So you fell and twisted your ankle and your foot swelled up like a balloon. You find out you have an ankle fracture and you’re sidelined for 4-6 weeks in a cast. Time goes by, you see the doctor and he says the bone is healed, you’re good to go! You get the cast removed, but you realize your calf is shriveled up and tiny compared to the other side. Even worse, it hurts to move your foot, your ankle feels weak, you can’t even put weight on your foot, now what?! In this article, we will detail exactly what an ankle fracture is and some excellent exercises to jump-start your rehab when you get your cast off. Learn all about what to do after an ankle fracture!
What Is An Ankle Fracture?
From Radiology Assistant
A broken ankle, also referred to as an ankle fracture, is typically a break in the distal fibula or tibia bone at the ankle joint, which are the bones located in the lower leg on the outside and inside respectively. Ankle fractures typically occur from falls that involve twisting of the foot, awkward landings, and contact sports injuries. Ankle fractures can range from being simple to complex, whether it be just an isolated medial or lateral malleolus fracture or an ankle dislocation with a bi/trimalleolar fracture. You can learn more about the type and severity of ankle fractures here
Have You Recently Fractured Your Ankle?
If you have recently fractured or injured your ankle, we have the perfect program to get you back to 100%!
How Do I know If I Broke My Ankle? Should I Get An X-Ray?
Maybe you stumbled upon this article because you just hurt your ankle and you’re trying to decide if you should seek medical attention or not. Well, you’ve come to the right place! This is a really good question, so good that researchers decided to figure out who should and who shouldn’t get x-rays to save the health care system some money. The Ottawa Ankle Rules concluded the following ankle x-ray screening questions…
- Can you take 4 steps (it is okay if you need to limp)? NO? –> GET AN X-RAY
- Do you have tenderness/pain around your medial or lateral malleoli (the little bone bumps on either side of your ankle)? Specifically the backside of the bones? YES? –> GET AN X-RAY
In regards to if you possibly have a bone fracture in your foot…
- Do you have tenderness/pain around the base of the 5th metatarsal (bump on the lateral/outside portion of your foot; halfway between your heel and your little toe)? YES? –> GET AN X-RAY
- Do you have tenderness/pain around the navicular bone (bump on the medial/inside portion of your foot?) YES> –> GET AN X-RAY
READ: DO I NEED AN X-RAY AFTER AN ANKLE SPRAIN?
So I Broke My Ankle, Now What?
It sucks to be stuck in a cast for 4-6 weeks. However, that doesn’t mean you have to be completely sedentary. Now we aren’t saying you have to lift weights and use cardio equipment with only one leg, but don’t just sit on your butt on the couch for a month! Technically you can still do upper body exercises and even train your other leg.
Moreover, our foot/ankle is influenced by our kinetic chain, meaning the joints, muscles, and body regions above it! We always preach that it is important to treat the entire body part, not sure the body part that was injured. Exercising on some proximal musculature and joints, including our knees and hips for example can help optimize post-operative outcomes!
Exercises After An Ankle Fracture: Stay Strong In A Boot!
The common concerns are that you will be lop-sided and create asymmetries/imbalances if you only train your other leg. That is false! If anything training your other leg can lead to something called the crossover effect, helping to maintain the size and strength of your other leg! This is a crucial part of what to do after an ankle fracture.
So I Got My Cast Off After My Ankle Fracture, Now What?
Getting your cast off can feel like the most glorious day ever. However, your calf and ankle may not be the prettiest sight, it may look extra skinny with dead skin. Even worse, your foot may be swollen and really STIFF. Don’t fret, we are going to teach you how to get your ankle and foot moving again and use it as much as you can! In regards to your skin, take a well-earned bath/shower and use lotion to nourish the skin.
Swelling is inevitable. The ankle is a distal joint and is more prone to prolonged swelling. That is Ok! What is important is to combat that post-operative swelling with early mobility. The more that you are able to move the ankle once you are able after surgery, the more that you can promote overall circulation as well as blood flow back towards the heart. We discuss this below with a hallmark exercise of ankle pumps, preferably elevated.
You can also listen to our podcast with Taryn on living well with lymphedema, as she discusses everything about the lymphatic system, as well as how to maintain a healthy lymphatic system. This podcast is full of excellent information related to the lymph, as well as how swelling may occur, and what you can do to combat the negative effects of swelling!
LISTEN: MANAGING SWELLING WITH THE LYMPHATIC SYSTEM
What To Do After An Ankle Fracture: Range Of Motion Exercises
With your average non-complicated ankle fracture, a gentle introduction to range of motion exercises in every direction is exactly what your ankle wants and needs. Below you will find multiple videos to help get your ankle moving again, with great exercises after an ankle fracture!
Ankle Pumps
Sample Ankle Fracture Rehab Program Exercise
Ankle pumps are a great exercise to start immediately as previously discussed to reduce swelling as well as promote the early range of motion. Mike is using a plinth to elevate his leg in this video; however, at home you can use pillows underneath your foot to elevate it!
Ankle Alphabets
Sample Ankle Fracture Rehab Program Exercise
With this exercise, early on after the surgery, your full range of motion will not be what it used to be. Do NOT be discouraged! What is important is to avoid compensation early on. For instance, one big compensation we see is individuals will move their hip joint into the internal and external rotation when trying to perform active inversion and eversion of the foot/ankle complex. Really focus on JUST using your foot/ankle joints and avoiding compensatory movements up the chain. Do not fear, movement will come with time!
Learn How To Improve Ankle Mobility After A Fracture!
Calf Stretch With Strap
Sample Ankle Fracture Rehab Program Exercise
The calf complex normally becomes tight after being in a cast and boot for a long period of time.
Ankle Pull-Ups
Sample Ankle Fracture Rehab Program Exercise
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Weight Shifts
Closing Thoughts
Some ankle fractures take longer than others to fully recover. It can take a really long time, even up to a year, for your ankle to feel back to 100% normal like it did prior to the injury if it was a complicated fracture. You can read about concepts of tissue healing HERE! This is especially true in regards to ankle mobility, strength, balance, and being able to support all of your weight through that foot and ankle in various positions. The bottom line is you have to be patient and remind yourself of how far you’ve come compared to day 1 of having your cast on. You can implement some of the concepts here when first starting to perform exercises after an ankle fracture. If you continue to have significant limitations and pain with your ankle, it may be in your best interest to seek help from a physical therapist. You can click here to learn more about what to expect in PT.
Have You Recently Fractured Your Ankle?
The foot & ankle is a truly unique design with 26 bones, 30 joints, over 100 muscles, tendons, ligaments, and over 7,000 different nerve endings! It’s complex but in complexity, we go simple because simple works! In the Foot & Ankle Rehab program, you will spend time developing the habit of consistency each week. Along with consistency, the goal is to increase confidence and decrease uncertainty by mastering safe, effective movements. As you work through the program make sure to take advantage of the education, training support, and assessments videos.
References
- Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326:417
About The Author
Craig Lindell PT, DPT, CSCS
[P]rehab Co-Founder & Chief Content Officer
Craig is a South Jersey native & Penn State Kinesiology Alumni. When the opportunity came, Craig packed his bags and drove to California to pursue his Doctorate in Physical Therapy from the University of Southern California. With [P]rehab, Craig oversees all digital content creation and multi-channel publication that reaches millions of people on a weekly basis. As a PT, Craig has a wide array of experience from working with various neurological conditions to working with collegiate & professional athletes across the Big Five in North American sports. Experiencing physical therapy first-hand as a soccer player in high school, Craig has a passion & special interest in adolescent athletic development working with young athletes to overcome injuries. In his spare time, Craig enjoys exercising, playing golfing, hiking, traveling, watching Philly sports, and spending quality time with his family.
Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.
About the author : Craig Lindell PT, DPT, CSCS
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YOur site is awesome to understand the fracture and exercise videos to enhance my workout!
Thanks!
Happy that it has helped you!!!!
Hi – thank you so much for these videos. Do we wait till the ankle is completely pain free before doing these exercises or it is okay to do these exercise when you are going through the healing process?
You’re welcome! Thank you for the great question. It is ok to start exercising with minimal discomfort in the ankle, and that may be the case when you perform certain exercises after an ankle fracture. Usually, as long as the pain is minimal and tolerable, and it returns to your baseline after you finish exercise, you know you are at the right dosage, frequency, and intensity. Sometimes, your body may tell you you did a bit too much one day, which is OK. We all have these days. Furthermore, it is encouraged to always understand your weight bearing precautions after your fracture with clearance from your healthcare provider as to when you can start weight bearing as well as what exercises you are allowed to perform. Best of luck!
Great videos and commentary!
Thank you!!
Hi. I found your article through a Google search. I slipped and fell on my stairs at home. I thought it was a sprain, but it was swollen and I could not put any weight on it. I decided to go to urgent care to get an x-ray. Diagnosis: nondisp fx of lateral malleolus of right fibula (my driving foot :( ). After leaving urgent care with a splint and crutches (and referral to orthopedic doctor), it was beginning to dawn on me how many adjustments I will have to make to recover, including workouts.
Your post gives me hope that I will be able to do something. (I am eager to make a full recovery, so I will do whatever the orthopedic doctor tells me.) Thank you.
Hello! Very sorry to hear about your injury. At this point, you are making all of the right steps, and we wish you the best with your recovery process!!! If you need anything further from us to help facilitate your recovery, feel free to email us at theprehabguys@gmail.com!
Thank you for your site. I broke my ankle December 3rd, 2 surgeries and a hard cast later, my ankle is now wrapped with an ace and I’m wearing a boot. I was given the go ahead to do range of motion, flexing and 50% weight bearing. Your site has shed light on what will help progress my healing. Thank you for giving clear demonstrations/descriptions of how to improve my ankle mobility through the healing process.
Hey Michael, thank you for the kind words and we’re super glad we were able to help you out in any way! We wish you best of luck with your recovery! Once you no longer have any post-op precautions, you may want to consider our foot & ankle program!
My 11yrs 7mths grandson is in an ankle boot after chipping his ankle bone (falling jumping off a wall and over a stream) – fracture clinic treating it as bad sprain/torn ligament, no cast – what physical exercise/activities can we do with him to have fun/keep him busy/aid his recovery and keep him off fortnite!
Hello, unfortunately we are unable to give direct medical advice on this platform as it is illegal. We would suggest following the advice from the healthcare professional who is working with your grandson in-person as well as a physical therapist who can get him exercising safely. Best of luck to him and we wish him a speedy recovery!
This website is great! I can’t wait to start my recovery and PT . I am currently a few weeks post ORIF from a Trimalleolar fracture with dislocation. It’s been really awful.
Thank you so much Dena!!! We appreciate your positive comments. If you are looking for more content related to foot ankle rehab, we have several programs which may benefit you!! here is a link to our programs page!! Please reach out to us directly if you have further questions and we would be more than happy to help you in anyway!
https://theprehabguys.com/prehab-programs/
I’m glad I stumbled on this page while searching for answers to why my ankle feels great after stretching but gets tight again after about 15-30 minutes of sitting or no. activity. I I learned a couple exercises but my ankle still gets tight.
I had ORIF 4 months ago and currently working working with a physical therapist. They tell me it’s normal for my ankle to keep getting tight but it still worries me. I do all kinds of calf and dorsi flexion exercises.
Thank you for reading our blog and providing your insight related to a personal situation overcoming an ankle surgery yourself! Continue to work hard with your physio, you will get there!! Best of luck to you! In case you wanted to read some more topics, here you go!
Tissue Healing Blog: https://theprehabguys.com/tissue-healing-timelines/
How Much Do I Need To Stretch: https://theprehabguys.com/how-much-do-i-need-to-stretch/
Foot/Ankle: https://theprehabguys.com/foot-ankle-prehab-program/
I had to hike over 12 miles on what I would’ve sworn was a really bad ankle sprain. Turns out it was a lateral malleolus fracture. So, I’d say I make it well over 4 steps ;) Excited to rehab this ankle and get back outside!
Hello
This site is amazing and educational. I have a question for you.
I had surgery 10.5 weeks ago to put a plate and 6 screws in my outter ankle and I fractured the inner bones as well, but no plate was needed.
I am currently walking w no cast and attend PT weekly. There is minimal pain, however swelling increases by end of day. I sleep w the elevation pillow and the swelling decreases come morning.
I’m just wondering if you think it’s too early to add yoga into my rehabilitation, doing modified poses when needed. My range of motion is so far great, as I started those excersizes as early as possible. I’m hoping yoga will assist in regaining lost strength and stability.
Thanks so much in advance.
Your thoughts are truly appreciated
Simome
Hi Simone!
Thank you for your such kind comment and excellent question! Unfortunately, we are unable to provide direct medical advice on this platform due to legality. However, we would advise that you discuss this with the physical therapist you are working with in person, as he or she will be able to give you the best, professional advice regarding this inquiry. We wish you the best with your recovery, and you can always reach out to us at info@theprehabguys.com if any other questions or comments arise!
Best,
Team [P]rehab
If I’m non weight bearing after my ankle fracture, can I use a strap to stretch my calf?
Hi Jim!
Great question! In most cases, open-chain exercises such as the one here you are inquiring about are acceptable within protocols; however, it is best to follow the specific protocol and guidance of who is in charge of your care. Best of luck to you in your recovery process!!
Best,
Team [P]rehab
Hi There, so glad I fund your videos. I am 68 yrs old. I broke my ankle Jan 15 2022. Surgery was Jan 27th 2022, It is now June 5th 2022. My PT is releasing me and I never did feel like I had the best care. However I am on my own now and need to find the discipline to keep up my exercises. Discipline and swelling are my main concerns. I realize you can’t help me with the discipline.. Is it “normal” to still have swelling here and there? And how will I know when its safe to ride my bike? I am now so aware of every step I take and now I know why seniors are often looking down when walking. Sure don’t want another foot injury. ut I also don’t want to live in fear each time I leave the house.
Hi Julie! We are emailing you to follow up in more detail regarding this message. Thank you so much for reaching out to us!
Best,
Team [P]rehab