Non-operative Treatment of an Ankle Fracture

  1. You will remain immobilized in the walking boot until 4 weeks post-injury.
  2. You are allowed to fully weight bear as tolerated in the walking boot. I would like you to discontinue use of the crutches or any other assistive walking devices as quickly as possible.
  3. You may remove the walking boot whenever seated or lying down, in a safe controlled environment. The walking boot is in place to protect rather than immobilize the fracture.
  4. I would like you to come out of the boot/brace to work on the following exercises, twice daily:
    • Write the alphabet with your foot. Do two repetitions.
    • Stretch the Achilles by placing a towel across the ball of your foot and pulling up. Hold the stretch for a five-count and do 5 repetitions.
  5. At 4 weeks post-injury, you will gradually transition to regular shoes. An ankle brace should be used to facilitate the process.
  6. Once you have returned to regular shoes, you may gradually ramp up your activities in a step-wise manner as tolerated.
    • I would like you to first become comfortable with activities of daily living before reintroducing straight-line, low-impact activities (walking, bicycling, using an elliptical trainer, weight training).
    • Once you are comfortable at this level, you may reintroduce higher-impact, straight-line activities (jogging, running).
    • The final step will be the addition of activities involving lateral movement and uneven ground.
  7. I would like to see you back in 4 weeks for a follow-up appointment. We will obtain new x-rays upon return.
  8. Ankle fractures typically take 10-12 weeks to fully heal.