♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet. ♪
- (claps) Hi, folks, I'm Bob Schrupp, physical therapists.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today, we're gonna talk about
the best ankle rehabilitation home exercise program
for those recovering from ankle injury.
We got four steps.
- That's right, Bob.
And you just take it step by step, and it all works out.
- Take you from injury to healing.
- That's right.
- By the way, if you're new to our channel,
please take a second to subscribe to us.
We provide videos how to stay healthy,
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Also go to bobandbrad.com.
Go to the giveaway section.
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Go to Twitter, Instagram, or Tik Tok
if you want a 60 second version of our program.
We're giving away the Thermotex Far Infrared Heating System.
- That's right, Bob. - And this is beautiful
if you wanna heat up an area,
because it penetrates much deeper than regular heat.
- Yeah, 2.36 inches.
It goes on the back, the hip, the knee, and call-
- Regular heat goes like that,
barely gets through the surface.
- Call before midnight tonight.
(Bob laughs)
I just wanted to say that.
They always used to say that back in the 70s midnight shows.
So getting to the serious side,
we wanna talk about ankle sprains.
One of the reasons is,
and we know this from doing our research and reading,
it's one of the most injured parts of the body
in the United States.
- It probably is the most injured part.
- Estimated 23,000 sprained ankles per day.
- I wonder how they could even estimate that,
'cause so many of them don't go in.
- We know that it's a very common.
Anyways, so we're gonna address it.
It's not that hard to rehabilitate one
if you follow these steps.
The first step-
- Well, let me just say real quick, Brad,
that we're not gonna go over whether or not
you should go see the doctor or not.
We're assuming that you maybe did already,
and that you're fine to go.
- If you cannot walk on it, it's very painful,
you should go get some x-rays.
- We actually had a video on, on how where to push
on the bones to tell.
- It was a technique. - Yeah, this is not
our first walk about with the ankle sprain.
So you've got an ankle sprain.
You know it's not fractured.
Even if it is fractured,
this first phase you do anyways.
So, we're looking at this.
You gotta take your shoe off.
It's probably swollen up.
I'm not gonna take my shoe off, 'cause I'll need it.
Get yourself a cold pack that's flexible,
put it around it, elevate it, lay down on the couch,
put some pillows underneath it, elevate it,
and stay off of it.
Be nice to it for a day or two.
We do have video on how to make your own ice pack.
- That's right, you don't have to go out and buy one,
but you can.
It's easy.
Just a cup of water, four cups.
- Just go Bob and Brad ice pack.
- DIY, do it yourself.
It'll come right up.
So, anyways, do that.
And you can take ibuprofen, some NSAID, if you can.
- If you're allowed medically.
- Sometimes other medications don't allow that.
You're gonna have to take responsibility for that.
No weight bearing.
If it hurts to walk on it, don't walk on it.
Get a cane, a crutch.
You can say you could be partial weight bearing,
possibly two.
You have to determine if you can walk with a cane
and it doesn't hurt, then you should be fine.
- One or two crutches, whatever.
And that phase, it takes a few days to get through.
Once you get to the point,
we're gonna go to step number two.
You could walk on it on the flat surface
if you take your time and it's not too bad.
Then we wanna start getting motion going.
So I want you to pretend.
You do this in a non-weight bearing position
just like Bob and I are.
Pretend there's a piece of chalk on your toe,
and there's a chalkboard right in front of you.
And you're gonna make the letter A, capital letter A,
and then cross it.
Now use your imagination.
I can clearly see the B turning out there,
and I've got red chalk on a blackboard,
so I can see it very good.
- Well, it's reversed from their side.
(both laugh)
- Anyway, you'll find out like the first day
you get up to D, and your ankle starts getting tired.
Well, you stop.
The second day, you might be able to get up to F.
- That's what's nice, so you can
see your progression. - You know where you're going.
So the ABCs works good for two things,
all range of motion,
all planes of range of motion are involved,
and you know how far you got,
so you got some objective progress.
The next thing is you do need to get some kind
of elastic resistive band.
We've used that stretch band that's wide.
It's like a ribbon.
Been using that for 20 some years.
And these large loop bands- - Work better.
- In my mind, hands down.
They're not that expensive, and they really work good.
So the first thing we're gonna do is take this.
You should do it with a shoe on,
because the sole of the shoe grips really well.
Excuse me, Bob
I'm gonna give them a profile.
And you can do it just like this sitting on a couch
or on the floor,
and start working plantar flexion, dorsiflexion.
If you get sharp pain with it when you come all the way up,
don't go that far up.
Just go in the pain-free range to start with,
10 to 15 repetitions, and then give it a break.
Then you take your other foot,
and we're gonna work eversion, which means out.
So can you see them going out, Liz?
Yep.
And you just put your foot there for a post,
and you work that.
Now, if that hurts when you go all the way over,
'cause it starts to irritate the tear,
then you just do mini ones,
and day by day, you'll see it gets stronger, stronger,
less pain, less pain, and do 10 to 15 of those.
- The reason we work eversion is because almost everybody,
a lot of people, sprain their ankle by inversion.
So they're spraining it this way,
so those muscles affected and those ligaments on that side.
So this is the strengthening for it.
- That's the primary exercise.
I believe the stats I heard is around 90% are inversion.
And then the next thing.
Now this is something that a lot of people don't know,
except for therapists is the hip abductor muscle,
this one right here, always gets weak with an ankle sprain.
I don't know if they really understand it,
but we always address it.
And every time I've had an ankle sprain patient,
I check it and it's clearly weak.
So, what you're gonna wanna do is you can do this standing,
hold on to the cupboard or chair.
I'm gonna use the Booyah Stik,
and we're gonna strengthen that.
Obviously it doesn't matter, because I'm not putting weight
to that ankle, and I'm gonna strengthen it
and get that muscle.
- Stay straight up and down, Brad.
- [Brad] You can lie down.
- Actually, it's probably harder lying.
- It is.
- 'Cause you're against more gravity here.
You can just, when wake up in the morning,
roll onto your side and just start doing
some hip abduction this way.
- Yep, and I've always found that people
with a sprained ankle, I have them do this
for less than a week.
And I'll do a manual muscle test,
and it recovers quite quick.
- I mean, that muscle can deteriorate fast,
but it can also recover fast.
- That's good news. - Especially if you're young.
- That's right.
So the next one, now we're into phase three.
We're skipping right through it here.
We're coming right along.
- Now, at this point, you should be able to walk
without crutches or anything.
You feel pretty comfortable.
It's not painful.
It's to the point where you're forgetting about a little bit
until you walk outside on uneven surfaces.
Then all of a sudden it'll tweak a little bit,
and you say, "Ow, I'm not quite there yet."
At that point, you're gonna start doing toe up,
and then make sure you pull back this way.
Toe up, heel up.
Make sure your weight's going through there.
If this gets too easy, you do 10 to 15,
put more weight on the involved ankle.
This would be my sprained one.
Okay, now this next one, I call the ziggy zaggy.
Now. I don't know if I did invent that name or not.
- I think you invented that name. (laughs)
- I've never heard it before.
This is really good for- - The Heineck ziggy zaggy.
(both laugh)
- [Brad] That's another story.
But anyways, this really works the lateral muscles
and the medial muscles.
- [Bob] He's getting some resistance almost.
- [Brad] You have to have your shoes.
- [Bob] Got your shoes on and you're going along the floor,
so you're actually feeling the resistance of the floor.
- [Brad] And make sure you go both directions.
Pick out a distance.
Go five feet.
If you're in your kitchen floor,
and you got something, mark, a design on the floor.
- [Bob] Our mics aren't picking up,
but you can hear them going swish swish.
- We'll put your head down there, Bob.
I don't wanna hear it. (Bob laughs)
I'm just kidding.
You may need a balance stick or a cane
or hold onto a cupboard, whatever you work,
and work that.
You will get tired.
My ankles are healthy, and they're getting tired
after that much. - Funny,
that works pretty good. - Yeah, it does.
Now the other thing is to continue that.
Bob? - Oh, what do you need?
- The loop strap is gone.
I just had it here.
- Oh, I think we're blaming me.
(Brad groans)
You don't have to get a loop strap,
but they really work well.
These are nice wide ones.
They work really good.
Some of them are the latex ones,
then they work fine too. - If you're gonna strengthen
your buttock or hip abductors on a regular basis,
these are well worth it,
because other ones roll up on you.
- [Brad] These are comfortable.
- [Bob] These are comfortable and stay in place.
- And make sure you do both legs
once you get to this point,
'cause even all of that hip, you need to strengthen it
in weight bearing as well as in the air.
So make sure you do both sides at this point in your rehab.
Boy, that's a nice-
- Yeah, you wanna balance out.
- That works really well, Bob.
Now, after you get to that, you can do 10 to 15 of those,
two or three sets.
Ziggy zaggies are easy.
Your toe heels up are easy.
You're going to phase or step number four.
Now you're getting ready to get back to activities.
Not football.
Not tennis where you're really zig zagging quickly,
but you're, you're getting there, almost there.
So we're gonna start out with same one heel toe up,
except only on one leg.
Now you're probably gonna need-
- [Bob] You're gonna need some balance,
or might need a chair.
- Yeah, don't have to have a Booyah Stik.
Use a chair, cupboard or whatever, and work that.
And then you're starting to get some proprioception
and balance into it.
Not so much proprioception yet,
but we got a couple coming. - You're getting some.
- And make sure you do that on the good leg,
do 15, 20 of them,
and then see how hard it is, how much difference
between the good foot and the bad foot.
And that's a good indication
when you're getting close to normal.
Th next thing, same thing, ziggy zaggy, but on one foot.
- You can do this along a countertop, too,
if you need to hang on. - Hold onto your countertop.
Make sure you clear it off.
If someone's baking on there, they got food,
eat as you do it.
I'm just kidding.
But this really is a big difference
between two foot. - Yeah, you're working now.
- So you're gonna work that 'til you get fatigued,
both directions.
And now the single leg balance test
on your good foot.
See if you can go 30 seconds
like this without touching.
You should be able to.
A healthy, normal person can.
Then try it on your injured foot.
And you might be surprised that it's a little bit harder.
- Yeah, you may wobble.
I mean, this is a test we do, usually on an evaluation
once the ankle is doing better.
- 30 seconds.
If you have to touch, that's one touch.
You can count how many times you touch.
You don't have to get that objective with it.
But the next thing you do, and that's easy.
Get a piece of foam.
You can just take something, a cushion off the couch,
or one of the pieces of furniture.
Set it down.
This is what we use.
It's called a Pete's Choice.
They work really good for this.
- Yeah, we use these things for everything.
- I have the same one.
I use it for deer hunting,
sitting out or kneeling in the woods.
I put it on my lawn chair when I'm grilling,
'cause it's nice and warm and soft.
And you can use it for balance.
I don't think they knew all that stuff.
So I'm gonna do the same thing.
Now look at that ankle.
That ankle's really working over time to do this.
- [Bob] Yeah, especially on one foot.
- I'm getting a little fatigued already.
And now the final step.
- This is more advanced.
This is for the younger folks.
- Get a basketball ball, a ball.
On that one foot.
Start to dribble it.
Start bouncing it off the wall.
Bounce sideways with your body sideways, straight forward.
- Now you're having to pay attention to the ball
and ankle has to work.
- Good point.
If that gets too easy, you try and do it on your foam.
- Again, safety first. (laughs)
Safety first.
- Yeah, we don't expect some 70 year old to be doing this.
- I wouldn't even do that one to be honest with you.
(both laugh)
- Yeah, it's one that it's fun to do
when you have as a therapist with athletes.
- All right, Brad, I think we bothered them long enough.
Remember Brad and I can fix just about anything.
- Except for. - A broken heart.
- There you go. - 13 minutes on-
- Just think what the stats are on a broken heart.
If there's 23,000 of these,
how many broken hearts? - Oh there's a lot
of broken hearts today.
Well, see you later. - We'll get there.
(cheerful tone)