♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks. I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together, we're the most famous physical
therapists on the internet.
- In our opinion, of course. Bob.
- Today, we're going to talking about five exercises
to rehab a sprained ankle for good.
Yeah, it's as opposed to being for bad?
(Brad chuckles)
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- Right, and real experts.
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(Bob chuckles)
- Anyways, let's get to the ankle sprain.
Ankle sprain, Bob. The most commonly injured joint across-
- Yeah, in the US - In society
in the Unite States, probably worldwide.
I don't know. We didn't get that stat.
- I was surprised, I think a lot of people
don't even go into the doctor, so it's probably
a lot higher than you think.
- Exactly. And you know, this whole routine,
these five exercises, if it's not a bad ankle sprain,
you can use this and you'll rehab yourself
and you should be just fine, but pay attention
very closely to what we say.
First thing you want to do after you sprain your ankle,
and let's say, if you cannot walk on it, cause it hurts you.
And you don't think you need to see the doctor.
The first thing you want to do is range of motion.
So we call these the ABCs. Pretend on your toe right there,
there's a piece of chalk and there's a chalkboard there.
Younger people probably don't
even know what a chalkboard is anymore.
- They probably don't.
- And you're going to make the letter A-
- There's a stylus on end.
- A stylus, What's that?
- That's for a computer.
- Oh, that's right.
So you're going to make a capital A, make the cross.
And the reason we use letters, capital letters,
is because it forces your ankle to move larger motion.
And you're doing all the planes of the ankle,
the joint planes of the ankle. In other words, the motions.
I'm at C, and sometimes when you start,
by the time you get to D or F or E or whatever,
your ankle is starting to get sore,
it's tired, and then you quit.
Then the next day you do it again or later on in the day
and you can find out, oh, I was at F I was tired.
Now I can go up to M and you can use
a alphabet to
calculate your progress. - Calculate your progress
- Right.
- And once you can, you know, get through that
and it's feeling pretty good,
and you can start to walk on it a little bit,
but kind of limping a little, then it's time-
- Good point, Brad. - Oh, sure.
We do have a video on how to tell
one of the things to look for
whether or not you have a fracture in your ankle.
- Sure.
- So that's not the worst thing to do.
Cause sometimes when you can't walk on it,
you need to have an x-ray.
I mean, so not always, but sometimes.
- No. (Brad laughs) Right, yeah.
So if you cannot walk and continue to, Oh,
Yeah, you better get it x-rayed and get it confirmed.
But this is a case where you can walk on it.
It's clear, it's getting better,
but you need to get it better faster.
So the next thing you're going to do
is simply see if you can do toe-ups.
Plantar flexion is probably the primary
strengthening ankle range of motion.
- That means lifting the heels up.
- Yep. At this point, we've got some
other ones that are important too, but right now,
and then you can actually pull back
this way and do a full rock.
Hold on to something for balance if you need to.
And once it gets too easy, you can do 10, 15 of these.
And it's not so bad anymore.
Just go to the sprained ankle and try that.
That will be harder.
- That is harder.
- Yeah. And if you're not sure how strong it really is,
compare it to the good ankle.
And if you could do like 20 on the good side easily
and on the sore one, you're getting about 10
and it's kind of sore, tired, painful, you know,
compare right to left until you get
so they're just about even.
Then the next one. You want to strengthen the lateral
muscles, side-to-side motion,
which is probably more important at this point
than what we just went through.
- And we have a sophisticated name for it
called the ziggy-zaggy.
- Ziggy-zaggy, and you'll see why in a minute, but see,
most 90% of the ankle sprains are inverted
or the way my ankle is rolling this way-
- Turned in like this.
- So we need to strengthen the perineal muscles here.
- And rolling out.
- Yes.
- Like that.
- Right. Get that muscle strong.
And without getting fancy with some
stretch bands or some fancy equipment,
you can simply put your shoes on.
You can do it on a carpet or a floor that gives resistance.
- Well, the carpet gives resistance.
- Yeah. A floor might too, it depends on your shoe,
the sole of your shoe.
- Yeah, right. Exactly.
- But it's amazing how much this works.
Not only your ankles, but your legs and your hips
- Yeah, the legs get tired.
- Yeah. And we want to strengthen not only the ankle,
but all these other muscles,
because it will help in the long run.
- Again, you can't do it if it's painful.
- Exactly. It should be pain free.
When you can go, you know, five feet this way
and five feet back this way,
and it's not so bad anymore, the pain is gone,
then go to just the painful or the sprained ankle.
And you're going to notice that that's a lot harder.
You're going to need something to hold onto.
Hold onto a cupboard, a cane,
the bulliere stick, whatever you have.
- And then you're working on strength and you're actually
working a little bit on your balance and proprioception too,
which is the next one, Brad.
- Right. Yeah. So some of these carry over to the other.
That's why it's a wonderful program, I think.
The next one. Oh, proprioception.
You mentioned that, didn't you?
- Yes I did. (Bob chuckles)
- You were reading it though?
- Yeah, I was.
- We all know what that is as therapists.
So here's my sprained ankle right there.
Look at those socks, they match.
- They match your shoes, Bob.
- You know what you're going to find out, Brad
is this is a good one to test one ankle versus
the other ankle - Right.
- Because you're going to find out
when I see someone who has a chronically sprained ankle
and they try to stand on that one,
- Yeah. They get wobbly.
- Yeah. Alex was a good example. Remember that?
You ever see us?
- Oh yeah.
- He had terrible ankles.
He couldn't stand on one leg.
- What was his last name?
- Coalmyer.
- Oh. (Brad chuckles) Colemyer.
Coalminer. Anyways. - Coalminer.
So you're going to stand on one foot and again,
you can do this on your good leg, first.
We're going to touch out here, touch over here,
touch here- - Now he's got
the stick for balance but you could
use a counter top or anything.
- On your good ankle if you're younger
or had, you know, athletic,
you're probably with your good ankle,
this shouldn't be a problem,
but you will find on your sprained ankle. Whoa.
- Right. That's weird. And that's a good test.
- So you're, you may only reach out here to start out with,
and that's going to be a little challenge.
And as you get better, you go farther as you can.
And then back to without the cane.
And hopefully if that's where you were,
that's where you're going to get to, that's the goal.
- You do look like Fred Astaire.
- Fred Astaire!
- Here we go. (Bob chuckles)
- They might know who Fred Astaire is.
Now the next one, is once you can do that,
we need to get some impact
into it, Bob. - Sure.
- So I'm going to-
- Because you, especially if you want to go back to sports,
We want to make sure your ankle is able
to tolerate like hopping and jumping.
- Right? That's a big difference.
- It is a big difference.
- I'm going to put this down.
This is just a loop strap,
but you can put anything down on the floor, except for,
I wouldn't use something round.
- Well, you could sprain your ankle.
- Yeah, you're going to fall down again.
So something that if you land on it-
- Flat like a yard stick would be perfect.
- Sometimes I'll put tape down
or if you have lines
on the floor - That's probably
the best idea.
- Lines on the floor that are in the floor, you know,
because that's the design of the floor,
but you need something visual.
You're going to hop over like this
and hop back and see how it feels.
If there's no pain in the ankle,
see if you can do it continually.
And you can do that for up to 30 seconds.
If you could do it 30 seconds and your sprained ankle
feels fine, that's good.
Then the next step, is turn side-
- Turn to side to side, right?
- Yeah. And take your time with this.
Just test it, it felt okay.
Well, it hurt a little bit going that way.
Give it a couple of days.
- Yep, exactly.
- Go back to those ziggy-zaggies
and then the balanced one we just did,
then come back to this.
And when it gets to the point that you can do this
for 30 seconds, no pain, excellent.
Then you go on one foot, test it out.
It's okay. No pain.
I feel pretty, whoop, better get this.
And always no pain. It should feel stable.
Then 15 to 30 seconds this way, no pain.
15 to 30 seconds this way, no pain.
You're probably back to walking pretty stable by then.
- So we got the ziggy-zaggies,
what do we call these, the hoppy-hoppies?
- (Brad laughs) The hippity-hops.
- Hippity-hops! I like it!
- Now, there is a test. If you want to do it,
and you want - The jump test.
- To get back to a high level activity.
If you Google Bob and Brad sprain,
this is if you type it in sprained ankle,
when is it safe to return to activities?
I give you a test that you can
actually calculate-
- Right.
- One leg to the other, and that's the one
I use with my patients all the time.
- Yeah, I do too.
- It works very well. I'll go with that video.
If you're just going to be walking around,
you're not doing so high activities
you don't need to do that.
- Yeah. This is for if you try to return to sports and-
- Didn't I say that?
- I think so.
(Brad laughs)
- I like to reinforce things.
- You really should, because I might forget anything.
Sometimes I think I said something,
Sometimes I think I'm somewhere,
I didn't even, like yesterday I didn't know where I was.
- My wife and I get in this argument.
That's our normal argument. It's like you said this.
And I said, no, I didn't.
She said, yes, you did.
- This has got nothing to do with sprained ankles.
Anyways - All right.
This will get you through it all.
It will make your ankle strong forever and be careful.
And remember Bob, we can fix just about anything except
- For a broken heart. - For a broken heart.
- And a broken marriage. (Bob laughs)
- Yeah, and we are working on that.
Is there something you're not telling me?
- No. I'm not telling you.
(both laugh)
- All right - All right.
- Thanks.
(short music)