Ankle rehab. exercises

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I had ORIF surgery on 29th November to repair fractures to my medial and lateral maleolus.

I had a post-surgery follow up appointment a week ago and a boot fitted. I am still non-weight bearing until 10th January but have been told to move my ankle up and down to get the joint moving. I forgot to ask how often I should be doing these exercises so I wondered if anyone has a similar injury and knows how much I should be exercising?

Thanks in advance smile 

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  • Posted

    IDk if we had the same type off surgery but I was told to do that same exercise up n down n also with a towel pull ya foot back alil n push it forward that self therapy try it 
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  • Posted

    I had a non-displaced fibula fracture that did not require surgery. While I was in my boot and NWB I was told to do my ankle range of motion exercises three times a day. My exercises were:

    1) Flex the toe up as far as it would go and then point my foot as far as I could get it. I did 3 sets of 10 (small pause after each 10) 3 times a day.

    2) Circles clockwise. 3 sets of 10 (small pause after each 10) 3 times a day.

    3) Circles counter-clockwise. 3 sets of 10 (small pause after each 10) 3 times a day.

    4) Alphabet writing with my toes - one set of the 26 letters, 3 times a day

    These were super exercises! I did them faithfully and I think they contributed to my speedy recovery. My dorsiflexion was at nearly 100% at my 6 week appointment (other directions ranged from 80-90%). At my 12 week appointment my ortho doc told me that my ankle ROM was amazing... better than hers and she's never broken any bones in her foot! smile

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    • Posted

      Thanks CarolynCL, I've been doing the first exercise but will definitely try the other two and hope my recovery is as good as yours. How long was it until you were weight bearing?

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    • Posted

      Hi Vicky,

      I was surprisingly quick. I went from 100% NWB to WBAT in the boot in two days. I think my attention to my ROM exercises plus my use of an iWalk 2.0 instead of crutches helped me to minimize the leg muscle  atrophy (the calf is now pretty much back to its original size at 13 weeks post injury). When I was allowed to ditch the boot at 6 weeks I just ditched it. My gait was a little bit awkward for a couple of days, and I had trouble going down stairs for about a week, but I didn't need to use crutches or a cane or anything.

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    • Posted

      Hi Carolyn,

      Your recovery sounds great, I'm keeping my fingers crossed mine goes down a similar path by keeping up with the exercises.

      I have an iWalk 2.0 too but haven't been brave enough to use it yet, might have to give that a go and overcome my fear of falling over!

      I have my 6 week follow up appointment on 10th January so hoping the doctor says I can start weight bearing then.

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  • Posted


    Sorry to hear you joined our ankle club.

    Range of motion (ROM) exercises are very important to prime your healing but busted ankle for demands of weight-bearing and walking later.

    I suffered a medial bimalleolar fracture with sprain, and of course I started these exercises as soon as my attending doctor allowed it. If x-rays show your fracture is mending well enough these gentle ROM movements are not going to hurt you.

    As far as how much ROM exercises to do, I would say it all depends. It depends primarily on any collateral soft tissue (that is, connective tissue intimately involved with and all around ankle joint: ligaments, tendons, muscles, nerves, fascia, joint capsules) damage you sustained (along with the fractures) in your accident.

    When you are non-weight-bearing in a CAM boot or cast these soft tissue issues, if they exist, usually are not readily apparent. They will make their presence loudly known when you add the stress of weight and movement later.

    I would suggest doing limited reps of ROM routines, and then slowly work up the rep counts until you feel too much discomfort or pain, then back off. You don't want to put ankle in too much distress too soon. But if it feels good and there is little or no pain then simply do more.

    Icing may help with any discomfort and swelling. Remember that an injured ankle is still in an inflammatory state as healing processes are underway.

    The more exercise you do now, and later when you are in weight-bearing status, will pay off in spades with a speedier and more complete recovery.

    It is vitally important to implement appropriate and extensive ankle rehab exercises for as long as it takes to rebuild strength and stability in ankle joint. Failure to get joints and supporting soft tissue like ligaments back to normal function could spell trouble later in form of degenerated cartilage/joints (the end state which could be chronic ankle dysfunction and arthritis). You can see this eventual progression play out in so many sad stories on this forum.

    In your rehab program, don't forget knee and hip exercises-- they are important in getting back your normal walking gait after being out of action for so long.

    Also, balance and proprioception exercises are just as important in getting ankle biomechanics back to normal.

    Best of luck to you.  biggrin

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    • Posted

      Thank you so much for your helpful response.

      The only exercise I have been given is to move my ankle up and down however I have done some research and other comments on here suggest more exercises when non-weight bearing to improve full range of motion. I'm not sure if this is just because of my particular injury or whether I could be doing more to help my recovery and haven't been advised to. I feel like I'll be a nuisance if I contact the doctor and haven't been referred for physio as yet.

      I'm keen to be back to my normal self asap (I actually miss going to work!) and the current exercises aren't too uncomfortable. Having only done them for a week there is a lot more movement, I could hardly move my foot at all this time last week! I will definitely look at the knee and hip exercises too, it makes sense to get some strength in the rest of the leg before I can walk on it, it looks so scrawny at the moment!

      Thanks again for your advice and welcoming me to the club! smile 

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  • Posted


    Glad to be of some small help to you.  On this forum we have altogether a wealth of experience to share.

    Don't be bashful about calling your doctor's office to get more guidance on what exercise and movement is advisable right now, and later on. Doctors usually have assistants to field patient calls between appointments. That's their job. Remember, the doctor is supposed to be working for you and you have every right to get all your questions answered,

    I can't stress enough the importance of continuing ankle rehab through weight bearing and walking stages and beyond. Chances are your ligaments were affected by your multiple fractures (you didn't mention an ankle sprain, but that usually is the case in these circumstances). If ligaments and tendons are stretched or even torn they need special attention to get them strong and toned. Ankle recoveries can fail if ligaments remain lax and don't provide needed support for joints-- this can lead to ankle joint misalignments/instability and arthritis later.

    Later on you will up the ante by doing more intense physiotherapy under advice of physician. They should recommend a competent and sympathetic physiotherapist to further your rehab regimen.

    Even as your recover and get back to normal walking it is important to protect ankle against reinjury. You may need to wear an ankle brace temporarily as you work on strengthening ankle. Wear strong supportive footwear meanwhile (say goodbye to high heels, flip flops, and flats, at least until your complete recovery is confirmed over time).

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    • Posted

      Hi kpower,

      I'm not sure if there was a sprain, my discharge notes just mention the fractures. I definitely need to compile a list of questions for my next appointment, so many things I wish I would have asked! I may give the doctor's office a call after Christmas and get some answers before I go back. The weirdest thing is I can't bend my big toe anymore, not sure if it will take time however all of my other toes seem to bend (even if marginally) so not sure why that could be.

      Luckily I'm rubbish in heels anyway so that won't be too much of a problem. Sat here moving my foot and wiggles my toes...every little helps right?!

      I think the hardest thing is the boredom, I'm so used to being busy it's hit me like a ton of bricks to just have to stay around the house. This forum definitely helps smile 

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    • Posted


      If there was an ankle sprain with your fractures, chances are you would have noticed it.

      A sprain usually involves swelling, pain, and possibly bruising (discoloration). However, your fractures may have similar symptoms. I personally believe it is nearly impossible to have ankle fractures (exceptions may be high fractures on tibia or fibula) with out some sprain involvement of ligaments, tendons, etc.

      As you know, each ankle injury is unique. I wish there was one size fits all, and we would know what to anticipate next. Ah, that is life's uncertainty principle at work for sure.

      Chin up then, and carry on.

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    • Posted

      I very much agree with the importance of quality footwear. My doctor did not want me to use a brace, so what I purchased was a pair of new hiking boots (backpacking type, which provide more ankle support), another pair of similar hiking boots geared for winter use and a brand new pair of runners (I bought a pair of trail running shoes as I figured they would provide me with the most support and stability on uneven surfaces). Gone are the fancy shoes ans the high heels until I am sure this ankle is fully healed (6 months at least).
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