what to do after an ankle fracture the prehab guys

What To Do After An Ankle Fracture

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?

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

 

How Do I know If I Broke My Ankle? Should I Get An X-Ray?

ankle fracture the prehab guys

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.ย The Ottawa Ankle Rules concluded the following ankle x-ray screening questions…

  1. Can you take 4 steps (it is okay if you need to limp)? NO? โ€“> GET AN X-RAY
  2. 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? โ€“> GET AN X-RAY

In regards to if you possibly have a bone fracture in your foot…

  1. 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? โ€“>ย GET AN X-RAY
  2. Do you have tenderness/pain around the navicular bone (bump on the medial/inside portion of your foot?) YES> โ€“>ย GET AN X-RAY

READ: DO I NEED AN X-RAY AFTER AN ANKLE SPRAIN?

x-ray after ankle sprain the prehab guys

 

So I Broke My Ankle, Now What?

ankle cast the prehab guys

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?

cast off foot the prehab guys

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 using 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 to 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: LIVING WELL WITH LYMPHEDEMA

living well with lymphedema the prehab guys

 

Ankle Dorsiflexion Overhaul [P]Rehab Program

ankle dorsiflexion overhaul program the prehab guys

Ask anyone in the industry, ankle dorsiflexion mobility matters. Without it, you run the risk of exposing other body regions to excessive strain due to compensatory strategies. This program is for anyone looking to improve their ankle dorsiflexion mobility. If your mobility is limited due to an injury/surgery in the past, or youโ€™re just dealing with stiff ankles that are limiting your workouts and athletic performance, this program is appropriate for you as long as you have general workout experience! Click HERE to learn more about the program.

 

What To Do After An Ankle Fracture: Range Of Motion Exercises

With your average non-complicated ankle fracture, 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

Ankle pumps are a great exercise to start immediately as previously discussed to reduce swelling as well as promote 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 Foot & Ankle [P]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 compensations early on. For instance, one big compensation we see is individuals will move their hip joint into 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!

Ankle Circles

 

Calf Stretch With Strap

Sample Foot & Ankle [P]Rehab Program Exercise

The calf complex normally becomes tight after being in a cast and boot for a long period of time.

 

Gas Pedals

 

Ankle Pull-Ups

Sample Foot & Ankle [P]Rehab Program Exercise

 

Toe Spreads

 

Toe Curls

Sample Foot & Ankle [P]Rehab Program Exercise

 

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, 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.

 

[P]Rehab Your Ankles

foot program the prehab guys

The 12 Week Foot & Ankle Prehab Program is a step-by-step program to help you minimize pain and optimize foot & ankle function. It will teach you how to build a strong foundation for your foot & ankle by bulletproofing your entire leg to enhance your fitness performance and progress.ย Learn more HERE!

 

References

  1. 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

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.

6 Comments
  • Sherri Miller
    Posted at 08:21h, 25 October Reply

    YOur site is awesome to understand the fracture and exercise videos to enhance my workout!

    Thanks!

    • Michael Lau
      Posted at 12:30h, 28 October Reply

      Happy that it has helped you!!!!

  • KRIS CHUNG
    Posted at 22:56h, 30 June Reply

    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?

    • Sherif Elnagger
      Posted at 09:46h, 22 July Reply

      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!

  • Andrew
    Posted at 06:28h, 12 November Reply

    Great videos and commentary!

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