How do you manage and heal a broken ankle? It helps to first understand what a broken ankle is. A broken ankle when there is a separation of the bone, the same as a fracture. Just as there are various types of fractures, such as greenstick or arthritic, there are common fracture types specific to the ankle as well that explain the pattern of the broken bone.
When it comes to the ankle, there are 3 types of Weber fractures to explain the location of the break relative to the ankle joint:
- Weber A: Occurs below syndesmosis (an immovable joint which joins the fibular bones and tibia).
- Weber B: Occurs at level as syndesmosis.
- Weber C: Occurs above the syndesmosis; these are the most unstable fractures. Treatment includes a moon boot and no weight bearing, and potentially surgery.
“Pseudo-Jones”: Occurs on the outside of the foot, at the base of the fifth metatarsal bone.
Tibial and Fibular: Occurs when there is a break in the tibia or fibular bones. The tibial fracture is generally more severe and unstable than a fibular fracture, which is typically treated like an ankle sprain.
If you have a broken ankle, a physiotherapist will give you a diagnosis of which type of break or fracture you have, which typically requires an MRI or x-ray scans. Then they explain the rehabilitation process and how to ease back into your day-to-day life.
Here is how a physio for a broken ankle will generally help you recover:
First, the bone must be immobilized, which is a critical first step in fracture management because a broken bone will shift in the first two weeks if it is going to move at all. This means either a moon boot or ankle brace for the bone to begin healing while your physio helps you maintain strength and range of motion around the fracture.
Second, you will work to increase your range of ankle movement over the next 4-6 weeks (or longer for more severe fractures). Generals goals at this stage include potentially walking again, typically with crutches, and being able to flex your foot toward your shin. This level of dorsiflexion will tell your physiotherapist how stiff the ankle is. Resistance bands alongside other treatments such as massage or joint mobilization are crucial for this stage in healing to increase range of movement.
Third, you will focus on strengthening. In this phase of physio for a broken ankle you will lose the crutches or boot if you have not yet already. Strength will be built back up by fully bearing weight again, along with heel raises, squats, running and possibly jogging.
Lastly, within 6-8 weeks of your initial injury you will return to your sport or normal activities depending on where you are with the healing process. Your physiotherapist may test certain movements by putting you through a sport test. If needed, you may be referred to a hydrotherapy program to return to your pre-injury fitness level.
Just as there are many types of fractures, not everyone heals the same. These phases are best to reference as a guideline, so always consult your healthcare professional before returning to your sport or specific activity.