Physiotherapy rehabilitation exercises following superior tibiofibular joint sprain with possible partial ligament tear

[Narcissus]

Summary – requesting a short program or list of exercises I can do to rehabilitate superior tibiofibular sprain with possible ligament tear.

Injury Description and History: So 5 weeks ago my knee took significant lateral/twisting force and I heard a loud pop. There was pain when it happened but I managed to walk around fine afterwards, but by the next day I couldn’t walk easily. Hit it with rest, ice and compression and elevation for 48 hours. There wasn’t a lot of swelling, and in 3 days time I was walking fine. I was able to do most activities (I do a lot of sport) pain and discomfort free, including lifting weights (squats, deadlifts), running, boxing, etc. In fact the only thing that caused me discomfort was Brazilian Ju Jitsu (BJJ), when lateral or twisting force was forced on my knee by sparring partners (which happens a lot in BJJ) or when stretching. Any full flexion of the knee joint caused a tiny amount of pain, but more pain was felt during stretches that applied some kind of lateral or torsional force on the knee joint, see photos of Ardha Baddha Padma, Ardha Baddha Padmottanasana Variation and Floor piriformis stretch. There was (and continues to be) pain at the head of the fibula on the outside of the knee, which hurts when touched with pressure or pushed.

Diagnosis: Since I am in a non-English speaking country it was difficult to get in to see a sports surgeon, but I did see one 2 weeks ago, 3 weeks after the injury. He diagnosed a sprain of the superior tibiofibular joint and ligament with likely ligament partial tear secondary to acute subluxation period. Based on what I have read online and the symptoms, especially the pain on the head of the fibula, I cannot see what else this could be, so I will proceed with my post assuming this is a correct diagnosis. The surgeon recommended complete rest for 6-12 weeks and no surgery at this point, and also did not recommend any physiotherapy exercises.

Current situation: Sport makes up a huge part of my life, so given that there was absolutely no pain doing most exercises, after getting the diagnosis, I stopped anything that caused pain (BJJ and stretches that hurt the knee), but continued stretching, lifting weights and boxing all without pain. Things don’t seem to have changed in the 2-3 weeks after seeing the surgeon. I have done no sport for 1 week now (due to other commitments) and if anything, the knee seems more sore to touch and when the Ardha Baddha Padmottanasana Variation rotation/lateral force is applied to it than while I was doing sport.

Request: I have seen online that most of the time the recommended treatment for this injury is physiotherapy to rehabilitate the joint and capsule ligaments. Since I am not in an English speaking country, nor in a city I can easily access an English speaking Physiotherapist, I was hoping someone could recommend a list of exercises that I could do to hopefully speed up recovery and strengthen the joint? If the exercises have well known names, I can simply Google them, so just the name of the exercise is fine, but for anything more exotic, I’d really appreciate a video link if you have one? Also, how will I know when it is ok to go back to full activity, including Brazilian Ju Jitsu, where the opponent is actually using 100% of his strength to actively twist this joint?

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