October/November 2022 - 37

Injury Rehabilitation
should address increasing function, improving strength
and proprioception, and normalizing gait. During this
phase, therapy should increase in demand and intensity
only as tolerated by the athlete.
This is a key period of recovery as too much activity
will perpetuate chronic ankle pain and tenderness over
the AITFL, and can create a painful cycle of disability.
Close attention needs to be paid daily by the athletic
trainer to limit overuse. Ideally, this is the transition time
to greater function and return to play.
Range of motion exercises should increase beyond
the 30 degrees of safe motion. Resistance training
within a greater ROM can also be increased. Biking may
be added with the seat high to minimize dorsiflexion.
Low-level proprioceptive exercises should be initiated
and progressed as tolerated. Here are some examples of
proprioceptive exercises:
* Weight-bearing: Have the athlete stand on two legs
and progress to weight bearing on the injured side.
* Weight shifts: Have the athlete shift his or her
weight from side to side and front to back.
* Heel-toe walking: Ask the athlete to walk in a
straight line with each step connecting lead heel to
trail toe.
* Balance exercises: Have the athlete start by
balancing on the injured leg, then progress to
bending at the waist while standing on the leg, and
finally progress to balancing on the injured leg with
eyes closed.
* Single-leg hop to balance: Ask the athlete to hop
from non-injured to injured leg, catch, and balance
LONG-TERM CARE
The third and final stage of returning from a HAS
is long-term management. Unfortunately, chronic
disability, pain, dysfunction, and HO are commonly
associated with HAS, and the disability associated
with the injury can range from days to months. Underrecognizing
the injury and perpetuating an athlete's
desire to " push through " the injury will prolong their
recovery and can contribute to chronic disability, so
long-term care is paramount.
Athletes may return to play when they can pass the
single-leg hop test from their toes, cut at high speed
without a noticeable limp, and very importantly, only
when they are mentally ready to return. This can be
determined by their willingness to tackle tougher drills in
their rehab process. Patients will be subject to re-injury
and chronic pain if they are not able to perform these
functional tasks. n
Helix AD-51-01-7 REV 0 - Training and Conditioning - October-November Issue 9-13-22.pdf 1 9/13/22 2:17 PM
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2021 Parker Laboratories, Inc.
AD-51-01-7 REV 0
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October/November 2022

Table of Contents for the Digital Edition of October/November 2022