Physical Therapy After Removal of Ankle Cast

No beach this summer
Someone is lying outside in an ankle cast. (Image: ASIFE/iStock/Getty Images)

An ankle fracture can produce considerable loss of functional mobility. Once the fracture has healed, most physicians refer patients to physical therapy, which after removal of the cast is a vital step to full recovery. Physical therapy following an ankle fracture can expedite the healing process by decreasing pain and improving range of motion to help you fully return to your activities of daily living.

The Initial Evaluation

After your ankle cast is removed, your physician will permit you to place more weight on your ankle, which may feel stiff, sore and weak. For safety purposes, your physician may require you to continue using crutches or a walker. The physical therapist will fully evaluate the strength, range of motion, pain and swelling. Based on her findings, she will construct a treatment plan. Treatment varies according to the severity of the fracture, patient goals and prior levels of function.

Ankle Strength and Range of Motion

Exercise to increase strength and range of motion is a main element of physical therapy in a clinical setting. The goal of the exercises is strengthening of the bone and the muscle tissue surrounding the ankle. Therapy will focus on the ankle, but it might also include exercises for the hips and knees. When you are capable, higher level weight-bearing exercises will be added.

Your physical therapist will also provide instructions for exercises to do at home. Follow the instructions carefully, and ask questions if you are unsure how to perform an exercise or are experiencing more pain than usual.

Getting the Gait Back

Gait training will be necessary following an ankle fracture. The physical therapist will instruct you on how to walk properly and efficiently with crutches or a walker as you work to regain full range of motion. Easy activities, like sit-to-stand transfers, getting in and out of a car or stair-climbing can be very difficult when walking with an assistive device. The physical therapist will show you how to perform these movements safely and competently, and eventually help you progress to walking independently.

Pain Management

A physical therapist may use an assortment of therapeutic measures to facilitate reduction of swelling and pain. Heat, ice, ultrasound, electrical stimulation and aqua therapy may be utilized separately or in combination with each other. Joint mobilization and massage may also be beneficial if scar tissue has formed.

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