Ankle Fracture

Ankle Fracture

John Miller Physiotherapist

Article by John Miller

Treating an Ankle Fracture

An ankle fracture, commonly referred to as a broken ankle, involves a break in one or more of the ankle bones: the tibia, fibula, or talus. Such fractures range from simple cracks to complex breaks affecting stability and function.

The Treatment Journey for a Broken Ankle

Physiotherapy plays a pivotal role in the recovery from an ankle fracture. Treatment begins with an accurate assessment to determine fracture type and stability, guiding the choice between non-surgical and surgical treatment paths.

Surgical Approach

Unstable fractures typically necessitate surgical intervention, usually through Open Reduction with Internal Fixation (ORIF). This procedure involves the use of metal plates and screws to realign and stabilise the bones. Post-surgery, the journey to regain your mobility begins earnestly with physiotherapy.

Non-Surgical Management

Stable fractures may heal with conservative treatments like splinting or a moon boot, which protect and support the ankle. Monitoring by a healthcare professional is essential to ensure the fracture heals correctly.

fractured ankle
Fractured Ankle in Moon Boot

Physiotherapy: The Backbone of Recovery

After an ankle fracture, physiotherapy is crucial, starting with gentle movements soon after surgery to prevent stiffness. As healing progresses, physiotherapists guide patients through stages designed to restore joint range, muscle strength, and balance.

Early Phase of Physiotherapy

In the initial weeks, physiotherapy focuses on controlling swelling, managing pain, and beginning gentle movements within the limits of a protective boot. The goal is to maintain as much movement and muscle activity as possible without compromising the healing process.

Progressive Weight-Bearing

This gradual reintroduction of weight-bearing activities helps in reconditioning the muscles and bones to bear the body’s weight again. Typically, patients start weight-bearing exercises under professional supervision of their physiotherapist.

Advanced Physiotherapy Techniques

As healing advances, physiotherapy becomes more dynamic. Exercise regimens become more rigorous, aiming to restore proprioception—a sense of joint position—which is crucial for balance and coordinated movements.

Restoring Functionality

When patients often transition to regular shoes and begin more strenuous physiotherapy to rebuild endurance and strength. At this stage, the focus shifts to regaining pre-fracture levels of activity.

Guided Return to Activities

Physiotherapy aims to safely return patients to higher-impact activities like running. However, such activities should only commence under a physiotherapist’s guidance after achieving specific milestones, such as a single-leg calf raise.

Customised Rehabilitation Plans

It’s worth noting that physiotherapy after an ankle fracture is not a one-size-fits-all approach. Programs are tailored to individual needs, and adherence to the prescribed plan is key to a successful recovery.

Supportive Devices and Ongoing Care

Throughout recovery, patients might use supportive devices such as a walking boot. Following the specific weight-bearing advice of your physiotherapist is paramount for a safe and effective return to full mobility.

Healing Timeframe

While general guidelines suggest a minimum of six weeks for bone remodelling, full recovery, especially for those requiring full weight-bearing, may take 12 weeks or longer. Adherence to physiotherapy instructions significantly impacts the speed and extent of recovery.

The Crucial Role of Patient Compliance

It’s vital for patients to understand that recovery from an ankle fracture is an active process. Compliance with all medical and physiotherapy instructions enhances the healing process and helps prevent complications like tibiotalar joint arthritis.


Physiotherapy treatment is a cornerstone in the recovery from an ankle fracture, ensuring that patients not only heal but also regain their full range of motion and strength. While the journey from a broken ankle to full recovery can be long, especially after surgery, the adherence to a personalised physiotherapy plan lays the foundation for a return to normal activities, offering a light at the end of the tunnel for those affected by this common but challenging injury.

Common Ankle Injuries

Welcome to an exploration of common ankle injuries. The ever-present sprained ankle is at the forefront, accompanied by various sources contributing to ankle pain. Fractures, stress fractures, and tendinopathies are part of this landscape, each with implications. Ankle impingement and foot posture issues emerge, and biomechanical issues take centre stage, affecting alignment and eventually fast-tracking ankle arthritis. Even the younger population experiences heel concerns, with Severs disease impacting many young athletes' seasons. This article serves as a concise guide to understanding the complexities of ankle problems.

Sprained Ankles

The most common ankle injury is a sprained ankle, but ankle pain can have numerous sources.

Ankle Fractures

An ankle fracture occurs when there is a break in one or more of the bones. The most common ankle fractures are avulsion fractures of your distal fibula, which can be a side effect of an ankle sprain. All suspected fractures require medical investigation and professional management by your health professional to avoid long-term foot and ankle issues. If your healthcare professional suspects an ankle fracture, you will be referred for at least an X-ray and potentially an Orthopaedic Surgeon.

Ankle Tendinopathies

While muscle strains are more common in your legs, there are essential muscles that converge into tendons that wrap around your ankle to stabilise your ankle and foot to protect them from sprains and allow you to walk and run. These muscles and their tendon vitally provide a normal foot arch and avoid flat feet. Your muscles or tendons can become injured or inflamed due to overuse or trauma. The inflammation is called tendonitis. They can also tear, completely rupture, or sublux out of place. Medically tendon injuries are known as tendinopathies, and at the ankle may include:

Ankle Arthritis

Your ankle pain and dysfunction can lead to degenerative conditions such as ankle osteoarthritis. While arthritis usually is a chronic deterioration of your ankle joint, it is crucial to slow ankle arthritis progression. Would you please seek the professional advice of your ankle and foot health practitioner, e.g. physiotherapist or podiatrist?

Biomechanical Conditions

Biomechanical disorders may result in foot deformation, painful weight-bearing and potentially nerve compression. In simple terms, this is where your foot and ankle do not have normal bone alignment and motion control. Here are a few possible conditions related to poor ankle biomechanics.

Muscle Injuries

Nerve-Related Ankle Pain

Children & Youth Conditions

Systemic Conditions That May Cause Ankle Pain

Soft Tissue Inflammation

Other Useful Information

Foot, Ankle & Heel Pain FAQs

Welcome to our comprehensive FAQ guide on Foot, Ankle & Heel Pain. In this guide, we aim to address common questions and concerns related to foot, ankle, and heel pain. We will cover various topics, including ankle injuries, heel pain, Achilles pain, foot pain, shin pain, youth injuries, and balance and proprioception. Whether you're experiencing discomfort or seeking preventive measures, this guide will provide valuable insights and advice to help you understand and manage these conditions effectively.

Ankle Injuries

Heel Pain

Achilles Pain

Foot Pain

Shin Pain

Youth Injuries

Balance & Proprioception

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