Jordi Sanchez-Ballester
FRCSEd FRCS Trauma & Orth
Consultant Foot, Ankle & Knee Surgeon
Fairfield Independent Hospital, St Helens
Spire Cheshire
Bone-Surgeon.co.uk
Fairfield Independent Hospital
Crank Rd
St Helens
Merseyside WA11 7RS
01744 739311
Spire Cheshire Hospital
Chris Davies
Fir Tree Close
Warrington WA4 4LU
0845 602 2500
Brostrom Repair
Weeks 0 to 2
Weight Bearing: NWB (non weight bearing) in cast, must use crutches
Therapeutic Exercises:
Strengthening
Quad sets (squeeze thigh muscles tight), 4-way SLR
(four directions straight leg raises: forward, backward, inside, outside),
knee extension (straightening) and flexion (bending) exercises; weight
training may be done if NWB on surgical foot
Conditioning
Stationary bike without using involved foot, UBE (upper body exercise bike)
Cryotherapy (Ice treatments): 6 to 8 times a day for 20 minutes
Weeks 2 to 4
Weight Bearing: NWB in boot, continue with crutches
Therapeutic Exercises
Toe curls/spreads, ankle alphabets, ankle circles clockwise/counter clockwise, gentle towel stretch
Strengthening
Remains same as weeks 0 to 2
Conditioning
Remains same as weeks 0 to 2
Manual Therapy
Soft tissue massage, scar tissue massage
Weeks 4 to 6
Weight Bearing: Partial weight bearing in boot, progress to full weight bearing in boot, continue with crutches as needed
Therapeutic Exercises
Toe curls/spreads, ankle alphabets, ankle circles clockwise/counter clockwise, gentle towel stretch
Strengthening
as weeks 0 to 2
Proprioception
Weight shifting
Conditioning
Remains same as weeks 0 to 2, may begin swimming
Manual Therapy
Soft tissue massage, scar tissue massage, joint mobilization
Weeks 6 to 8
Weight Bearing
full weight bearing, no crutches
Therapeutic Exercises
Continue with ankle ROM activities
Strengthening
Unrestricted weight training, closed chain exercises, core strength training
Proprioception
Weight shifting, single leg balance activities
Conditioning
Stationary bike, treadmill, swimming
Manual Therapy
Soft tissue massage, scar tissue massage, joint mobilization
Week 8 to 12
Therapeutic Exercises:
Strengthening
progress strengthening as tolerated
Proprioception
Weight shifting, balance activities
Conditioning
Stationary bike, treadmill, stair climber, elliptical machine, ski machine; begin straight running outside
Weeks 12 to 6 Months
Therapeutic Exercises:
Conditioning
Progress all activities towards returning to sports; include
plyometrics and cutting/agility drills