Damage to the structure of your ankle joint because of arthritis or an ankle fracture may cause extreme pain and loss of movement in your ankle. Severe damage often requires doctors to replace the damaged ankle bones with a man-made joint composed of man-made, low-friction materials to help restore ankle movement and reduce pain. Physical therapy after an ankle replacement aims to increase your ability to move your ankle, strengthen the muscles around your ankle and strengthen your leg muscles to help you return to the activities you enjoy.
Range-of-Motion Exercises
Range of motion exercises improve your ankle's motility and flexibility while increasing blood flow to your ankle to promote healing. Physical therapy teaches you safe ways to move and stretch your ankle -- generally within a week of ankle replacement surgery, when your cast or splint is removed. The exercises taught to you vary based on the extent of bone damage prior to your surgery, your current range of motion and ability to work through discomfort. "Ankle alphabet" requires you to write the entire alphabet using only the motion of your ankle and foot. Ankle pumps require you to pull your toes toward your head and then point them. Your physical therapist may also teach you ankle rotations and ankle inversion and eversion exercises.
Strengthening Exercises
Advancement from range of motion exercises to strengthening exercises may take anywhere from four days to a month, depending on your ankle strength prior to surgery, your progress with range of motion exercises and your pain level. Strengthening the muscles of your ankle, foot and leg increases your ability to walk, run and jump independently. Your physical therapist may add a resistance band or other form of light resistance to the range-of-motion exercises already taught to you once your range of motion improves. Exercises such as toe raises where you stand and raise up on your tippy toes; balancing on one leg; leg swings to the front, back, left and right; and jumps around a small square help strengthen the muscles that support your ankle and your ability to walk.
Return to Normal Activities
The more motion and strength you gain back in your ankle, the quicker you can return to your normal activities of daily living. Your physical therapist teaches you how to transition from a walker to a cane, from two crutches to one crutch or from an assistive device to walking without assistance. Physical therapy also teaches you how to safely ascend stairs, descend stairs and maneuver around objects safely.
Considerations
Physical therapy following an ankle replacement often consists of two to three sessions with your physical therapist each week and exercises you perform at home. Recovery time decreases when you keep your scheduled appointments and exercise as directed at home. Do not try to perform exercises not approved by your doctor or physical therapist and only exercise as often as directed. Discomfort and some pain may occur while performing exercises, but if the pain becomes severe, stop exercising and contact your doctor or physical therapist.
References
- Heath Brown, Physical Therapist; Rehabilitation Today; Bradford, Pennsylvania
- MedlinePlus; Ankle Replacement; Feb. 3, 2009
- California State University; Ankle Strengthening Program; Manuel A. Escalante, Jr.
- Orthopaedic Specialists of North Carolina: Active Ankle and Foot Range of Motion Exercises
