People undergo ankle surgeries for many different reasons. Sometimes, in the case of acute injuries like a crush injury or a fracture, ankle surgery becomes an emergency and the focus of physical therapy will be on recovery after the fact. Many other surgeries, however, may occur after a period of conservative care and chronic symptoms. While there are many types of ankle surgeries, here is a list of common ankle surgeries that may benefit from a course of prehabilitation:

• Ankle fusion
• Ankle replacement
• Lateral ankle ligament repair
• Ankle tendon repair

WHY NOT WAIT UNTIL AFTER SURGERY?

Physical therapy can set you up for success on both sides of the operating table. Many people are not surprised to hear that physical therapy will be needed after their ankle surgery to help the ankle recover and to restore normal function. Fewer people are familiar with how they can benefit from working with a physical therapist in anticipation of undergoing ankle surgery. Many times after we’ve sustained an injury or if we’ve been dealing with symptoms for a long time we naturally decrease our level of movement and exercise to avoid provoking uncomfortable or painful symptoms. While this choice will most likely accomplish the goal of reducing our symptoms, it doesn’t necessarily put us in the best position for an easy recovery from surgery. If the surgery isn’t an emergency, there are many ways that a physical therapist can help prepare you and your body for the upcoming procedure. It is normal for inflammation, weakness, and stiffness to develop in response to surgery, especially if a period of modified weight bearing or time spent in a cast or boot is required. The better condition your ankle, your leg and let's face it, your entire body is prior to surgery, the easier it is to return to your normal activities.

If you decide to work with a physical therapist to help with ankle prehab issues, 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 YOU EXPECT FROM ANKLE PREHABILITATION?

My team of therapists will individualize a prehabilitation program just for you, however, there are many elements that are common across different prehabilitation programs. To help you gain a better understanding of what to expect, here is a list of some common goals of ankle prehab:

Set expectations: The idea of surgery can be quite scary. Having an idea of what to expect after the procedure can ease some of your anxiety and help ensure you have what you need to support your recovery. Getting to know your physical therapist before surgery will help build trust with them when it comes time for post-operative care. They can also advise you on any equipment or modifications to your home that might be necessary, help you understand what kind of help or support you will need from others, and prepare you for how your body may feel after surgery.

Manage pain and inflammation: Pain and inflammation are natural side effects of injuries. They alert us that we need to protect the injured area and that the body is taking steps to start the healing process. In some cases, however, your surgeon may require that your injury is “quiet”, meaning it can tolerate some stress and activity without causing significant swelling, before they want to operate. If this is the case, or if surgery is delayed for any reason, learning strategies to manage pain and inflammation in the meantime will help you stay comfortable and as active as possible.

Learn how to use assistive devices: If you will be leaving the hospital with a shiny new walker, cane, or crutches, learning how to use them beforehand can be very helpful. Immediately post surgery, when you are still feeling the effects of anesthesia, and pain and stiffness are setting in, is not the best time to learn how to use an unfamiliar device that is meant to protect your recently operated-on ankle.

Build or maintain strength and flexibility: While the brain knows that surgery is intended to “heal” the injury, the body views the surgical procedure as another injury to the tissues. While the surgeon may have sewn a torn ligament or repaired your bone, which will ultimately improve your symptoms and get you moving again, the body will need to heal from the effects of the surgery before that can happen. Maximizing strength and flexibility prior to the surgery can help decrease muscle atrophy and stiffness following the procedure which can ultimately quicken your recovery.

Prehabilitation for ankle surgeries is an excellent choice for those wanting to get a head start on their recovery and to help improve their chances of a good surgical outcome. My team of therapists and I would love to help you prepare for your upcoming ankle surgery. Call the office at Evolve today to get started.