Our Ankle fracture treatment program is designed for when the bone has healed and you are no longer in a plaster cast or walking boot.
*If you suspect you have broken your ankle then seek medical attention immediately.
Who is this program suitable for?
This program is suitable for anyone suffering from pain, stiffness, and weakness after a period of immobility post ankle fracture. It is very important that you follow the advice of your consultant and only progress through the phases as pain allows.
Program structure
The Ankle fracture treatment program consists of five phases. In order to progress to the next phase, you must reach specific exit criteria. So whatever type of injury you have, you begin at phase 1 and work through each phase.
Introduction to Ankle fracture treatment
This program is suitable for anyone suffering from pain, stiffness, and weakness after a period of immobility post ankle fracture.
It is very important that you follow the advice of your consultant and only progress through the phases as pain allows.
Ankle fracture treatment phase 1
This is the acute management phase immediately after your cast is removed. Use this phase if your ankle remains swollen, red, hot, and/or painful.
Rest
Complete rest. However, it is important you do other stretching and strengthening exercises as long as they are not painful.
Cold therapy
One of the most important elements for Ankle fracture treatment is to apply cold therapy at least 3 times a day, or every 2 hours for 10 minutes if possible. Keep the ankle in an elevated position. Do not apply ice directly to the skin but wrap it in a wet tea towel.
A commercially available hot and cold wrap is more convenient and can be used to apply compression as well.
Massage for ankle fracture
A very light superficial massage to help reduce swelling. Application of an anti-inflammatory cream may be useful, as well as deeper massage techniques to the calf muscles.
Taping
Use a compression bandage or Tubigrip. Tape as required, especially if you are on your feet as this will support and protect the ankle as well as help reduce swelling.
Exercise – Isometric eversion
Apply tension to the band and resist this movement with your foot, which should not move. Hold for 15 seconds and repeat this 4 times, once daily. Ensure this is pain-free and with no movement.
Exit Criteria
Move onto phase 2 when you have:
- Rested completely for at least 3 days
- Applied the PRICE principles min 3x /day for 2 days
- Walk for 15 minutes pain-free
- You have no pain to touch
- Pain-free single-leg stand
- You are pain-free on exercises
Ankle fracture treatment phase 2
Phase 2 is an intermediate phase lasting approximately 2 to 3 weeks. It comprises:
- Cold therapy
- Massage
- 2 mobility exercises
- 2 activation exercises
- 5 strengthening exercises
- 4 movement control exercises
- 4 functional exercises
The aims of phase 2 are to restore normal function, and global stability control, and to begin to progressive load the ankle.
Move onto phase 3 when you have:
- Completely rested for at least 3 day
- You have applied the PRICE principles – a minimum of 3 times a day for 2 days
- Pain-free to walk x 15 min
- You have no pain to touch
- Pain-free on single-leg standing
- You are pain-free on exercises
Ankle fracture treatment phase 3
Phase 3 Ankle fracture treatment is the main rehabilitation phase and begins a minimum of 2 weeks following injury.
It comprises:
- 4 mobility & stretching exercises
- 5 activation exercises
- 3 strengthening exercises
- 8 movement control exercises
- 5 functional exercises
To move on to phase 4 you must:
- Hop 3 times for distance with less than 10% difference between the good and injured leg
- Do 20 or more straight leg heel raises can you do in 30 seconds
Ankle fracture treatment phase 4
Phase 4 Ankle fracture treatment is the late rehabilitation stage and comprises:
- Cold therapy
- Massage
- 6 strengthening exercises
- 5 proprioception exercises
- 2 functional
- 6 plyometrics
- 4 running drills
In order to move on to phase 5 you must be:
- Pain-free through exercises
- Manage plyometrics pain-free
- No pain during a run
- Zero pain at speed (24hrs)
- No pain on touch
- Have equal strength in the right and left leg
Maintenance phase 5
Maintenance phase. The aim of phase 5 is to mitigate the risk of future injury. We have selected a few exercises from phases 3 and 4 to incorporate into your normal training routine.
However, if you have particular favourites, or particular areas you feel need improving then feel free to include or replace exercises.
