A broken ankle is also known as an ankle fracture. This means that one or more of the bones that make up the ankle joint are broken. The three bones that make up the ankle joint are the tibia or shin bone, the fibula on outside of your lower leg, and the talus which is underneath the tibia and fibula, transmitting weight through to the foot. A broken ankle usually refers to a fracture of the lateral malleolus of the fibula, and/or the medial malleolus of the tibia.
Depending on how serious the fracture is will determine the amount of ankle rehab, and the broken ankle recovery time. An ankle fracture can range from a small hair line fracture in one bone, which may not stop you from walking, to a complicated fracture that may require surgery and a period of non weight bearing to allow for bone healing and recovery.
Broken Ankle Rehabilitation
The main aim of the treatment is to promote the best union of the two bones in the correct alignment. Broken ankle rehab will vary depending on the bone that is fractured, the type and site of fracture, whether the fracture is stable or unstable, if other bones of the foot are damaged, as well as the damage to the soft tissue such as the tendons and ligaments surrounding the fracture. A fracture is classified as stable or unstable. A stable fracture is when the two ends of the fractured bone maintain their alignment with one another, and an unstable fracture is when the two ends of the fractured bone shift apart from one another, and are now misaligned. Unstable fractures are likely to require surgery to realign the bone fragments followed by a period of non weight bearing to allow for bone healing and recovery. Surgery to reduce fractures involves screws, plates and wiring techniques, aiming for the best bony union possible. Stable fractures may be managed conservatively with no surgery, and may require an ankle plaster cast, or a moon boot, and may need a period of non weight bearing to allow for the two bone fragments to heal together. In some cases, surgery may be considered even if the fracture is stable. This is done to reduce the risk of the fracture not healing, referred to as a non-union, and to allow you to begin your rehab and recovery quicker. Ankle specialists will require investigations such as X-rays, CT scans, and an MRI scans to determine the full extent of the damage, and the appropriate treatment.
Fractured ankle recovery time will vary as there is a wide range of ankle fractures and injuries. Many surgeons have different views on how long plaster casts should stay on for, whether a boot is used post cast, and the time in weeks of how long you need to be non weight bearing for. It generally takes 6-8 weeks for the bones to heal and possibly more for complicated fractures. Your specialist will repeat X-rays frequently for the first 6 weeks whether you have surgery or not to reassess the union of the two bones. Most people return to normal daily activities in 3-4 months and can return to sports at 6 months.
The key to your broken ankle recovery is well managed exercise programs from your physiotherapist. Depending on the fracture will determine when you can start putting weight through your ankle. During your broken ankle rehabilitation your physiotherapist will guide you through how much weight you can put through your foot, and gradually increase this as able. However, if you put weight through the ankle before it is safe to do so it may inhibit the fracture from healing and slow your recovery time. Your physiotherapist will tailor your ankle rehabilitation with a specific exercise program including exercises to improve your range of motion and flexibility, your ankle strength, and your balance and proprioception. Your broken ankle rehab will also include exercises targeting your hip and pelvis such as the gluteal muscles, as these muscles all weaken during the non weight bearing period. You may benefit from supports or braces when returning to sport or activities requiring high level balance for a short period of time, however if you complete your rehabilitation and your muscles have returned to full strength, you may not need your support brace anymore.
What is a Sprained Ankle?
An ankle sprain is when you tear the ligaments on the outside of the ankle joint, or the lateral ligaments, and is done usually by rolling your ankle inwards during a fall or twisting playing sport. This is quite different from an ankle fracture. These are graded as I, II and III, with a grade I being a small sprain, and a grade III being a complete rupture. Usually an ankle sprain will heal well with good ankle rehabilitation from your physiotherapist. A sprained ankle recovery time is much faster than a broken ankle recovery time. A sprained ankle rehab will take around 6-8 weeks with a range of ankle rehabilitation exercises to help your strength and balance.
Sprained Ankle Rehabilitation
Sprained ankle recovery time will vary as there is a wide range of sprains. Most patients will need a time of non weight bearing and partial weight bearing, and can then begin the sprained ankle rehab. The phase of non weight bearing can be from 1 day to 1 week, which allows the ligaments to heal and reduce the inflammation, hence improving the ankle injury recovery.
The key to your sprained ankle recovery, as with a broken ankle, is a well managed exercise programs from your physiotherapist. During your sprained ankle rehabilitation your physiotherapist will guide you through how much weight you can put through your foot, as well as through a range of ankle rehab exercises. Your physiotherapist will tailor your ankle rehabilitation with a specific exercise program including exercises to improve your range of motion and flexibility, your ankle strength, and your balance and proprioception. Sprained ankle rehabilitation will also include exercises targeting your hip and pelvis such as the gluteal muscles, as these muscles all weaken during the non weight bearing period. As with a broken ankle recovery, supports or braces when returning to sport or activities requiring high level balance for a short period of time, however if you complete your ankle rehabilitation and your muscles have returned to full strength, you may not need your support brace anymore.
What is an Ankle Fusion?
An ankle fusion is when the talus bone and tibia are fused together via screws. This is a procedure for patients who have osteoarthritis in the ankle joint, and suffer from severe pain, poor movement and poor strength of the ankle joint. This procedure is done to eliminate motion of the ankle joint and therefore reduce the pain. Ankle fusion recovery time will take much longer than ankle sprain recovery time and for a fractured ankle recovery time.
Ankle Fusion Rehabilitation
Ankle fusion recovery time will take much longer as already mentioned. There will be a period of non weight bearing for 6-8 weeks in a cast in order for the ankle to settle, and improve the ankle surgery recovery. The cast will then be taken off, and a boot will replace it. You will still be on crutches, and gradually wean off as your physiotherapist allows you. Your physiotherapist will then begin your ankle rehabilitation by using manual therapy and exercises to improve the movement of the foot, as well as ankle rehab strength exercises to improve your strength and balance. Your ankle renabilitaition will also include strength work for your hips, gluteals and core stability. At the 12 week mark we can remove the boot, and begin wearing supportive footwear for you ankle. Your ankle rehab will continue for up to 12 months, with your physiotherapist closely monitoring your strength and balance program, and try and reduce your ankle fusion recovery time.