Physical Therapy Exercise Progression after Ankle Fracture

1
Rehabilitation Exercise Program for a Broken Ankle

Photo of woman's ankle on treadmill.
Your PT can help prescribe the right exercise program for your ankle fracture. Peopleimages.com/Getty Images

If you have suffered a broken ankle, you may benefit from the skilled services of a physical therapist to help you return to optimal function once your fracture has healed. Your physical therapist may use various treatments and modalities to help control your pain or swelling or to improve the way your ankle moves.

Therapeutic exercise is one of your main treatments to help you restore mobility after an ankle fracture. Your physical therapist can prescribe the right exercises for you to do at the right stage of healing to ensure that you can return to optimal mobility quickly and safely.

Here is a step-by-step exercise program similar to one your PT may prescribe during your ankle fracture rehabilitation. Check out the program, and consider visiting your local physical therapist to help guide you in your ankle fracture PT program.

Before performing any exercise program for your broken ankle, check in with your doctor to ensure that exercise is safe for you to do.

2
Range of Motion Exercises

Photo of physical therapist assessing ankle mobility.
Your PT can help you restore ankle range of motion. Jeannot Olivet/Getty Images

Ankle range of motion (ROM) exercises are one of the first things your PT will prescribe once you get out of your cast or brace after an ankle fracture. Your physical therapist may passively move your ankle joint through various motions, and he or she may have you actively move your ankle to improve the motion around the joint.

Some simple exercises to do to improve your ankle ROM may include moving your ankle by pointing your toes up and down as far as possible, and moving you foot ankle in and out, motions called inversion and eversion. Hold each position for a few seconds, and perform 10 to 15 repetitions.

Another fun exercise to do to improve ankle ROM after a fracture is to do ankle alphabet. Simply pretend that your toes are a pencil, and draw letters with you foot by moving your ankle. Draw each letter slowly and deliberately in both upper and lower case. This can be performed several times per day. Expect to feel a little pain, but stop the exercises if you feel any lasting, intense pain. If that happens, check in with your PT or doctor.

Once you have perfected ROM exercises, it is time to start to improve ankle flexibility with the next exercise.

3
Flexibility Exercises after Ankle Fracture

To improve muscular flexibility around your ankle after a fracture, you can perform a few different exercises. Towel calf stretching can improve the flexibility of the muscles on the back of your lower leg. Simply wrap a towel around your toes and give a slow, gentle pull to stretch your calf. Standing runner's stretches can also be done to improve flexibility of your  calf.

To stretch the muscle on the front of your ankle, perform the kneeling anterior tibialis stretch. Kneel down with your ankle and toes pointed, and gently press upon your foot to stretch the front of your lower leg.

Hold each stretch for 15 to 30 seconds, and then move on to the next exercise group: ankle strengthening.

4
Ankle Strengthening Exercises

Photo of PT working with woman's ankle.
Your PT can help you strengthen your ankle after fracture. BraunS/Getty Images

After a period of immobilization in a cast or brace, you may notice that the muscles around your ankle have become significantly weakened. This is common after an ankle fracture, and your PT will likely prescribe exercises to improve your ankle strength.

You can use a resistance band to perform ankle strengthening exercises. Simply play the band around your toes, and have someone hold it as you move your ankle into dorsiflexion, plantarflexion, inversion, and eversion. Perform 15 to 20 repetitions of each exercise, and stop if you feel any sharp pains.

Once you have gained some strength, you can begin weight bearing exercises for your ankles. The Alfredson Protocol for Achilles' strengthening is a great way to start to place some controlled stress through your ankles to improve strength.

5
Return to Walking and Running

After an ankle fracture, you may be having difficulty returning to normal walking. Your PT may have you perform various gait training exercises like stepping over and around obstacles to improve the way you walk. He or she can also help you choose the correct assistive device, like crutches or a cane, as your gait changes and improves.

Many people wonder if returning to running after an ankle fracture is a possibility. This depends on the severity of your injury and how things have healed, so check in with your doctor before attempting to run to make sure it is safe for you to do.

6
Balance and Proprioception Exercises

Photo of a BOSU ball.
You can use a BOSU ball to perform advanced balance exercises. Rich Legg/Getty Images

After an ankle fracture, you may notice that your balance is a bit off. Your PT may prescribe single leg standing exercises to improve your balance, and you can try the T-stance exercise to help you gain confidence in your ankle's ability to help you stay upright. Your PT may also use specific tools - like a BAPS board - to improve your proprioception after your ankle fracture.

Once basic single leg standing exercises are mastered, you may benefit from advanced balance exercises like using a wobble board or a BOSU to challenge your balance and proprioception.

7
Plyometric Exercise

Photo of an athlete doing a box jump.
Plyometric training may be a part of your ankle fracture rehab. John Fredele/Getty Images

If you participate in high intensity sports, you may want to perform plyometric exercises like jumping and hopping to prepare for return to sport after an ankle fracture. Learning to jump and land properly can ensure that your ankle can tolerate to forces placed upon it when running, cutting, and hopping during sports. Your PT can devise a specific training strategy to include plyometrics after an ankle fracture.

If you have suffered the unfortunate event of a fractured ankle, you may benefit from performing exercises similar to this program to help you return to normal walking and mobility. The best plan is to check in with your doctor regularly and participate fully in a rehab program geared specifically for your condition and needs to quickly and safely get back to your normal activities.

Continue Reading