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Is Physical Therapy Effective After Ankle Surgery?

About two million Americans injure their ankles each year, suffering sprains, tears, fractures, and other damage. Although people of any age or activity level may incur an ankle injury, it is one of the most diagnosed injuries that occur when people play a sport.

The ankle is a major weight-bearing joint, making it susceptible to injury. Movements like jumping, running, sudden stops and starts, and pivots while supporting weight can overstretch or tear the ligaments that support the ankle.

Some ankle injuries or conditions do not require surgery. A qualified physical therapist may be able to help you recover strength, mobility, flexibility, and range of motion in your injured ankle without surgery.

While you may be able to self-treat a mild sprain, professional treatment for a more severe injury is critical to avoid living with a weak or unstable ankle prone to re-injury. A licensed physical therapist can help you manage pain and regain mobility, flexibility, strength, and range of motion in your injured ankle.

Why Are Ankle Injuries So Common?

Your ankles and feet contain 26 bones and 33 joints, ligaments, tendons, and muscles. Any time your ankle twists or is forced into an unnatural position while bearing body weight, you may experience an injury. Running or jumping forces ankles to support several times your body weight and is especially hard on the joints.

Symptoms of an ankle injury may include swelling, bruising, tenderness or pain, ankle instability, stiffness, limited range of motion, and difficulty in bearing weight to the affected ankle. You may hear or feel a popping sensation or sound at the time of injury.

Ankle Surgery

Overuse or trauma to the ankles affects mobility and may prevent you from participating in your sport or daily activities. Your doctor may recommend surgery to repair the damage so you can get back to an active lifestyle.

Depending on the damage to your ankle, arthroscopy, ligament reconstruction, fracture repair, ankle replacement, ankle fusion, or repair of a ruptured Achilles tendon may be appropriate. Most surgeons recommend you begin outpatient physical therapy as soon as possible after surgery, usually within two to four weeks.

Physical Therapy After Ankle Surgery

During your first physical therapy visit, your therapist will perform specific assessments to determine your starting point. They will perform a physical exam and discuss your goals for recovery.

The assessment may include:

  • Pain level
  • Ankle measurements
  • Strength, range of motion, and flexibility of the ankle
  • Overall function and mobility

Physical therapists typically use a combination of manual therapy, exercise therapy, and passive modalities during your recovery program. Modalities may include hot or cold treatment, electrical stimulation, ultrasound, kinesiotaping, and other passive approaches. Passive modalities mean they are performed on you and not by you.

The first phase of your physical therapy will include non-weight-bearing ankle motion exercises and stretches to counteract the adverse effects of immobilization. You can begin weight-bearing activities once your doctor clears you to do so.

Most studies find physical therapy for ankle rehabilitation can effectively restore ease of mobility and functional ability. Your physical therapist will design a program tailored to your specific needs but generally will seek to:

  • Reduce pain, discomfort, and stiffness
  • Improve range of motion and flexibility
  • Strengthen muscles, ligaments, and tendons that support the ankle
  • Improve mobility of scar tissue
  • Strengthen core muscles (pelvic floor, back, abdominals, hips, diaphragm)

Strong core muscles enable the body to work together to provide balance, stability, and gait, reducing your risk of ankle re-injury.

You will also learn how correct posture, footwear, stretching and warm-ups before sports activity, and awareness of uneven surfaces can decrease your risk of reinjuring your ankle.

Once your surgeon has cleared you to place weight on your recovering ankle, your physical therapist will gradually introduce weight-bearing exercises to avoid re-injury. Your doctor may advise you to use a boot, crutches, or cane as you transition to increasing degrees of weight.

Once your range of motion and ability to bear weight has improved, you may be ready to add the use of a stationary bike, a walking program, and other more challenging exercises.

Importance of Home Exercise

Your commitment to a home exercise program is an integral part of your rehabilitation and the long-term health of your ankles. Throughout the clinical portion of your rehab program, your physical therapist will teach you exercises to perform at home. If you continue to practice your home program once you complete the in-clinic program, you decrease the risk of a future injury.

How Long Does Outpatient Physical Therapy Take? Does it Hurt?

Each person heals at a different rate, depending on their age, overall physical condition, weight, underlying health conditions, and the type of ankle surgery they required.

A typical timeline may mean you attend outpatient physical therapy two or three times a week for six to eight weeks. If you have injured a tendon, the rehabilitation process may take longer as tendons heal more slowly than muscles. It may take about three months before you can resume normal activities after breaking an ankle.

Some parts of the healing process can be uncomfortable. Minimization of scar tissue is one reason surgeons recommend physical therapy as quickly as possible after surgery. Your physical therapist may use tissue massage to break up scar tissue to regain joint mobility after surgery, which can cause discomfort.

Exercises and stretches, deep tissue massage, and other movements you perform during physical therapy may also cause some discomfort. You are working with parts of your body that have undergone trauma or suffered from long-term pain, so some soreness is not uncommon. If you experience unusual pain or intense discomfort, be sure to let your physical therapist know. Never hesitate to give feedback of any kind to your physical therapist.

Whether you are anxious to get back to your sport or are longing to resume your daily life, Athletic Physical Therapy’s team will get you there more quickly than you thought possible.

Learn more about how our proprietary physical therapy program, the Active Rehabilitation Continuum (ARC), expedites recovery with maximum results. Contact Athletic Physical Therapy today.