Phase I- Maximum Protection (Weeks 0 to 8)
- Cast or boot for 8 weeks
- Elevate the ankle above the heart
- Non-weight bearing x 8 weeks
- Multi-plane hip strengthening
- Core and upper extremity strengthening
Phase II- Range of Motion and Early strengthening (Weeks 8 to 12)
- Partial weight bearing based on healing and physician instruction
- Passive and active ROM all planes
- Isometric progressing to isotonic dorsi/plantarflexion
- Hip, quadriceps and hamstring strengthening
- Foot intrinsic strengthening
- Orthotic Arch Support
Phase III- Progressive Strengthening (3 to 6 months)
- Gradually wean out of boot and progress to full weight bearing
- Restore full ROM all planes
- Normalize gait mechanics
- Progressive strengthening all planes
- Closed chain bilateral progressing to unilateral strengthening
- Proprioception training
- Gradual progression to non-impact cardio-vascular and fitness activities
