Table 3.
The 3 Phases of Intervention Used For a Collegiate Athlete after sustaining 1st MTP Dorsal Dislocation.
| PHASE I | PHASE II | PHASE III |
|---|---|---|
| Early Protection | Activity Progression | Return To Sport |
| Days 1 to 3 | Day 3 to 4 Weeks | Weeks 5 to 6 |
| NWB, short leg walking boot | PWBAT (day 4–8) | Orthotics/shank |
| AROM | Discontinue walking boot (2 wks) | Great Toe Taping |
| Great Toe Flexion and Extension | Orthotics/shank (2 wks) | Gait Training |
| Great Toe Taping | Jogging sagittal plane (limiting extension and abduction) | |
| Ankle Circles | Jogging multiplanar | |
| Ankle Pumps | Agility: | |
| BAPS Board (anterior-posterior, medial-lateral, clockwise and counterclockwise) | Long sit hamstring stretch, kneeling hip flexor stretch, piriformis stretch | - running routes |
| - passing/driving blocks: non-contact. | ||
| Longsit and Standing Gastroc Stretch, Great Toe flexion and extension stretching | ->With sandband-> with sled-> live contact | |
| Towel Toe Crunches | ||
| Marble Toe Pick Ups | ||
| Gait Training | 4 way SLR with cuff weights (ie hip flexion, adduction, extension abduction) | Return to practice non-contact prior to live contact |
| Ultrasound, 2 MHz 8 min, pulsed 50% | ||
| Electrical Stimulation premodulation 15 minutes | Ankle Theraband 4 way | Full Return to Practice |
| Ankle Isolator Exerciser | Electrical Stimulation premodulation 15 minutes as needed. | |
| Contrast Bath (alternating cold/warm whirpool) 15 minutes | SL balance with balance pad | |
| Clamshell | ||
| Step up (forward and sideways) | Cold Pack 20 minutes | |
| Cold Pack 20 minutes | Lunges (clock) | |
| Compression Wrap | Leg press with resistance cords | |
| Leg curl | ||
| Leg extension | ||
| Walking program | ||
| Sidelying leg press (shuttle) | ||
| Hip extension in standing with pulleys | ||
| Forward and lateral step ups | ||
| Heel raises | ||
| Core program (ie bridges on ball with sagittal flexion and oblique curl ups) | ||
| Ultrasound, 2 MHz 8 min, pulsed 50% | ||
| Electrical Stimulation premodulation 15 minutes | ||
| Cold Pack 20 minutes | ||
| Compression Wrap |