing a circular motion of your foot in clockwise and counterwise direction for 3 minutes. Then start exercise program
Ankle Plantarflexion Exercise
1)Stand in front of a table or chair
2)Place your hands on the table/chair for balance
3)Raise yourself up on the tips of your toes
4)Remain on your toes for six seconds
5)Slowly return to standing position
6)Repeat 10 times
Ankle Dorsiflexion Exercise
1)Stand in front of a table or chair
2)Place your hands on the table/chair for balance
3)Rock back on your heals lifting your toes off the floor
4)Remain on your heals for six seconds
5)Slowly return to standing position
6)Repeat 10 times
Ankle Inversion and Eversion Exercise
1)Sit up straight with your back against a wall and your feet out in front of you with your knees straight
2)Slowly turn your left foot inward and hold this position for six seconds
3)Now turn your foot slowly outward and hold for another six seconds
4)Repeat this exercise 10 times
5)Repeat steps 1-4 with the right foot
For added difficulty use theraband (elastic band) to provide resistance
Other advanced ankle strengthening exercises include
1. Jump rope
2. hacky sack and dance.
Tilt Board for propioception and balance
Sincerely,
Dr. Donovan
Dear Gratis TV,
Part 2 regarding painful Achilles tendon. Pain is a blessing. Get evaluated by Podiatrist to rule out any tears of the Achilles tendon. Podiatrst may recommend an MRI. In the interim remember PRICE = Protect, Rest, Ice, Compress, Elevate. PRICE is initiated to:
Minimize initial injury
Decrease pain and swelling
Prevent further tissue damage
Other recommendations: Heel Lift/Orthotics to shorten distance of Achilles tendon insertion and eliminate pathomechanics.
Caution on:
use of Quinilone Antibiotics such as Ciprofloxacin which has been associated with Achilles tendon rupture
Steroid injection into tendon which can cause a rupture of Achilles tendon.
Wishing you good health,
Dr. Donovan
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