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Ankle Arthroscopy/Debridement - Physical Therapy Protocol

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Preoperative Guidelines

  • Restore full ankle AROM
  • Teach normal heel-toe gait
  • Strengthen involved extremity
  • Explain importance of PRICE
  • Educate patient on post-op protocol, use of crutches (level surfaces and stairs)

Note: Exercise prescription is dependent upon the tissue healing process and individual functional readiness in all stages. If any concerns or complications arise regarding the progress of any patient, physical therapy will contact the orthopedist.

Phase I (Post-op Days 1 – 7)

  • Crutches – WBAT (Unless otherwise specified by Ortho)
  • Stationary bike as tolerated
  • Ankle ROM all planes: alphabet, rotations, ankle pumping
  • Calf stretching
  • Ankle isometrics…progress to light Theraband
  • Towel crunches/marble pick-ups
  • Weight shifting
  • Seated BAPS
  • Ice as needed, keep elevated


Goals – Pain and edema controlled, Independent crutch ambulation level and stairs


Phase II (Weeks 2 – 4)

  • Crutches – WBAT (D/C when gait is WNL)
  • Mini-squats as tolerated
  • Continue stretching and ROM
  • Elliptical, Stairmaster
  • Treadmill…walking progression
  • Increase ankle Theraband resistance INV and EVER and DF
  • Double heel raises…progress to single leg
  • Single leg bridging (and then go into PF and hold position)
  • Single leg balance activities as tolerated, Plyoback, Body Blade
  • Fitter, rocker board
  • Standing Well-leg Theraband
  • Double leg BAPS board…progress to single leg
  • Teach scope site massage when healed
  • Pool therapy
  • Ice as needed


Goals: Normal heel-toe gait x 2 miles without pain or increased edema, full ankle ROM


Phase III (when Phase II goals met)

  • Continue appropriate previous exercises
  • Progress BAPS with larger ball and add resistance
  • Lateral step-downs
  • Gym Program
  • Walk to Jog progression
  • Agility drills/shuffles/figure 8s
  • Plyometrics…start with bilateral, then progress as tolerated


Goals – Jog 2 miles without increase in pain or edema

 

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