Ankle fractures can occur in the tibia, fibula or talus. Nonoperative ankle fractures can be minor to moderate breaks treatable with an aircast, or they may be more severe and treated with a walking boot. Operative fractures usually require pinning or placing a bone to its natural position. Operative fractures are usually severe and may require use of a wheelchair or crutches. Severe fractures may be immobilized by a hard cast or reinforced boot. Certain types of fractures can also have coexisting ligament damage.
Recovery and Rehabilitation
Recovery time will depend on the fracture location, severity, method of treatment and your ability to heal. Healing time can range from several weeks to three or more months. Those that are younger and healthier will heal much faster than those with compromised immune systems and underlying conditions. Dedication to an ankle-strengthening program can decrease recovery time.
Range of Motion
Regaining range of motion will first be done passively with the aid of a health care provider or self-administered using a towel to move the ankle. Range of motion should be executed in all directions. Active range of motion uses your ankle muscles to move your ankle in all directions: up, down and side to side. If active range of motion is too difficult, a combination of passive and active may be used. Active assistive exercises are done with your provider's assistance.
Stability
Balance exercises should be done to increase ankle stability. Balance exercises will help rebuild much of the stability lost during ankle immobilization. Exercises will start out simple, using only double leg weight-bearing exercises. Exercises will gradually start shifting to the injured ankle. When weight bearing is tolerated, single leg balance and balance on uneven surfaces can be started. Wobble boards and trampolines can be added to exercise.
Strength
Range of motion should be full prior to starting a strengthening program. Weight-bearing exercises should be pain free before starting a strengthening program. Beginning exercises will be isometric strengthening. These exercises allow the muscle to contract while keeping the ankle in a fixed position. As you progress, exercise can switch to isotonic. Isotonic exercises shorten and lengthen the muscle by combining range of motion and resistance. Resistance may be done manually with a resistive band or with an ankle weight.
Return to Full Activity
Discomfort, swelling and walking difficulties are contradictions to full activity. Unrestricted activity is permitted when a fracture has healed. Pain-free range of motion, full stability and bilateral strength measurements should be evident before activity becomes unrestricted.
Warning
Exercises should be done under the suggestion of a health care professional. Weight-bearing exercises should not be attempted without prior approval from a health care provider. Doing too much exercise or strengthening can impede recovery time. Any activity that causes pain or discomfort should be stopped.
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