Physical Therapy for Broken Ankle

If you broke a bone in your ankle; the fibula, tibia, or talus; you’re likely in a boot or cast to allow the fracture to heal. Once cleared by your doctor, physical therapy for a broken ankle is a great way to boost your recovery. Your ankle will be stiff, sore, and weak but, after a necessary rest period,  physical therapy can help. Here’s what to expect from a round of physical therapy for an ankle fracture.

The Benefits of Physical Therapy

When recovering from a broken bone or any injury, seeking help from a physical therapist is always a good idea. There are some great potential benefits. These include:

• Decreased pain, bruising, and swelling
• Increased joint range of motion/decreased stiffness
• Improved tolerance for daily activities and exercise
• Professional guidance to choose the best ankle exercises
• Get in-depth injury education and tips to help you feel confident in the recovery process
• Focus on restoring proper ankle balance and coordination as it relates to full body biomechanics
• Boost overall long-term recovery to prevent any chronic issues

Do I Need Physical Therapy?

Yes, physical therapy is almost always prescribed after a broken ankle. However, keep in mind most states don’t actually need a doctor’s prescription for PT anymore. That means you are welcome to talk directly to your physical therapist to schedule your first appointment when it is appropriate.

When the ankle joint is injured with a fracture or ankle sprain, it affects two very important functions of the feet: proprioception and coordination.

The pain, swelling, bruising and extended immobilization impair the normal feedback loop between the lower leg and the brain that allow you to coordinate normal and high level activities with ease. This is one of the primary goals a physical therapist will address with you as your healing progresses that you won’t get at home.

When to Start PT After a Broken Ankle

There are a few different factors that will determine when is the right time for you to seek rehab.

• Most often, your doctor will prescribe a round of physical therapy once you are cleared to start weight bearing (partially or full).
• Ankle exercises should be avoided until the fracture is stable.
• If you’re struggling with pain, swelling, or even how to use crutches an earlier PT visit can help. You can also receive guidance on what to do while resting your ankle (it’s probably more than you think).
• Otherwise, you may find it more beneficial to wait 6+ weeks until you’ve been cleared to spend time out of your boot and start moving the ankle again.

How Rehab Helps Manage Pain

Pain management is an important first step in the recovery process. If moderate to severe pain is present, it will significantly limit your ability to complete exercises and walk. Here are the most common pain relief treatments your physical therapist will prescribe:

• Modalities

  Pain modalities are initiated in a physical therapy clinic to determine efficacy. If they work well, your physical therapist will instruct you in how to continue treatment at home for better pain relief between sessions. Options include a TENs device, light therapy, ice packs, ice bath,  ice compression, and heat when applicable.

  Common At Home Treatments for Broken Ankles

• Sports Massage Therapy

  Local ligaments, muscles, and joints tend to be extremely stiff and sore when recovering from an ankle fracture. A physical therapist can help alleviate some of your symptoms with massage techniques for addressing your specific ankle dysfunction. Including trigger point, myofascial, lymphatic, and deep tissue massage. Additionally, a therapist can facilitate normal joint movement with guided range of motion. These can also be taught for home treatment as needed.

• Modified movements

  Until you’re cleared to fully bear weight through your leg, you will need to adjust the way you get around each day. How you choose to do this is important to minimize risk of injury to other parts of your body and decrease unnecessary pain too. A PT can help train you in using crutches or a knee scooter with the best possible mechanics. If you’re allowed to walk in your boot with partial weight bearing status, there are also specific ways you can walk to maximize efficiency.

Active Recovery for a Broken Ankle

Once you are cleared to take your ankle out of your boot or brace, your physical therapist will prescribe more extensive exercises and training for the return to normal activities. Here’s what you can expect from each.

• Stretches and Exercises

  You may be able to start some exercise before you can walk to reduce the loss of ankle function. Typically, this starts with gentle stretches and building range of motion. Followed by ankle strengthening exercises and eventually weight bearing moves. The ultimate goal is to restore ankle coordination so that you can balance and stand on your leg without impairment.

  Exercises for Ankle Fracture

• Gait Training

  Bearing weight on your injured ankle will take some preparation and adjustment to be able to tolerate full weight through your leg without pain or a limp. A physical therapist will give you specific advice for optimizing your walking mechanics. Plus, the exercises chosen for both your clinic and home exercise program should help prepare your leg for walking as well.

• Education

  Continual education and gaining body awareness are the biggest benefits of receiving physical therapy. This empowers you to understand exactly what’s going on and how to sustain long term benefits, lasting results and confidence in injury recovery.

How Long Will Physical Therapy Last?

How long your therapy sessions will last is completely dependent on the severity of your injury, the time you needed to wear a boot and rest, and your previous level of function.

Typically, you will see your physical therapist 1-3 times a week for up to 12 weeks. As you make progress and feel more confident you may go longer between visits and just check in as needed. It can be totally customized for your needs.

Questions for Your PT

When it’s time for your first visit, it’s important to come prepared with questions to get the best understanding of what you will gain from your physical therapy appointments. Take these questions with you:

• What can I expect from my first visit? Will I be sore?
• How often should I see you?
• Can I call you if I have any questions about my home program or symptoms?
• What am I allowed to do?
• What activities should I avoid?
• What can I do at home for pain relief before, during, and after my PT sessions?
• When can I return to ___ activity?

Receiving Safe Treatment with Physical Therapy

Having a guide for your ankle injury recovery can reduce stress and give you the confidence to get back to normal life as soon as possible. There are different stages of recovery that your PT can help with, depending on your comfort level and where you feel you need the most guidance. Call and talk to your physical therapy clinic or orthopaedic doctor if you’re not sure when you should start therapy or if it is even for you. As always, if your symptoms get worse or don’t improve with treatment, make sure to keep your physical therapist and doctor in the loop so they can make adjustments as needed.

Sources:

https://www.verywellhealth.com/rehabilitation-exercise-program-for-a-broken-ankle-2696027

https://www.thepodiatrygroup.com/2019/10/04/do-i-need-physical-therapy-after-an-ankle-fracture/

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