The Chrisman-Snook procedure uses the peroneus brevis to replace severely damaged lateral ligaments of your ankle---the anterior talofibular ligament and the calcaneofibular ligament. These ligaments are usually injured as a result of repeated ankle sprains and ankle instability. After Chrisman-Snook surgery, your ankle is immobilized up to six weeks, at which point rehabilitation will begin.
Active Ankle Range of Motion
Your physician or physical therapist will instruct you to "write" the letters of the alphabet with your toes in the air. The alphabet exercise does not require any equipment and can be performed anywhere. This exercise should be done first as the warm-up to your ankle rehabilitation protocol.
Calf Raise
This exercise strengthens the ankle joint because it is a weight-bearing exercise and the ankle joint moves from neutral to plantarflexion. Early on in your rehabilitation it may be necessary to hold onto a chair or table for support. Slowly lift your heels off the ground and lower yourself slowly, taking care not to roll the ankle out. As you gain strength during rehabilitation, progress to performing this exercise only on the involved side.
Balance
When a joint has been injured, balance is affected. Perform single leg balances on the involved side to improve proprioception of the joint. Start by trying to hold your balance for 10 seconds and work your way up to 30 seconds. Your physical therapist or athletic trainer will progress you to more challenging balance exercises using wobble boards or foam pads as your balance improves.
Ankle Inversion
The repair done during the Chrisman-Snook procedure helps to stabilize the ankle joint and limit lateral instability. Ankle inversion mimics the mechanism of injury. Begin first by turning your foot in. Ten weeks or more after surgery, inversion can be done with light resistance. Using light level resistance tubing or Theraband, wrap it around the involved foot. Pull the band around the edge of a table at the desired resistance to perform the exercise.
References
- "Rehabilitation Techniques in Sports Medicine"; Third Edition; William E. Prentice; 1999
- Chrisman-Snook Procedure Protocol
- "Treatment for acute tears of the lateral ligaments of the ankle."; P Kannus and P Renstrom; Journal of Bone and Joint Surgery; 1991
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