The ankle is a complex joint where three bones meet: the tibia (shinbone), fibula (the smaller bone next to the tibia), and talus (the small bone that sits between the tibia and fibula and rests atop the heel bone). Ligaments hold these bones together, providing stability, while tendons connect muscles to bones and allow for movement. The ankle plays a crucial role in helping you keep your balance, walk, run, jump and even stand still. 

Breaking an ankle can be a frustrating and painful experience. Not only does it limit your mobility, but the recovery process can also feel slow and challenging. Physical therapy exercises play a key role in recovering from a broken ankle, helping you regain strength, flexibility and coordination. 

What happens when you break your ankle?

A broken ankle, or ankle fracture, occurs when one or more of the bones that make up the ankle joint are fractured. The severity of the injury can range from a minor crack in the bone to a complete break, which may require surgery. There are several types of ankle fractures:

• Lateral malleolus fracture — A break in the fibula
• Medial malleolus fracture — A break in the tibia
• Posterior malleolus fracture — A break in the back of the tibia
• Bimalleolar fracture — A break in both the fibula and tibia
• Trimalleolar fracture — A break in the fibula, tibia and talus

Broken ankles are one of the most common injuries, particularly among athletes and active individuals. Slips, falls, car accidents and sports-related incidents are different types of incidents that can result in a broken ankle. 

What happens to your ankle while it’s in a boot or cast?

While your ankle is immobilized in a boot or cast, several changes can occur:

• Healing — Immobilization supports the bones in healing, which can take six to eight weeks. 
• Loss of muscle mass — Muscles around the ankle and calf can weaken significantly because they aren’t being used. 
• Nerve “sleeping” — Nerves in the ankle may lose some responsiveness due to immobilization, which can lead to tingling or numbness initially when the case or boot is removed. 
• Thinning cartilage — Without movement, the cartilage in the joint may thin, impacting the joint’s smooth movement.
• Tightening of ligaments and joint capsules — Lack of motion can make ligaments and joint capsules stiff, reducing flexibility and leading to a limited range of motion postrecovery. 

The role of physical therapy during recovery from a broken ankle

Physical therapy is crucial in the recovery process after an ankle fracture. When you seek PT, a licensed physical therapist will design a personalized rehabilitation program to help you regain strength, flexibility, balance and coordination.

10 key physical therapy exercises for broken ankle recovery

Even while your ankle is immobilized, there are exercises that can help you maintain strength and flexibility in the rest of your body, as well as improve blood flow in the injured leg.

• Toe movements — Move your toes to help stimulate blood flow and keep the smaller muscles in your foot active. Wiggle your toes, spread them out and press them together a few times each day. This can help reduce swelling and can prevent stiffness in the foot. 
• Strengthening the uninjured leg — To avoid losing too much strength on your uninjured side, try strengthening exercises like seated leg raises, quad sets and hamstring curls. Working the uninjured leg helps maintain balance and can even minimize muscle imbalances during recovery. 
• Strengthening the rest of the body — Exercises that focus on the core, upper body and uninjured leg can help you keep your overall strength and stability. Arm and core workouts, along with resistance band exercises for the noninjured leg, are beneficial to support your body and keep you active during the healing process. 

Once your boot or cast is removed, you’ll likely feel a mix of stiffness and weakness in the injured ankle. Physical therapy exercises can help you regain mobility, flexibility, strength and balance: 

• Range-of-motion exercises — Regaining a full range of motion is the first step to restoring mobility in your ankle. Range-of-motion exercises include:
• Ankle circles — While seated, extend your leg in front of you and rotate your ankle slowly in circles. Your physical therapist will give you instructions on how many rotations and repetitions you need to do.
• Alphabet exercise — Point your toe and “draw” the alphabet in the air. This helps move your ankle through a full range of motion. 
• Strengthening exercises — Once you’ve regained some flexibility, you can begin strengthening exercises that focus on the ankle’s muscles and supporting structures, such as:
• Resistance band exercises — Wrap a resistance band around the ball of your foot and gently press forward and back, working on dorsiflexion and plantarflexion.
• Calf raises — Stand with your feet flat on the ground and slowly rise onto your toes, holding briefly before lowering back down. Your physical therapist will start you with a lower number of sets and increase as your strength improves. 
• Stretching exercises — Stretching keeps the muscles flexible and helps reduce tightness: 
• Calf stretch — Place your hands against a wall and extend one leg back, keeping the heel down and stretching the calf. 
• Achilles stretch — Place your injured foot behind your uninjured foot and gently bend your knee, stretching the Achilles tendon. 
• Gait training — Regaining a normal walking pattern, or gait, is crucial for overall recovery. Your physical therapist may have you do gait training exercises such as:
• Heel-to-toe walking — Practice placing your heel down first and rolling through to your toes as you walk. 
• Slow walking drills — Walk slowly and mindfully, focusing on taking even steps and minimizing any limp that may have developed. 
• Balance and proprioception exercises — Proprioception is your body’s ability to sense its position in space, and balance exercises are key to helping restore this stability:
• Single-leg stand — Stand on the injured leg while holding on to a stable surface. Progressively try to balance without holding on. 
• Balance board — Use a balance board to challenge the injured ankle and improve stability. This exercise helps retrain the muscles and ligaments around the ankle.
• Tandem stance — Stand with your feet together; then slowly move one foot in front of the other. 
• Foam roller exercises — Roll your foot over a foam roller to help improve flexibility and reduce muscle tension. 
• Balance beam exercises — Practice walking on a balance beam to improve balance and coordination. 
• Plyometric exercises — Once your broken ankle has regained sufficient strength, gentle plyometric exercises can help with jumping, running and other higher-impact activities. These exercises include:
• Jumping jacks — Your physical therapist may have you start with low-impact variations and progress you to full jumping jacks as your strength increases. 
• Box jumps (advanced) — Stand in front of a small, sturdy box and step or jump onto it. This should only be done with the guidance of your physical therapist.
• Lateral jumps — Jump from side to side to help improve your agility and coordination. 
• Full-body exercises — Rebuilding your strength throughout your entire body helps create a stable foundation for your recovering ankle. Your physical therapist may recommend full-body exercises such as:
• Squats — Begin with body weight squats, focusing on even weight distribution between both legs. 
• Lunges — Step forward or backward into a lunge, focusing on keeping your balance and moving slowly to control the movement.

Physical therapy techniques for broken ankle recovery

In addition to therapeutic exercises that can be done in clinic and also at home, depending on the recommendation of your physical therapist, other physical therapy techniques may be used to help your broken ankle recovery, including:

• Manual therapy — Manual therapy encompasses a range of hands-on techniques where your physical therapist will use their hands to move and manipulate your healing ankle, including: 
• Soft tissue manipulation — Your physical therapist will use soft tissue manipulation to focus on the muscles, tendons and ligaments around your healing ankle. They will use their hands or even tools to gently apply varied levels of pressure to help gradually break down any adhesions, increase flexibility and relieve tension. 
• Joint mobilization — Joint mobilization is a technique that involves your physical therapist using small, controlled movements to your ankle joint, allowing it to slide smoothly within its natural range. 
• Aquatic therapy — Aquatic therapy takes advantage of water’s natural buoyancy, which reduces the stress on your healing ankle joint. Your physical therapist will guide you through specific exercises in a warm therapy pool, such as ankle circles, gentle leg lifts and walking in the water. Aquatic therapy can be helpful in the early stages of recovery when full weight-bearing on the ankle may still be uncomfortable. 

Physical therapy techniques and exercises play a unique role in recovery, and your physical therapist will often combine several approaches to create a comprehensive plan. This personalized approach helps ensure that your treatment addresses every aspect of your ankle’s recovery.

Trust your broken ankle recovery journey to Lattimore Physical Therapy

Recovering from a broken ankle can be challenging, but the right care can make all the difference. At Lattimore Physical Therapy, our experienced team is dedicated to providing compassionate, comprehensive support to help you regain strength, mobility and confidence in your healing ankle. With a personalized approach tailored to your specific needs, we use a combination of proven physical therapy techniques designed to ease pain and restore function. 

Contact our team today for more information or to schedule an initial appointment.