Physical therapy after ankle surgery: the road to a successful recovery
A ankle surgery can be a drastic event, often necessary after serious injuries such as a fracture, torn tendon or ligament. After surgery, the real work begins: the recovery process. This process is crucial to regaining full functionality and preventing future complications. Physiotherapy plays a central role in this recovery process. In this blog, we will take you through the different phases of physical therapy after a ankle surgery, and give you insight into how to achieve a successful recovery.
Injuries in the ankle that may require surgery
The ankle is a complex joint that experiences a lot of stress on a daily basis. Because of the many movements and weight the ankle must bear, it is more susceptible to various types of injuries. Although many ankle injuries can be treated with physical therapy, there are cases where surgery is necessary.
Bone fracture in the ankle
A common ankle injury that may require surgery is a bone fracture in the ankle. This is a fracture in one or more of the bones that make up the ankle: the tibia (tibia), fibula (fibula) and talus (ankle bone). Ankle fractures can range from simple stable fractures to complex unstable fractures in which the bones are displaced. In cases where the bones are not in the correct position, surgery is necessary. A common surgical procedure for these fractures is the open reduction and internal fixation (ORIF), in which the bones are set in place and secured with metal plates, screws or pins to promote proper healing.
Ankle ligament injuries
Another type of injury that may require surgery is torn ligaments. Ligaments are strong bands of connective tissue that connect bones and provide stability in the ankle. A serious sprain can lead to a partial or complete tear of one or more ligaments. Although mild to moderate sprains usually heal without surgery, surgery may be necessary for a complete tear or when conservative treatments have not brought sufficient recovery. Surgical reconstruction of ligaments may involve repairing the torn ligament or replacing it with a graft, which is a piece of tissue from elsewhere in the body or from a donor.
Osteoarthritis in the ankle joint
Osteoarthritis, or wear and tear of the cartilage in the ankle joint, is another condition that may require surgery in some cases. In severe cases of osteoarthritis, where conservative treatments such as physiotherapy, medication and injections are not effective, surgery may be considered. This may be an ankle fusion or arthrodesis, in which the bones of the ankle are permanently fixed to reduce pain. Another option is an ankle prosthesis, in which the damaged joint is replaced with an artificial joint to restore motion and reduce pain.
Osteochondral lesions are lesions in which both the cartilage and underlying bone in the ankle joint are damaged. They can occur as a result of trauma such as an ankle sprain. When the lesion is large and does not heal with conservative treatment, surgery may be necessary. This is also true if loose cartilage or bone fragments are present in the joint or if pain and restrictions persist despite physical therapy and other treatments. Surgical options for osteochondral lesions may include microfracturing. Here, small lesions are made in the bone surface, stimulating new cartilage growth. Other methods may include osteochondral grafting and cartilage repair techniques.
Serious tendon injuries
Tendon injuries, such as a torn Achilles or peroneal tendon, can cause severe pain and functional limitations. Although smaller tears often heal without surgery, surgery is often necessary for a complete rupture of the Achilles tendon or persistent pain and loss of function following a partial tear of a tendon. In such cases, surgery may involve suturing the torn tendon or using a graft to strengthen the tendon and restore function.
Physical therapy after ankle surgery
The first phase after ankle surgery is all about rest and recovery. Immediately after surgery, your ankle will likely be swollen and painful. It is essential to take this phase seriously. Your body really needs time to heal from the surgery. Our physical therapists advise you on using assistive devices such as crutches to take the weight off your ankle and avoid doing too much too soon.
At this stage, it is important to keep the ankle elevated and use ice regularly to reduce swelling. Your physical therapist will teach you how to do this properly. In addition, gentle mobilizationexercises are introduced to promote blood circulation without interfering with healing.
Getting back to gentle exercise after ankle surgery
After the first few weeks of rest, the focus will shift to regaining movement in the ankle. During this phase, you will begin gentle stretching and mobilization to prevent stiffness and improve range of motion. Your physical therapist will guide you in performing specific exercises designed to increase ankle flexibility without causing strain.
An example of an exercise in this phase is gently bending and stretching the toes and foot which will make the muscles and tendons in your foot and ankle active again.
Strength building after ankle surgery
As your ankle gets stronger and your range of motion increases, physical therapy will focus on building strength. Stronger muscles support the ankle and aid in the recovery process. Your physical therapist will guide you through exercises aimed at strengthening the muscles around the ankle, such as the calf muscles and the muscles in your foot.
An effective exercise in this phase is to do the calf raise. Stand upright and slowly lift your heels off the ground, balancing on your toes. This strengthens the calf muscles and helps with ankle stability. Other exercises can include various machines that you can also find in the gym and exercises such as lunges and squats.
Functional training for sports and all kinds of daily activities
Once you have regained sufficient strength and range of motion, the focus shifts to restoring functionality and preparing to return to daily activities and sports. This is an exciting phase as you begin to see how far you have come since surgery.
Your physical therapist will introduce exercises and activities specific to your goals and lifestyle. For example, for someone who is a runner, this may mean gradually starting back to running on a treadmill under supervision. For others, it may mean resuming daily activities, such as walking without pain or climbing stairs with confidence.
Prevention of future injuries
An important aspect of physical therapy after a ankle surgery is to learn how to prevent future injuries. Your physical therapist will advise you on wearing appropriate footwear, performing regular exercises and strengthening the muscles around the ankle. In addition, you can learn how to tape your ankle or use a brace during sports activities to provide additional support, should it still be necessary.
The right treatment Physical therapy after ankle surgery
Restoring a ankle surgery is a long journey that requires time, patience and commitment. Physical therapy plays a crucial role in every stage of this process, from reducing pain and swelling immediately after surgery to restoring strength, mobility and functionality. By following a clear transparent approach, we can help you make your recovery as smooth and effective as possible.
At Fysio Fitaal, we are ready to support you every step of this journey. Our experienced physical therapists will work closely with you to develop a customized treatment plan tailored to your specific needs and goals. Together, we work toward a successful recovery and a strong, healthy future.
Richie Brewer
Physical therapist, sports rehabilitation
Evidence-based and measurable physical therapy. That's how we make care as efficient and targeted as possible. By collecting data during your rehabilitation, we know what you do, and therefore how you improve over time. In this way, together we ensure that you will soon be able to sport and move again without any complaints!
