中級 足関節・足部 捻挫・挫傷 リハビリテーション

Pain at rest ≤2/10 on VAS scale,ATFL and CFL ligamentous integrity maintained with negative anterior drawer and talar tilt tests,Able to perform ankle alphabet exercises without increased swelling,Weight-bearing as tolerated with assistive device (crutches),No exacerbation of Achilles tendon pain with gentle plantarflexion,Peroneal tendons tolerating isometric eversion without pain

→ 次の段階へ： Week 3 - Early Mobility

Full pain-free ankle ROM in all planes (dorsiflexion ≥15°, plantarflexion ≥45°, inversion ≥30°, eversion ≥15°),No increase in swelling following exercise sessions,Isometric contractions of calf complex (gastrocnemius/soleus) held for 10 seconds without pain,Plantar fascia flexibility improved with passive dorsiflexion of first MTP joint,Peroneal tendon gliding exercises tolerated without tendon subluxation,Single-leg stance ≥10 seconds with minimal compensation

→ 次の段階へ： Week 3 - Strengthening Phase

Dorsiflexion strength ≥4/5 on manual muscle testing,Plantarflexion strength ≥4/5 with resistance bands,Eccentric loading of Achilles tendon initiated at low load (body weight × 0.3) without post-exercise pain,Everter strength (peroneus longus/brevis) ≥3+/5 against manual resistance,Plantar fascia-specific stretching holding 30 seconds × 3 repetitions,Functional gait pattern without visible antalgic compensations

→ 次の段階へ： Week 5 - Progressive Strengthening

Single-leg heel raises completed with ≤25% compensation,Eccentric Achilles loading progressed to body weight × 0.6 without 24-hour soreness,Peroneal tendon strengthening with resisted eversion in multiple angles,Proprioceptive training: balance board eyes closed ≥15 seconds,Plantar fascia tension reduced with rolling massage protocol,Return to normal activities of daily living without pain flare-ups

→ 次の段階へ： Week 5 - Power and Endurance

Double-leg hopping in place 20 repetitions without pain,Eccentric Achilles loading at full body weight,Peroneal tendon endurance: resisted eversion with Theraband × 30 repetitions,Calf endurance: 25 single-leg heel raises,Proprioceptive progression: single-leg stance on unstable surface ≥30 seconds,No pain with sustained Achilles tendon stretch (5 minutes)

→ 次の段階へ： Week 7 - Sport-Specific Training

Single-leg hop for distance ≥90% of contralateral side,Running progression initiated at 50% intensity without increased swelling,Agility drills: ladder, cone drills at 50% speed,Plantar fascia loading during stance phase normalized,Peroneal tendon reaction time improved with perturbation training,Patient-specific functional goals achieved per individualized assessment

→ 次の段階へ： Week 7 - Return to Activity

Full-speed running without Achilles or peroneal tendon discomfort,Cut drills and pivot movements without ankle instability,Return to sport-specific training at 75% intensity,ATFL/CFL ligamentous stress testing negative for instability,No compensatory strategies during single-leg landing tasks,Patient-reported outcome measures showing ≥80% of pre-injury function

→ 次の段階へ： Week 8 - Maintenance and Progression

Full return to sport or activity without restrictions,Single-leg hop test ≥95% of contralateral side,Ankle Outcome Score within normal limits,Independence with home exercise program for Achilles, plantar fascia, and peroneal maintenance,No fear of movement or reinjury anxiety,Strength ratios (eversion:inversion, dorsiflexion:plantarflexion) within 10% of contralateral side