This past Wednesday Packers right tackle Bryan Bulaga (former Iowa Hawkeye) sprained his right ankle
in practice. He is going to be held out for the rest of the pre-season and will be re-evaluated before the
season opener against the Seattle Seahawks. I am frequently asked by my patients if I would want to
work for the Packers, while I am very happy here at Freedom, here is what I would do if Bryan were my
After ruling out that there was no fracture, the first goal would be to get his symptoms under control.
So we would employ the standard PRICE principal.
Protect (boot or crutches as needed)
All the above are done to decrease the inflammation and swelling associated with an acute ankle sprain.
At Freedom, we would also use manual therapy to help decrease swelling and improve any joint related
issues. Once past the acute phase, we would progress him to range of motion exercises, theraband
strengthening and partial weight bearing balance exercises. As his symptoms improved, he would
progress to more balance and functional activities. Initially, he would start these activities with both
feet on the ground and then progress to single leg balance, plyometrics, and finally football related
drills. At this point, I would evaluate his readiness to return to play. As long as I felt that his ankle was
strong, had good mobility, and he was ready to play, I would send him back on the field.