Rehabilitation Protocol: Broström Procedure

Phase 1: Protection and Healing (Weeks 0–2)

Goals:

- Protect surgical repair

- Minimize pain and swelling

- Begin tissue healing

Precautions:

- Non-weight bearing (NWB) with crutches

- Immobilized in a posterior splint or cast

Interventions:

- Elevation and ice

- Toe curls and gentle isometric exercises (quad/hamstring sets)

- Gentle active ROM to toes

- Avoid inversion/eversion of the ankle

Phase 2: Early Mobility (Weeks 2–6)

Goals:

- Gradual increase in ROM

- Begin partial weight-bearing

- Continue healing

Precautions:

- Transition to a CAM boot or walking boot

- Still avoid inversion and eversion

Interventions:

- Begin partial weight-bearing as tolerated

- Active ROM exercises (plantarflexion, dorsiflexion, neutral inversion/eversion)

- Light resistance band exercises (except inversion)

- Continue swelling control and scar management

Phase 3: Strengthening and Proprioception (Weeks 6–10)

Goals:

- Normalize gait

- Improve ankle strength and balance

- Restore functional ROM

Precautions:

- Avoid high-impact activity

Interventions:

- Wean off boot into supportive ankle brace

- Begin full weight-bearing in brace

- Strengthening with resistance bands (now including inversion/eversion)

- Proprioceptive training: single-leg stance, balance board, wobble cushion

- Stationary biking or elliptical

Phase 4: Advanced Strengthening and Functional Training (Weeks 10–16)

Goals:

- Restore full strength and proprioception

- Prepare for return to low-level sport

Interventions:

- Agility drills (ladder, cone drills)

- Sport-specific movements (light jogging, cutting drills)

- Plyometric exercises

- Continue proprioception and neuromuscular training

Phase 5: Return to Sport (Months 4–6)

Goals:

- Safe return to sport

- Full functional stability and strength

Criteria to Return:

- Full, pain-free ROM

- 90–100% strength compared to contralateral side

- Negative anterior drawer test

- No swelling after activity

- Completion of a functional test (e.g., hop test)

Interventions:

- Gradual reintroduction of full sport participation

- Ongoing neuromuscular training and injury prevention program

- Continue using ankle brace or taping for sport activities as advised

General Considerations

- Rehabilitation should always be guided by the surgeon and tailored to the individual

- Patient education is key—emphasize adherence to precautions and gradual progress

- Early physical therapy involvement is important for optimal recovery