Ankle surgery addresses various conditions, from fractures to chronic pain. A structured recovery process is important for regaining ankle function and mobility. This guide outlines key steps for a successful post-operative period.
Initial Care After Surgery
Managing pain is a primary priority after ankle surgery. Take prescribed medications as directed. A nerve block provides initial relief, but pain may increase for a few days as it wears off. Consistent icing and elevation also help manage pain and reduce swelling.
Reducing swelling is a significant part of initial care. The RICE principle—Rest, Ice, Compression, and Elevation—is a widely used approach. Elevate the operated leg above heart level to minimize swelling and throbbing. Apply ice packs for 20 minutes every few hours, avoiding wet bandages or direct skin contact until a nerve block wears off. Compression also helps control swelling.
Proper wound care prevents infection. Keep surgical dressings clean and dry, following all instructions for changes. Initial bleeding or drainage is normal, but foul-smelling discharge or pus indicates a potential issue. Do not submerge the wound in water until it has fully healed.
Immobilization and weight-bearing restrictions protect healing tissues and bones. Patients typically wear a splint, cast, or medical boot for two to twelve weeks, depending on the surgery. Non-weight-bearing means no weight should be placed on the operated foot, even for balance, to prevent damage. Crutches, walkers, or knee scooters are common mobility aids during this period.
Regaining Strength and Movement
Physical therapy (PT) is important for recovering strength and movement after ankle surgery. A physical therapist guides rehabilitation, developing a personalized exercise plan to restore function. They monitor progress and adjust exercises as the ankle heals and strengthens.
Weight-bearing progression is carefully managed to avoid re-injury. Patients begin non-weight-bearing, then transition to toe-touch weight-bearing for balance. This progresses to partial weight-bearing, then full weight-bearing. The timeline for full weight-bearing varies significantly, from weeks to months, depending on surgery type.
Range of motion exercises prevent stiffness and improve flexibility. Early exercises include ankle pumps to maintain movement and promote circulation, helping prevent blood clots. As recovery progresses, controlled ankle movements like writing the alphabet with the foot are introduced to regain full flexibility.
Strengthening exercises rebuild muscle strength around the ankle and lower leg. These may involve resisted movements with exercise bands to target specific muscle groups. Heel raises, initially seated then standing, are common exercises to strengthen calf muscles for ankle support.
Balance and proprioception training enhance stability and reduce future injury risk. Proprioception is the body’s awareness of its position in space. Exercises begin with supported standing on the affected leg, progressing to unstable surfaces or single-leg stands. This training helps the ankle react appropriately to different movements.
Returning to Daily Life
Resuming daily activities requires a gradual approach, guided by medical advice. Driving is a significant milestone, with timing dependent on the operated foot, vehicle type, and pain levels. For right foot surgery, wait until full weight-bearing is achieved and pain medication is no longer needed. Left foot surgery patients with automatic cars may drive sooner once comfortable and off pain medication.
Returning to work or school depends on the activity’s physical demands. Sedentary jobs may allow an earlier return, within days to weeks, if pain and elevation are manageable. Physically demanding jobs require a longer recovery, aligning with weight-bearing and strength progression. Accommodations like modified duties or reduced hours can facilitate a smoother transition.
Reintroduce hobbies and recreational activities incrementally. Listen to your body, avoiding activities that cause pain or excessive swelling. High-impact sports or activities with quick direction changes are typically restricted for six to twelve months for complete healing. Gradual reintroduction under physical therapist guidance helps prevent re-injury.
Appropriate footwear supports long-term ankle health. Supportive shoes providing good ankle stability are recommended during recovery and beyond. High heels or unsupportive footwear may be discouraged due to undue stress on the healing joint. Prioritize stability and comfort in footwear choices to protect the ankle.
Long-term self-care involves maintaining ankle strength, flexibility, and balance. Adhering to a home exercise program after physical therapy helps prevent stiffness and weakness. Regular activity within comfortable limits, combined with proper footwear, contributes to sustained ankle function and prevents future issues.
When to Contact Your Doctor
Certain symptoms after ankle surgery warrant immediate medical attention. Signs of infection include fever, chills, spreading redness, increasing pain, warmth, or unusual discharge like pus or foul odor from the wound.
Deep Vein Thrombosis (DVT), a blood clot, is another serious concern. Leg symptoms may include throbbing pain, swelling, tenderness, warmth, or redness, often in the calf or thigh. If accompanied by shortness of breath or chest pain, this could signal a pulmonary embolism, a medical emergency.
Nerve damage can present with concerning symptoms, though sometimes temporary. Report persistent numbness, tingling, burning, shooting pain, or increasing weakness in the foot or toes to your doctor. Worsening or new nerve symptoms need evaluation, even if some healing takes time.
Communicate excessive or uncontrolled pain, especially if it doesn’t improve with medication or sharply increases, to your medical team. New or worsening swelling, bruising, or any loss of sensation or movement in the foot or toes also requires prompt medical advice. Discuss any cast or boot issues, such as persistent pressure points, rubbing, or unresolved discomfort, with your healthcare provider.