Physical Therapy to Prevent Ankle Scar Tissue

If you have scar tissue in the ankle from an injury, surgery or overuse, you might have restricted mobility in this part of your body. Although scar tissue serves a specific purpose in the wound-healing process, it can also result in pain, or in the case of an ankle injury, decreased activity.

When you injure soft tissue such as ligaments, muscles, tendons or fascia, your body responds to the trauma by forming scar tissue. While an injury is one of the more common reasons for scar tissue in the ankle, you can also have scar tissue from surgeries or overuse. The soft tissue that is damaged is replaced with new collagen fibers, but unfortunately, your body is not able to replicate the exact injured tissue.

The good news? Certain treatments, such as physical therapy, can make a difference in how your body responds to this new scar tissue.

"Physical therapy can certainly help minimize scar tissue and the negative effects it may have on functional mobility and physical performance," physical therapist Colleen McQuate, DPT, at the University of Maryland Rehabilitation & Orthopaedic Institute, tells LIVESTRONG.com. To ensure the best results, McQuate says a structured, multi-faceted approach is essential in reducing the effects of scar tissue and treating the underlying causes.

"A physical therapist will perform a thorough evaluation and construct a plan to address impairments and performance limitations," she says. Adhering to a comprehensive plan developed by a physical therapist can help you maintain good ankle health, which McQuate says is extremely important for daily function and higher levels of performance — especially since developing scar tissue at the ankle can lead to chronic pain and physical limitations.

Read more: 13 Exercise to Help You Recover From an Injury

In general, physical therapist, Frank Hoeffner, PT, DPT of Professional Physical Therapy tells LIVESTRONG.com that active range of motion exercises — moving the joint through its full range of motion — and stretching exercises such as calf stretching can assist in maintaining normal ankle mobility and counteract the harmful effects of scar tissue formation.

The key to treating scar tissue pain in the ankle is to act fast. "After an injury, it's important to introduce mobility early and often, within specific guidelines," says McQuate.

Stretching the muscles that support the ankle joint is a common exercise to help with scar tissue. One stretch for the back of the ankle that McQuate recommends is a "runner's stretch." When performing this stretch, it's important to hold it for 30 to 60 seconds and to use gentle, constant pressure and no bouncing.

McQuate says ankle circles and the ankle alphabet are also helpful in minimizing scar tissue and improving mobility.

The American Academy of Orthopaedic Surgeons recommends following an exercise conditioning program that combines stretching and strengthening exercises for the ankle to help you return to physical activity. In general, they suggest performing ankle-specific exercises at least three days a week for four to six weeks after an injury or surgery occurs.

Read more: 3 Exercise to Heal a Stiff Ankle After a Sprain

In addition to mobility exercises and stretches for increased flexibility, your physical therapist may recommend other tools to help alleviate the pain associated with scar tissue in the ankle.

Other tools that work in combination with stretching, according to McQuate, include therapeutic exercise, manual therapy, instrument assisted soft tissue mobilization (aka the Graston technique) and kinesio taping.

According to a June 2015 review of research published in the journal Evidenced-Based Complementary and Alternative Medicine, researchers found that in clinical practice, the use of kinesio tape is a successful treatment for managing myofascial pain that can result from scar tissue.

Instrument-assisted soft tissue mobilization, otherwise known as the Graston technique, is a treatment option your physical therapist may choose to use to help improve soft tissue mobility. The process involves using an instrument to remove scar tissue.

According to a February 2017 article review published in the Journal of Exercise Rehabilitation, this technique is shown to reduce pain and improve soft tissue function and range of motion in acute or chronic sports injuries to soft tissues.

To ensure proper treatment of scar tissue in the ankle, you should always consult a licensed physical therapist following injury to ensure these exercises are appropriate and performed in a safe manner.