Health Care

The Process of Healing a Broken Ankle with a Physio

To understand how to manage a broken ankle and know how seeing a physio for a broken ankle is going to work, it is important to know more about what a broken ankle is. Just like a fracture, a broken ankle involves the separation of two sides of a particular ankle bone.

You may be familiar with a greenstick fracture, which is common in children whose bones haven’t fully developed yet; or, an arthritic fracture, which happens mainly to elderly and people with arthritis, as the name suggests.  

There are three types of fractures to explain the location of the break when it comes to the ankle: Weber A, B, and C. 

Weber A occurs below syndesmosis, a thick ligament that joins the fibula and tibia via connective tissue.

Weber B occurs at the same level as syndesmosis.

Weber C occurs above syndesmosis and are generally the most severe and unstable of fractures.  

There is also another common fracture type known as the “Pseudo-Jones” fracture, which occurs at the base of the fifth metatarsal bone, outside of the foot. Then there are the fibular and tibial fractures, which involve a break in either of these bones. The fibular fracture can usually be treated like an ankle sprain, while a tibial fracture tends to be more severe.

An MRI or x-ray is typically needed to determine what type of fracture you have. Your physiotherapist will then diagnose you and determine treatment. But a general guideline for physio for a broken ankle will look like the following: 

  1. Immobilize the bone. The bone can shift in the first two weeks post-injury, which is what makes the use of a moon boot or ankle brace during this period so critical. This immobilization will also allow the bone to start healing. During this time your physio will coach you through maintaining range of motion and strength. 
  2. Increase range of ankle movement. The main goal here is dorsiflexion; your ability to flex your foot toward your shin to a certain degree will determine stiffness of the ankle. This stage will typically span over four to six weeks, during which time you may start walking again with the use of crutches, depending on the severity of your break. You will also be focusing on resistance band training and incorporating it with treatments like massage to increase range of movement.
  3. Strengthening. In this stage you will work back to full weight bearing, so walking to possibly jogging, accompanied by single leg heel raises and squats.
  4. Return to your sport or activity. Depending on how far along your injury is with healing, typically you will return to your previous activities in this last period of physio for a broken ankle, which is within six to eight weeks of your injury. Your physiotherapist may perform a sport test during this time, to gauge your progression. If further rehabilitation is needed, they may recommend a hydrotherapy program to improve your fitness levels. 

Remember that this is just a general process for broken ankle physio, and not everyone heals according to the same timeline. Let your healthcare professional provide guidance when returning to your previous activities or sports after the rehabilitation of your broken ankle.