The treatment of functional rehabilitation is based upon
four stages of biologic healing. In the first stage, the RICE
(rest, ice, compression, elevation) protocol is used to decrease
inflammation and swelling in order to promote and
improve conditions for healing. In the second stage, ligaments
are protected for one to three weeks during the healing
or proliferation phase. Fibroblasts invade the injured area
and form collagen fibers. Bracing or taping is recommended
as it can decrease radiographic talar tilt.30 Approximately 3
weeks after injury, collagen fibers mature and become scar
tissue in the maturation phase. By performing controlled
stretching, the collagen fibers are able to be reoriented and
help prevent stiffness. At 6 to 8 weeks post-injury, the fourth
and final stage of healing brings the patient near full strength
and able to return to full activity. However, patients should
be counseled to allow six to 12 months for full maturation
and remodeling of the injured ligaments.