Do I need surgery for an ankle fracture?

Not always. Stable fractures may heal well in a cast or moon boot. Displaced or unstable fractures often need surgery to restore alignment and ankle stability. A doctor or surgeon decides this based on X-ray findings and joint stability.

How long does an ankle fracture take to heal?

Bone healing often takes around 6 weeks, but full recovery usually takes longer. Many people take 10 to 12+ weeks to regain comfortable walking, and longer again for running or sport, depending on fracture severity and rehab progress.

When can I start weight bearing after a broken ankle?

Weight bearing timing depends on fracture type and whether you had surgery. Some people progress earlier, while others need longer protection. Follow your surgeon or doctor’s instructions, then progress under physiotherapy guidance.

What does physiotherapy do after an ankle fracture?

Physiotherapy may help reduce swelling and stiffness, restore ankle mobility, rebuild calf and foot strength, and retrain balance and walking. Later stages may include return-to-work and return-to-sport drills based on your goals.

Can a broken ankle cause long-term stiffness or arthritis?

It can. Joint injuries and long periods of immobilisation may increase stiffness and, in some cases, post-traumatic arthritis. A staged rehab plan that rebuilds movement, strength, and balance may reduce long-term issues.

Ankle Fracture

Article by John Miller & Erin Runge

$Ankle fracture physiotherapy assessment with soles of feet examined in clinic$

Physiotherapist assessing foot and ankle alignment following an ankle fracture

Ankle fracture physiotherapy may help you settle pain and swelling, regain ankle movement, and return to walking with more confidence. Many people also need help managing related ankle pain and preventing a repeat sprained ankle once they return to activity.

An ankle fracture (broken ankle) means a crack or break in one or more bones around the ankle joint. It may involve the tibia, fibula, or talus. Fractures range from small cracks to unstable breaks that change ankle alignment and joint stability.

Because a broken ankle can also injure ligaments, cartilage, and the syndesmosis, your early assessment matters. A physiotherapist can help guide the next steps, coordinate timing with your GP or surgeon, and build a staged plan that matches your fracture type and goals.

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Treating an Ankle Fracture

Treatment depends on fracture stability, bone position, swelling, skin condition, and whether the ankle joint stays aligned. Imaging (usually X-ray) confirms the diagnosis. In some cases, CT helps clarify joint involvement.

Many people benefit from simple early priorities: protect the ankle, keep swelling down, and keep the rest of your leg active. For practical aftercare tips (elevation, icing, and general precautions), see this MedlinePlus guide: ankle fracture aftercare.

Non-surgical management

Stable fractures may heal with immobilisation such as a cast or a moon boot. Your team will usually set weight-bearing limits (non-weight-bearing, partial, or full) based on fracture pattern and healing stage. Regular review helps confirm the fracture stays well-aligned.

Surgery (ORIF) for unstable fractures

Unstable or displaced fractures often need surgery, commonly open reduction and internal fixation (ORIF). Surgeons use plates and screws to restore alignment and stabilise the ankle. After surgery, your rehab plan focuses on protecting the repair while progressively restoring motion, strength, and walking capacity.

Physiotherapy after a broken ankle

Physiotherapy supports recovery in phases. First, you aim to reduce swelling and protect healing tissues. Next, you restore ankle mobility and rebuild calf and foot strength. Finally, you retrain balance, walking, and higher-level tasks like stairs, hopping, and running (when appropriate).

Early phase: swelling, pain, and safe movement

Early rehab often includes gentle ankle and toe movement (within your medical limits), swelling management, and maintaining strength above and below the injury. Your physiotherapist may also work on knee and hip strength so your overall movement stays steady while the ankle heals.

Middle phase: restore range and strength

Once your fracture shows healing and your team clears you to progress, rehab usually targets:

ankle dorsiflexion and calf flexibility
calf strength and endurance
foot and ankle control (especially single-leg stability)
walking pattern retraining

Later phase: balance and proprioception

Balance retraining helps you trust the ankle again. This matters because time in a boot can reduce joint position sense and reaction speed. Many rehab plans include progressive balance drills and stepping tasks to rebuild control and reduce re-injury risk. See: balance and proprioception exercises and balance training.

Return to work, sport, and running

A safe return depends on your strength, swelling, mobility, and confidence. Your physiotherapist may use practical milestones such as:

walking without a limp for a set distance
single-leg balance control
a quality single-leg calf raise (and building endurance)

If running is one of your goals, a graded return program reduces flare-ups and helps rebuild capacity. Read: running injuries and return-to-run planning.

What to do next

If you think you have a fracture, get assessed promptly. Then, once your fracture plan is clear, focus on steady progress.

Follow your weight-bearing and boot/cast instructions.
Keep swelling down with elevation and gentle movement (as allowed).
Start rehab early, then progress strength and balance when cleared.
Ask about return-to-work and return-to-sport milestones so you don’t rush.

Ankle Products

These ankle products are commonly used by our physiotherapists to improve ankle pain, strength, balance, proprioception, endurance and flexibility, plus assist home exercise programs.