Phase I- Maximum Protection (Weeks 0 to 6)
- Cast or boot for 6 weeks
- Elevate the ankle above the heart
- Non-weight bearing x 6 weeks
- Multi-plane hip strengthening
- Core and upper extremity strengthening
Phase II- Range of Motion and Early strengthening (Weeks 6 to 12)
- Partial weight bearing based on healing and physician instruction
- Orthotic insert to support arch
- Active ankle ROM all planes
- Isometric and early isotonic ankle
- Foot intrinsic strengthening
Phase III- Progressive Strengthening (3 to 6 months)
- Restoration of full range of motion all planes
- Gradually wean out of boot and progress to full weight bearing
- Normalize gait mechanics
- Advance ankle and foot intrinsic strengthening
- Proprioception training
- Gradual progression to non-impact cardio-vascular and fitness activities
