Physical Therapy After Ankle Surgery: A Step-by-Step Guide

You’ve just had ankle surgery, and while the hard part might feel like it’s over, the real work is only beginning. The crutches are leaning against the wall, the swelling finally subsiding, and your first tentative steps toward independence. That’s where physical therapy comes in – a tailored roadmap to help you strengthen, stabilize, and step confidently into your recovery.

We’ve got the 411. Let’s go through what goes into physical therapy after ankle surgery.

Ankle Surgery Recovery Tips: Managing Pain and Swelling

Pain and swelling are natural responses to ankle surgery, but managing them effectively is crucial to kickstarting your recovery. Keeping your ankle elevated is one of the simplest and most effective ways to minimize swelling. Elevate your foot above heart level whenever you’re resting, especially in the first few weeks post-surgery.

Using a compression wrap or bandage can help limit swelling and provide gentle support to the healing ankle. If your surgeon has prescribed a brace or boot, wear it as instructed to immobilize the joint and protect it during this sensitive phase of recovery. Ensure the compression is snug but not so tight that it restricts circulation.

Applying ice packs to the affected area is another effective method to manage pain and swelling. Wrap the ice pack in a cloth to avoid direct contact with the skin, and use it for 15-20 minutes every few hours, especially after physical therapy exercises. Cold therapy not only reduces inflammation but also numbs the area, providing temporary relief from pain.

Early Exercises for Range of Motion

Early ankle recovery exercises are designed to gently restore mobility without putting undue stress on the surgical site. These movements help prevent stiffness, improve circulation, and prepare your ankle for more intensive rehabilitation in the future.

Ankle pumps involve pointing your toes downward and then pulling them back toward your shin in a slow, controlled manner. This exercise helps maintain range of motion in the ankle joint and stimulates circulation to prevent blood clots. Perform this movement in sets throughout the day to keep the joint active.

Doing the ankle alphabet involves tracing the letters of the alphabet in the air with your toes while sitting or lying down. The variety of movements engages the ankle in all directions, promoting flexibility and circulation without placing weight on the joint. Begin with small, controlled motions and increase the range as your comfort level improves. A physical therapist can help make sure you do these movements correctly.

To gently stretch the Achilles tendon and calf muscles, sit on the floor with your leg extended and loop a towel or band around the ball of your foot. Pull the towel toward you until you feel a light stretch in the back of your ankle and calf. Hold for 15-20 seconds and repeat several times. This exercise enhances flexibility and reduces tightness that can develop after surgery.

Strength-Building Phase

Once the initial healing period has passed and your surgeon or physical therapist has cleared you for more active rehabilitation, the focus shifts to rebuilding strength in and around your ankle. This phase is crucial for restoring the stability and endurance needed for everyday activities, as well as preparing for higher-intensity movements down the line.

Start with seated heel raises, where you lift your heels off the ground while keeping your toes planted. As you progress, move to standing heel raises for a greater challenge. This exercise strengthens your calf muscles, which play a vital role in ankle support and stability.

Resistance bands are a versatile tool for safely building ankle strength. Attach the band to a stable object or hold it with your hands, then loop it around your foot. Perform movements such as plantar flexion (pushing your toes downward), dorsiflexion (pulling your toes upward), inversion (rotating the sole of your foot inward), and eversion (rotating it outward).

Improving Balance and Proprioception

Improving balance and proprioception is a critical step for post-surgery rehabilitation. These skills are essential for:

• Regaining full functionality
• Preventing future injuries
• Preparing for everyday tasks or athletic activities

Balance boards and wobble cushions introduce instability, requiring your ankle to make small, constant adjustments to stay balanced. Begin by gently rocking forward and backward or side to side. Once comfortable, progress to circular motions or holding steady for a set amount of time.

Activities that mimic real-life movements, such as side-stepping, walking heel-to-toe, or light lunges, can improve functional balance when you’re healing after surgery. For advanced recovery, incorporate gentle hopping or skipping drills to enhance dynamic stability.

Low-impact activities like:

• Yoga
• Tai chi
• Water aerobics
• Swimming
• Cycling

Can also enhance balance and proprioception. These practices emphasize controlled movements, stability, and mindfulness, making them excellent additions to your recovery program.

Functional and Sport-Specific Training

The final phase of healing after surgery focuses on functional and sport-specific training. This stage prepares you to safely return to daily activities, work responsibilities, or athletic performance. By incorporating exercises that mimic real-life movements, this phase bridges the gap between rehabilitation and your lifestyle or sport-specific goals.

Functional training emphasizes movements you use in everyday life. Exercises such as squats, lunges, and step-ups help rebuild the strength, coordination, and balance required for walking, climbing stairs, or carrying loads. Your physical therapist may also incorporate tasks like lifting objects or standing for extended periods to simulate your daily routines.

For those returning to sports, this phase includes activities that replicate the demands of your chosen sport. Runners might practice gradual jogging on a treadmill or track, progressing to agility drills like quick directional changes.

Basketball or soccer players could focus on lateral movements, pivoting, or ball-handling exercises that test stability and control. Tennis or racquet players may practice short sprints and dynamic lunges to simulate court play.

Physical Therapy After Ankle Surgery: Now You Know

Physical therapy after ankle surgery can be a long process. With this guide, you’ll know what to expect.

Are you ready to begin post-surgery rehabilitation? MPOWER Physical Therapy offers comprehensive health and wellness services to help you bounce back as fast and as fully as you can.

Book an appointment with us today.