The ankle is a hinge joint where the primary motion is to lift and point the foot. If we look at an image of the ankle joint you will see the larger inner bone of the lower leg leg called the tibia and the thinner outer bone called the fibula articulate with a bone called the talus in the posterior part of the foot. Beneath the talus lies the calcaneus or heel bone. The articulation between these bones allows for movements like inversion/eversion or supination/pronation. Many ligaments, muscles and tendons travel between the bones of the lower leg and foot, crossing the ankle joint.

Because of the complex anatomy in the ankle area, there are many potential sources of ankle pain or discomfort that might lead to a need for surgery. Here are some common types of ankle surgeries that are often addressed post-surgically by physical therapists:

Ankle fusion: An ankle fusion, also known as an ankle arthrodesis, is a surgical procedure often performed in the case of severe arthritis (osteoarthritis, rheumatoid arthritis, etc.) with significant pain, swelling and difficulty walking. During this surgery the tibia bone is fused with the underlying talar bone and often the calcaneus to restrict movement at these joints.

Ankle replacement: Ankle replacement surgery involves the replacement of a damaged or injured ankle joint with a prosthetic/artificial implant. Ankle replacements are performed usually in the case of severe arthritis (osteoarthritis, rheumatoid arthritis, etc.) where pain, swelling and difficulty walking is significant.

Lateral ankle ligament reconstruction: This surgery is performed to address the symptoms of lateral ankle ligament instability. During this procedure the surgeon will tighten or firm up one or more of the ligaments on the outside of the ankle that serve to stabilize the bones. A person who has experienced frequent lateral ankle sprains or has certain foot deformities may experience loosening and lengthening of these ligaments over time which leads to instability.

Ankle tendon repair: When a tendon is injured or damaged, an ankle tendon repair may be needed to restore normal function in the tendon and its corresponding muscle. These injuries can be the result of a disease process like diabetes or arthritis or from an injury, ankle deformity or even from overuse. Pain, swelling, difficulty walking or performing weight bearing activities and even ankle instability are signs of tendon injury. For minor tendon injuries a surgeon may suture the tendon back together. For more severe tendon injuries a surgeon may graft a piece of tissue from another healthy tendon to strengthen the injured one.

Fracture repair: plates and screws may be needed to stabilize a severe ankle fracture if there is concern it will not heal adequately with only immobilization.

If you decide to work with a physical therapist to help with ankle rehab, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

WHAT CAN I EXPECT FROM PHYSICAL THERAPY AFTER SURGERY?

The exact progression of your recovery will depend on the type of surgery you had. Some surgeries will require a period of ankle immobilization to allow tissues to heal sufficiently before any stress is applied to them, while other surgeries will benefit from a more active recovery approach right away. Right after your surgery your physical therapist may use modalities, manual therapy techniques or gentle passive range of motion to address pain and inflammation and to preserve motion. As you progress through your recovery and the surgical site is allowed to undergo more stress, your program will likely include some of the following types of treatment in order to achieve your maximal level of function:

Strengthening: Restoring strength and endurance to the muscles around the ankle, foot and lower leg is an important part of post-surgical rehabilitation. It will reduce the risk of re-injury and help you return to your prior level of function.

Stretching: Stretching is often needed after a surgery to restore normal joint motion and muscle length but needs to be done carefully to prevent disruption of the healing process.

Neuromuscular Re-education: This type of treatment is used to improve the motor control and coordination of muscles around the ankle so that the ankle functions well and remains stable during everyday activities.

Gait training: This type of treatment involves learning how to walk normally again following the surgery.

Balance: Balance is often affected by ankle injury and surgery and you will likely be practicing balance exercises under a number of conditions.

Power and Agility: In the late stages of post-surgical rehab it is important to address power and agility so that you can jump, run, cut and so forth.

Sport-specific Tasks: For athletes returning to sport, sport-specific exercises will be incorporated later on in your rehabilitation to prepare the ankle for the demands of returning to play

CALL TO SCHEDULE AN APPOINTMENT TODAY!

Having any type of surgery can feel daunting but my team of physical therapists and I are here to help make that process as smooth as possible. Call Evolve today to get started on your recovery from ankle surgery.