McKayla Paulson Testimonials

• NCAA Division I student athlete
• Defender, Sr. Captain women’s soccer team
• Started and played in 20 games/1723 minutes in 2014

Chronic ankle instability after 2014 injury, resulting in 7 missed games

Unable to return to previous level of play

• Played only 6 games / 540 minutes in 2015
• In 2016, played 1726 minutes with pain and instability

Exam of the right ankle shows 2+ instability

Lateral ankle ligament reconstruction (Brostrom with Internal Brace augmentation) is performed on December 2, 2016

• Walking boot applied intraoperatively
  • May be removed for dorsiflexion/plantarflexion range of motion
• Immediate weight bearing as tolerated
• Sutures are removed at 2 weeks postop
  • Transition to a lace-up brace
  • Begin physical therapy

Physical therapy protocol

• Weeks 1-2 :
  • WBAT, dorsiflexion / plantarflexion exercises, hip, knee ROM, core strength
• Weeks 3-6:
  • Lace-up brace, continue to elevate as needed for swelling
  • Stationary bike, begin inversion/eversion, continue to work on hip, knee, core exercises
• Weeks 7-10:
  • Continue to use ankle brace in a regular shoe
  • Stationary bike, ROM as tolerated with inversion/eversion/DF/PF
  • Continue with core, hip and knee strengthening exercises

• Weeks 11-12 :
  • Regular shoe, brace, continue strengthening exercises, work on proprioception, gait training, muscle stimulation as needed
• Weeks 13-16:
  • Brace, regular shoe
  • Continue with proprioception exercises, begin lunges, squats, toe raises
  • Begin jumping, running as tolerated
• Week 17 and beyond:
  • Activity-specific training
  • Return to full play
  • Continue to wear brace as needed

4 months after surgery she returned to play starting against Houston Dash professional women's soccer team on April 7, 2017 (unfortunately, the Aggies ran out of time…)

McKayla played in all 5 Spring season games

At 5 months post-op her ankle feels stable and she is pain-free

In patient’s own words:

• "Before the surgery was done, I could not play without heavy taping, which restricted my speed, agility, being able to kick the ball in any direction and move quickly"
• "Another surgeon’s plan did not have Internal Brace as an option, involved a period of initial casting instead of bracing and possibly a bigger incision or two incisions"
• " After returning to training, I feel like I have a new ankle"
• "I feel confident to play on it"
• "Speed and strength are good"
• "I am able to accomplish any movements without tape, have full speed and full mobility"

The Internal Brace Difference

• Immediate weightbearing
• Early mobilization (days vs weeks)
• Early rehabilitation
• Less muscle atrophy
• Earlier return to full activity
• Improved stability
• Lower recurrence/reoperation rate