Total ankle replacement became a procedure in the 1970s after successes with total hip and knee replacement arthroplasty. During the 1980s, many experts said total ankle replacement procedures were not worthwhile because of a lack of long-term benefits, but as of 2011, these procedures are more advanced and common.
Aerobic Exercise
After ankle replacement, the range of motion in the ankle is never 100 percent, but you do have more range of motion than a fused ankle, so exercises such as walking and cycling are possible. Both walking and stationary cycling are actually types of aerobic exercise that are relatively safe prior to joint replacement surgery. Crutches, walkers and supportive boots, however, are necessary during the beginning of rehabilitation after surgery. Walking in water once your doctor gives you permission is a way to strengthen your muscles while allowing the buoyancy of water to take weight off your joints.
Ankle Range of Motion Exercises
The ankles are complex joints that flex, extend, rotate and move side to side. The range of motion of a replaced ankle is limited, but ankle range of motion, or ROM, exercises promote as much mobility as possible. ROM exercises simply involve moving your injured ankle in different directions through a full range of motion, so although you should be careful, you should also move your ankle as much as possible. An example of an ankle ROM exercise is the ABCs exercise. By tracing all the letters of the alphabet on the floor with your toes, you move the ankle in many directions. Sit in a chair with your knees bent and uninvolved foot on the floor.
Ab Exercises
Another type of exercise for ankle replacement patients is ab exercises. Abdominal exercises promote a strong core, which supports the spine and pelvis, making the hips more stable and improving balance. The hip, knee and ankle joints all connect through the leg and work together to do activities such as walking, climbing stairs and sitting down. One exercise you can do is the abdominal vacuum to recruit and strengthen the transverse abdominus muscle. Sit in a chair or lie in bed to take pressure off the ankle while you do this exercise. Simply pull your navel in toward your lumbar spine to activate the transverse abdominus.
Hip Strength
Exercises to improve strength in the hips also improve joint stability and make using crutches or a walker safer. The clam shell is an example of a hip strengthening exercise. To perform this exercise, lie on your right side with your head supported on your right arm and your left arm bent over your abdomen with the palm on the floor. Bend your knees and stack the left on top of the right. Then raise your right knee toward the ceiling, but keep the sides of the feet touching. Repeat on the other side.
References
- "American Journal of Othropedics"; "Total Ankle Arthroplasty: Indications, Results, and Biomechanical Rationale"; S.K. Neufeld and T.H. Lee; August 2000
- Bcfootandankle.com: Post-op Ankle Replacement Protocol -- Physical Therapy Guidelines
- MedicalCenter.osu.edu: Ankle Range of Motion Exercises
- The Institute for Foot and Ankle Reconstruction at Mercy: Total Ankle Replacement
- University of Wisconsin Health: Clam Shell Hip Strengthening
- MedicalCenter.osu.edu: General Guidelines for Returning Home After Total Joint Replacement
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