♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Howdy, folks.
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.
- Today, we're gonna talk about advanced ankle sprain
exercises for the athlete at home.
- Right, something you can do
if you're a person who's gonna be running,
jumping, spinning, uh gymnastics, volleyball, karate.
Anyways, this'll get you there.
- Before we start, Brad,
- Okay
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- Oh yeah.
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- Yep.
- Well, Bob, let's get on with this.
- I'll move it off to the side.
- I've got to be honest with you, Bob,
we are doing this video not just for, uh,
Everybody, but it is for everyone
who wants to get to that higher level.
- Right.
- They're more athletic, this is for a women,
that, uh, she lives in Bali, which is
like half-way around the world from here.
- Okay.
- And she asked, or her husband asked for me
because I know him from years ago.
He was in Karate, black belt.
- Gotcha.
- Along with me.
And now she's training for her black belt test.
And she needs, uh, she fell out of a tree
and broke one ankle and severely injured both ankles.
And then now she is just a go-getter.
- That's quite a story, Brad.
- It is. Anyways we've got to get to this.
So if you have a sprained ankle
and you're going to be doing activities that require
jumping, twisting, turning, uh and you want
to get to that without, and, uh
maintaining good ankle integrity at your highest level.
- Yeah, these are more advanced.
- Absolutely, you'll see in just a little bit.
- Right.
- So, Cara I hope this is helpful for you.
Good luck.
And I'm sure you're going to do outstanding
because you're a real good.
- She's a real good athlete.
- She understands her body very well,
she's a yoga instructor.
- Gotcha.
- And she's very, very fit and athletic.
So, now to do this, let's say you've already
injured your ankle and you rehabbed,
you're at the point where you can walk,
there's no pain with it.
- Right.
- You could maybe even start to jog a little bit, but,
anytime you start to do some twisting motions,
some impact activities,
you can tell your ankle is not feeling strong.
- Right.
- There might be some pain associated with it.
- You decreased range of motion.
- Right, exactly, so I'm going to go through
four different training activities,
treatment that you can do. And between these,
I think you will find one, two, or all four of them
that will help you become more agile,
improve your balance, and your strength.
- Gotcha.
- All right, so I'm going to start out with--
- [Bob] I'm not going to do them Brad because...
- Yeah, Bob, is going to talk about it a little bit.
- Well, you can only focus on one person at a time.
- Right, right.
- So, let's focus on that.
- So obviously you need to warm up
and all athletes know that, but,
you know for... I'm just going to give a suggestion.
You do what you want that works good for you.
But at least do some toe-ups and heel-ups.
They just call them rocks.
You know if you need something for balance, go ahead.
- Like a rocking chair.
- Yep. Hold onto the wall, furniture.
I'm going to use this stick here.
And do this enough to get you moving.
- A little bit of range of motion and
a little bit of strength training.
- Yep if you have some other stretching things
that you like to do, that you have been doing.
Please go ahead and do that.
With all of these, the rule is, if any of these exercises
create sharp pain in the ankle, and you know that,
then you need to back off on it.
Don't go so aggressively, give it some time.
It may take, you know, a few weeks to
get into the higher levels. So be patient,
and listen to your body. All right, so, the first thing
I am going to do here is actually the warm up.
This is the first exercise.
- Sure.
- Do this and you should be able to do with your heels
coming up high and back,
and both ankles at hopefully the same range
of motion approximately injured compared to the uninjured.
In cares.
- Right so if you bring it up one, and the other.
the other tends to lag behind.
- Yep, so if I go up like this.
- Right.
- And this toe hardly comes up, uh, you know
we want to work at that to get those even.
Uh, you should be able to do twenty-five
of these evenly without anything.
If you are at that level.
- Over time.
- When it gets, when you can do that twenty-five,
then start going to one foot.
Uh, use the strong leg first and
twenty-five of these, doing them slow like I'm doing.
You'll feel some strengthening going on in those ankles.
And make sure you do that on the injured one as well.
Work that up to twenty-five over time,
You know when you're fatigued, you get pain,
just stop, give it a break.
Wait till the next day for more.
Now the next one, so that's, that's working
in the sagittal plane, Bob.
- Right, right.
- So as therapists we know we are going to work
the lateral movements as well because,
- Right, very important.
- Yeah, because when you're shifting.
Now this is a nice, all these exercises,
you don't need hardly need any equipment,
any equipment at all, which is what the goal was.
- Maybe something to balance you, but nothing else.
- These are called ziggy zaggys,
they're going to work smaller muscles in the ankles
and you just go like this. Now,
depending on the level your ankles are at,
you can do it with your shoes on,
which will be a little more resistance,
a little more difficult.
Or you can do it with your shoes off. Socks or barefoot.
And it depends, if you are on carpet or on hard floor.
That's going to be up to you, you're going
to have to use your own judgment.
But your ankles should fatigue after you do this
for about thirty seconds to a minute.
After a minute for sure you should feel fatigued,
and you'll need a break.
- You're really engaging most of the muscles
in the wrong ankle.
- Exactly, it's interesting because ziggy zaggy.
I don't know how you just came up with that,
but there's a term for Oktoberfest in La Crosse,
which is going on now.
- And they call it zig zaggy?
- Well, no, there's an old German thing,
ziggy zaggy, ziggy zaggy, oi oi oi.
- Really?
- You're German and you don't even know that?
- I know, I don't know that.
- Now, when, let's get back on the program.
When you can do it with two feet,
it's easy going back and forth for thirty seconds
to sixty seconds. Go to one foot.
Do the good one first, and you can see.
- A lot tougher.
- Oh yeah. But this is what you are going to want to get to.
- Sure.
- Yep.
- And you know you are going to be in good shape
once you get beyond that.
- You can set a timer or go back and forth
about five feet, work both legs.
The good one, the sore one.
- You can do it along the counter top.
If you need some support.
- Exactly, yep. So you know, here we'd be doing that.
- Right.
- There you go. Okay, let's go to the third one.
Now impact.
- Sure.
- So you if you're a runner and you're getting into running,
you can start to jog. I'm just going to show you
in the house, without the jogging.
You know just start to see what.
- Right.
- How this goes. If this feels fine,
then I'm going to suggest
putting something down on the floor that is flat,
or you can put a piece of tape down.
- Right, right.
- If you have a floor that has designs on it,
some lines on it, pick out a line.
But we want something we can see and we can jump over.
Okay, so you are just going to go forward and backwards.
And do that for fifteen seconds. Start out slow,
and if it's easy, go a little faster.
As long as there is no pain, you feel stable.
Get rid of the balance,
if you are using a stick or the wall or whatever.
Then we are going to go sideways.
It's critical that you go sideways, and just take your time.
If you do that, ah! Sharp pain when you bounce down,
you're not ready for it.
- Right, you gotta back off.
- Go back to the ziggy zaggys.
- Right.
- So if, if not. Count your, get your clock,
go fifteen seconds. And that's why you don't
want to use something round, like a cane or stick.
- Right, right.
- Because you don't want to stumble.
- It could trip you up.
- Yeah exactly. So eventually you want to get to this,
fifteen second, no pain.
Then, you're definitely going to want to go to one.
- One leg, that should be a challenge.
- Yeah. And always on the good ankle first.
The stronger ankle first, see how it goes.
Count how many jumps you can do in fifteen seconds.
Then the sore ankle. And boy you're going to find out.
- A lot more challenging.
- Yep, and that's normal. Give it some time.
That may take a couple weeks to.
- Sure.
- To work through. Maybe more. Depends on your level.
I'm starting to get tired, Bob.
- I can hear it on your voice.
- (laughing) All right, then next one,
this is our most advanced one,
is we need to work rotation and twisting of the ankle.
So, we can just start. We are going to face this
and we are going to do 180 degrees, and just rotate.
And this is going to be on one,
it's hard to do it on two because your feet get tangled up.
- Right, right.
- And that's not functional when you do activities anyways.
So, on one foot we start here.
Again, have something to hold onto,
stick, chair, wall, whatever.
- Countertop, yeah exactly.
- And then go the other way. 180 degrees if you can make it.
Again, you can start with your shoe off
and work with your socks, it will be easier.
It will slip a little easier, but you want to get back
to a shoe so you do have some resistance.
- Did you invent this one?
- Huh?
- Did you invent this one?
- Yeah.
- Huh, I thought so.
- But it absolutely perfect for someone rotating.
- Right, exactly.
- Particularly Cara in karate because it's the same motion
that you do with spinning kicks.
Okay. Now once you get done with that,
we have to add the jump, so.
- The jump?
- Start this way.
- Oh, the 180 degree jump?
- Jump, whoa! And just take your time,
have something to hold onto.
- Yeah, this is advanced, and this is high level.
- Jump, and jump.
- Sure.
- Yep, and again, no pain. If there's a little pain,
you know use your best judgment.
Usually these type of people, overdo things.
- Right.
- I talked to Cara about this.
She said, "I used to be that way", and now she's--
- She's learned to throttle back?
- Yep, she's learned to control her levels.
Now this is even more advanced is,
we are going to talk about improving the balance.
- Sure, proprioception.
- Yeah so that's proprioception.
So, you're going to look at one spot.
I'm going to look over here at one spot,
and do this when you do the jump in particular.
If you turn your head and look over there
and then if you look over here, it's much harder.
- Right.
- Pick out one spot, so your visual aspect of balance
is helpful and being aided in the way it should be done.
But, I want to talk about vision.
- Sure.
- If you're really feeling pretty good,
and you want to go to the very next level.
Try and do these with your eyes closed.
- Uh, ha-ha-ha.
- But, you have to have someone with you.
- Yeah.
- Or I don't want you getting hurt, so use good judgment.
- Right, we don't want to recreate the ankle sprain.
- So just start out with the twist,
and the twist back, eyes open.
Look at one spot, if you wanna do this one
without looking at one spot, it's harder. You can do that.
But then with your eyes closed, you can see already.
- Yeah this is where you are going to need
somebody to hold you.
- Don't worry, Bob, I'll do it. And it's here.
So you really take your time. It takes the vision out.
- Right.
- That's one part of your balance system,
you still have your vestibular system
and your proprioception system are being taxed even more.
- Taxed to the max.
- Yeah. And I'm not even going to try it,
the jump with my eyes closed. Although,
again, you know, this is high level, people.
- Right.
- This is athletes.
- Young athletes, probably.
- Yeah, yeah we're talking.
- Not 58 year old.
- Well Cara is young.
- She is, is she?
- Yeah, relatively.
- Yeah, compared to us, everybody is.
- Yeah, she's very fit. She's going to do well with this.
So, those are some excellent things
you can do at home, no special equipment.
And it's going to be really fine tune you
for those activities of higher level.
- And look at us two today, we're matchies.
- Oh yeah.
- We're strong like bull.
- Right and this is something that you
want to think about Cara. You think strong like bull.
- Strong like bull.
- When you are training and you are out there.
They did invite me and my wife, to come out.
- Oh, fun.
- And watch a black belt test.
So, it's a very tempting thing. Where we are going to see.
- It's a lot of travel.
- Yep, how things go. It's only half way around the world.
So what the heck, you know?
- Only take you a couple days.
- Yeah they gotta see how the COVID situation
is going by then.
- Gotcha.
- So we'd love to get there.
So very good, be careful.
- Take care.
- In everything that you do.
- Hopefully it works for you.
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