- Hi, I'm Bob.
- Schrupp.
- Hi, I'm Bob Schrupp, Physical Therapist.
- Brad Heineck, Physical Therapist.
- Together we are the most famous Physical Therapists
on the internet.
- In our opinion of course, Bob.
- I hesitated 'cause I didn't think
she had pushed the record button
but okay, today we're gonna talk,
we're actually gonna show a video on a treatment
of a person who just sprained her ankle
within the last hour,
so we thought this was a great opportunity.
She didn't wanna be shown face wise
so we're not gonna reveal - Right.
- Who it is.
But it's at my house - Okay.
- And first I'm gonna show her walking
and showing the sprain, how bad it is.
And then we're gonna show two treatments,
one treatment you can do on your own.
- Sure.
- And the other treatment, you need a therapist to do.
But they're both really good treatments.
- Are you gonna put a link?
- To what?
- To the video that we.
- Oh yeah, I can put a link to the other,
we just did a video too on the two treatments.
- Right.
- But I do the treatments actually on the patient.
- Sure, oh, excellent.
- And at the end we show her walking again
and that's it, so.
- Successfully?
- Yeah.
- Or wait, wait, watch the video and find out.
- All right, thanks.
Okay, now back.
It's hurting quite a bit apparently.
Okay, so this young lady just sprained her ankle
this morning and this is not a very bad sprain.
You can see there's just a little bit of swelling
around the fibula here.
And I'm assuming that she's gonna be tender right here
and yes she is, she's nodding her head.
Actually I'm gonna take a pen.
You wanna give me a pen, Sarah, real quick?
And what we're seeing here,
this is the anterior talofibular ligament.
So that runs like this.
Oh, can you see that Sarah?
- [Sarah] Um, barely.
- Barely?
It runs like that
and this is the fibula right there, the bone there.
Here comes the cats.
Anyway, so there's a couple things you can try.
First off, she can ice of course and wrap it.
We even have people start doing a little bit
of cross fiber massage, even on this,
just real gentle to start off with,
to get a little bit more blood flowing to there
and help that ligament heal quicker.
But the other thing that is recommended by Mulligan
is to actually, this fibula often gets pushed forward
during the sprain so what we're gonna do
is push it back a little bit.
And this is a very difficult maneuver,
I don't know that the average person can do this,
you're probably gonna need a therapist to do it.
The therapist needs to push it back and also up that way
toward the hip.
So I use the meaty part of my thumb here
and I just go ahead like this and I push like that
and there's a little pain with that.
The patient is wincing a little bit with that.
Quite often if I'm doing it right, the foot kinda moves.
I don't know if you can see that
but it's kinda moving up and down
and that means I'm doing it right.
So you do this for, well,
I like to do it for a couple minutes.
Try to hold on. Is it hurting? You can talk.
- It's good.
- It's good, she said.
So it's feeling a little bit better.
After you've pushed it forward like this,
you actually take some tape
and I like to use an underlying tape first
so that the tape doesn't go up against the skin,
this is a hypoallergenic tape.
And I'm gonna put it right over the fibula
and wrap it around like this
so it's gonna hold the fibula back.
Now this one's not gonna do anything,
this is just protecting the skin.
This is a heavier tape that goes over the underlying tape
and what I do is I put it in place right there
and get it ready and now I take my thumb
and I push the fibula back
and I pull real hard and tape it in place.
And usually what I do is do two pieces right away.
So again, I put it on the fibula and the force
is pushing back and up a little bit
so into this direction here.
That's the direction of the tape
and it's also the direction I'm pushing with my thumb.
Try to relax a little bit.
And I'm pushing, pushing, pushing
and I'll pull like that.
Okay.
Now want you to stop the camera right now.
Okay so now I'm gonna have her walk now,
here comes the cat parade.
All right, come on forward
and as you see, she's barely limping at all,
walk back towards the fireplace again.
Before she was limping quite a bit
and now it feels better I take it?
- Yeah.
- [Bob] Okay good.
One more time toward me.
Good, yeah.
So again, that's the Mulligan technique.
I would highly recommend it.
It also works well with chronic.