Ankle Injuries

What is your injury?

It’s a sprain to your ankle. This means you have damaged the soft tissue such as ligaments, tendons or muscles around the ankle joint. This can be graded from a mild sprain to a more severe sprain.

Healing

This injury normally takes up to 12 weeks to heal, but this may differ depending on your individual circumstances.

Follow up

Injuries like yours usually heal well on their own over time, so most people won’t need a follow up. If you do, we’ll contact you by phone. A follow up may be for physiotherapy or a clinical examination in Fracture Clinic.

Please contact the Fracture Clinic on 01872 253091 if:

• you’re unable to follow this rehabilitation plan
• you have any questions
• you’re struggling to remove your boot after 6 weeks
• you experience pain or symptoms other than at the site of the original injury or surrounding area
• you experience significant pain after 12 weeks.

Your rehabilitation plan

Your consultant or specialist may give you a different rehabilitation plan based on your injury and circumstances.

For the first 2 weeks after your injury:

• you can put weight through your injured leg
• early weight bearing (putting weight through your injured foot) helps speed up healing, so try to walk as normally as possible
• you may find it easier to use crutches in the early stages
• start the initial exercises straight away (see below).

If you’ve been given a boot:

• wear it when standing and walking if needed – it will protect your ankle and make you more comfortable
• wear a long sock in your boot
• take the boot off at night, when resting at home and when doing your exercises.

Between 3 and 6 weeks:

• stop using the boot and walk without it around your house
• build up to walking without the boot when you go outside or for longer walks
• gradually increase your activity
• start the exercises below labelled ‘exercises from week 3 onwards’.

After 6 weeks:

• resume day-to-day activities but respond to any pain you might experience
• avoid impact for 3 months (running, jumping and dancing)
• you might have mild symptoms for 3 to 6 months, especially after heavy tasks or long walks.

Exercises

Follow the exercises below without causing too much pain. This will prevent your ankle and foot from becoming too stiff and help the healing process. It will also promote circulation and reduce the risk of developing a blood clot (Deep Vein Thrombosis, or DVT).

Exercises to start straight after your injury

Do these initial exercises for ankle and foot range of movement 3 to 5 times a day.
Repeat each of the following 10 times:

1. Point your foot up and down within a comfortable range of movement.

2. With your heels together, move your toes apart to turn your foot outwards. Do this gently as long as it’s comfortable for you

3. Turn the feet in towards each other as in the picture, keep the legs still, moving from the ankle only.

Exercises from week 3 onwards

Ankle stretches

Repeat the following 5 times.

1. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of your calf. Hold for 30 seconds.

2. Point your toes down as far as they go. Use your other foot on top to apply some pressure to create a stretch on the top of your foot. Hold for 30 seconds.

Balance strategy exercises – for patients who could NOT stand on one leg before their injury

Step 1: Stand with your feet as close together as possible. Hold onto a firm surface (back of a chair or a table) for support. Hold this for 30 seconds.

Step 2: Follow step 1 above but remove your hand from the support so that you’re balancing. Hold this for 30 seconds.

Step 3: Still holding onto the support, put one foot in front of the other as close together as possible. Hold this for 30 seconds. If you feel confident with this exercise, try to keep your balance without holding onto the support.

Balance strategy exercises – for patients who could stand on one leg before their injury

Step 1: Hold onto a firm surface (back of a chair or a table). Try to stand on just your injured leg. Hold this for 30 seconds making sure it does not cause any pain. Once you can do this pain free, move onto step 2.

Step 2: Try to stand on just your injured leg without holding on to a support. Try to hold this for 30 seconds.

For more about your injury and demonstrations of the exercises

Watch this video about soft tissue ankle injuries from Brighton and Sussex University Hospitals.

What is your injury?

You have a small break in one of 3 places:

• the outside of your ankle (a lateral avulsion fracture)
• the inside of your ankle (a medial avulsion fracture)
• your shin bone where it meets your ankle (an anterior tibia avulsion fracture).

Healing

This injury normally takes up to 12 weeks to heal, but this may differ depending on your individual circumstances. More severe avulsion fractures can take longer.

Follow up

Injuries like yours usually heal well on their own over time, so most people won’t need a follow up. If you do, we’ll contact you by phone.

Sometimes however, an avulsion fracture may be more severe. If you have significant pain or swelling that is not settling after 4 to 6 weeks, please call the Fracture Clinic to book a face to face appointment on 01872 253091.

Please contact the Fracture Clinic on 01872 253091 if:

• you’re unable to follow this rehabilitation plan
• you have any questions
• you’re struggling to remove your boot after 6 weeks
• you experience pain or symptoms other than at the site of the original injury or surrounding area
• you experience significant pain after 4 to 6 weeks.

If you feel you’d like to see someone at any time in the 6 months after your injury, you can book an open appointment. Please call 01736 758892 to make an appointment.

Your rehabilitation plan

Your specialist may give you a different rehabilitation plan based on your injury and circumstances.

For the first 4 weeks after your injury:

• you can put weight through your injured leg – early weight bearing (putting weight through your injured foot) helps speed up healing, so try to walk as normally as possible
• you may find it easier to use crutches in the early stages
• wear your boot when standing and walking if needed – it will protect your ankle and make you more comfortable
• wear a long sock in your boot
• take the boot off at night, when resting at home and when doing your exercises
• start the initial exercises straight away (see below).

Between 4 and 6 weeks:

• stop using the boot and walk without it around your house
• build up to walking without the boot when you go outside or for longer walks
• gradually increase your activity

After 6 weeks:

• start the exercises below labelled ‘exercises from week 6 onwards’.
• you should not be using the boot
• resume day-to-day activities but respond to any pain you might experience
• avoid impact for 3 months (running, jumping and dancing, contact sports)
• you might have mild symptoms for 3 to 6 months, especially after heavy tasks or long walks.

Exercises

Follow the exercises below without causing too much pain. This will prevent your ankle and foot from becoming too stiff and help the healing process. It will also promote circulation and reduce the risk of developing a blood clot (Deep Vein Thrombosis, or DVT).

Exercises to start straight after your injury

Do these initial exercises for ankle and foot range of movement 3 to 5 times a day.
Repeat each of the following 10 times:

1. Point your foot up and down within a comfortable range of movement.

2. With your heels together, move your toes apart to turn your foot outwards. Do this gently as long as it’s comfortable for you

3. Turn the feet in towards each other as in the picture, keep the legs still, moving from the ankle only.

Exercises from week 6 onwards

Ankle stretches

Repeat the following 5 times.

1. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of your calf. Hold for 30 seconds.

2. Point your toes down as far as they go. Use your other foot on top to apply some pressure to create a stretch on the top of your foot. Hold for 30 seconds.

Balance strategy exercises – for patients who could NOT stand on one leg before their injury

Step 1: Stand with your feet as close together as possible. Hold onto a firm surface (back of a chair or a table) for support. Hold this for 30 seconds.

Step 2: Follow step 1 above but remove your hand from the support so that you’re balancing. Hold this for 30 seconds.

Step 3: Still holding onto the support, put one foot in front of the other as close together as possible. Hold this for 30 seconds. If you feel confident with this exercise, try to keep your balance without holding onto the support.

Balance strategy exercises – for patients who could stand on one leg before their injury

Step 1: Hold onto a firm surface (back of a chair or a table). Try to stand on just your injured leg. Hold this for 30 seconds making sure it does not cause any pain. Once you can do this pain free, move onto step 2.

Step 2: Try to stand on just your injured leg without holding on to a support. Try to hold this for 30 seconds.

For more about your injury and demonstrations of the exercises

Watch this video about avulsion fractures to medial navicular from Brighton and Sussex University Hospitals.

What is your injury?

You have broken a bone on the inside of your ankle. This often involves some damage to the deltoid ligament which is also on the inside of your ankle.

Healing

This injury normally takes up to 12 weeks to heal, but this may differ depending on your individual circumstances.

Follow up

You’ll see a specialist 1 to 2 weeks after your injury and have a weight bearing (standing) x-ray. The specialist will explain the results and discuss the next stage of your care. There’s a chance that this fracture can move, or that it may not heal completely by itself, and you may need an operation. You can find out more about having an operation on your ankle further down the page.

We will follow up with you at 6 weeks and sometimes again at 12 weeks.

You can also book an open appointment at any time in the six months after your injury. Please call 01736 758892 to make an appointment.

Please contact the Fracture Clinic on 01872 253091 if:

• you’re unable to follow this rehabilitation plan
• you have any questions
• you haven’t heard from us about your follow up appointment by 4 days after your injury
• you experience pain or symptoms other than at the site of the original injury or surrounding area
• you experience significant pain after 12 weeks.

Your rehabilitation plan

Your specialist may give you a different rehabilitation plan based on your injury and circumstances.

For the first 6 weeks after your injury:

• you can put weight through your injured leg – early weight bearing (putting weight through your injured foot) helps speed up healing, so try to walk as normally as possible
• you may find it easier to use crutches in the early stages
• wear your boot when standing and walking if needed – it will protect your ankle and make you more comfortable
• wear a long sock in your boot
• take the boot off at night, when resting at home and when doing your exercises.
• start the initial exercises straight away (see below).

Between 6 and 12 weeks:

• stop using the boot and walk without it around your house
• build up to walking without the boot when you go outside or for longer walks
• stop using your crutches and boot (after 8 weeks)
• gradually increase your activity
• start the exercises below labelled ‘exercises from week 6 onwards’.

After 12 weeks:

• resume day-to-day activities but respond to any pain you might experience
• avoid impact for 3 months (running, jumping and dancing)
• You might have mild discomfort and swelling for 6 to 12 months, especially after heavy tasks or long walks.

Exercises

Follow the exercises below without causing too much pain. This will prevent your ankle and foot from becoming too stiff and help the healing process. It will also promote circulation and reduce the risk of developing a blood clot (Deep Vein Thrombosis, or DVT).

Exercises to start straight after your injury

Do these initial exercises for ankle and foot range of movement 3 to 5 times a day.
Repeat each of the following 10 times:

1. Point your foot up and down within a comfortable range of movement.

2. With your heels together, move your toes apart to turn your foot outwards. Do this gently as long as it’s comfortable for you

3. Turn the feet in towards each other as in the picture, keep the legs still, moving from the ankle only.

Exercises from week 6 onwards

Ankle stretches

Repeat the following 5 times.

1. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of your calf. Hold for 30 seconds.

2. Point your toes down as far as they go. Use your other foot on top to apply some pressure to create a stretch on the top of your foot. Hold for 30 seconds.

Balance strategy exercises – for patients who could NOT stand on one leg before their injury

Step 1: Stand with your feet as close together as possible. Hold onto a firm surface (back of a chair or a table) for support. Hold this for 30 seconds.

Step 2: Follow step 1 above but remove your hand from the support so that you’re balancing. Hold this for 30 seconds.

Step 3: Still holding onto the support, put one foot in front of the other as close together as possible. Hold this for 30 seconds. If you feel confident with this exercise, try to keep your balance without holding onto the support.

Balance strategy exercises – for patients who could stand on one leg before their injury

Step 1: Hold onto a firm surface (back of a chair or a table). Try to stand on just your injured leg. Hold this for 30 seconds making sure it does not cause any pain. Once you can do this pain free, move onto step 2.

Step 2: Try to stand on just your injured leg without holding on to a support. Try to hold this for 30 seconds.

What is your injury?

You have broken a bone on the outside of your ankle (fibula).

Image / Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org. From the case rID: 9642

Healing

This injury normally takes up 12 weeks to heal, but this may differ depending on your individual circumstances.

Follow up

Injuries like yours usually heal well on their own over time, so most people won’t need a follow up. If you do need a follow up or physiotherapy, we’ll contact you by phone.

If you still feel you’d like to see someone, you can book an open appointment at any time in the six months after your injury. Please call 01736 758892 to make an appointment.

Please contact the Fracture Clinic on 01872 253091 if:

• you’re unable to follow this rehabilitation plan
• you have any questions
• you’re struggling to remove your boot after 6 weeks
• you experience pain or symptoms other than at the site of the original injury or surrounding area
• you experience significant pain and stiffness after 12 weeks.

Your rehabilitation plan

Your specialist may give you a different rehabilitation plan based on your injury and circumstances.

For the first 4 weeks after your injury:

• you can put weight through your injured leg – early weight bearing (putting weight through your injured foot) helps speed up healing, so try to walk as normally as possible
• you may find it easier to use crutches in the early stages
• wear your boot when standing and walking if needed – it will protect your ankle and make you more comfortable
• wear a long sock in your boot
• take the boot off at night, when resting at home and when doing your exercises.
• start the initial exercises straight away (see below). Do them regularly to get your movement back.

Between 4 and 6 weeks:

• try to stop using the boot and walk without crutches. Start walking around your house, then try outside
• wear your boot when you go for a long walk
• gradually increase your activity
• start the exercises below labelled ‘exercises to do after 4 weeks’.

After 6 weeks:

• Your fracture should have healed
• start the exercises below labelled ‘exercises to do after 6 weeks’
• resume day-to-day activities but respond to any pain you might experience
• avoid impact for 3 months (running, jumping and dancing)
• You might experience mild discomfort and swelling for up to 6 months, especially after heavy tasks or long walks.

Exercises

Follow the exercises below without causing too much pain. This will prevent your ankle and foot from becoming too stiff and help the healing process. It will also promote circulation and reduce the risk of developing a blood clot (Deep Vein Thrombosis, or DVT).

Exercises to start straight after your injury

Do these initial exercises for ankle and foot range of movement 3 to 5 times a day.
Repeat each of the following 10 times:

1. Point your foot up and down within a comfortable range of movement.

2. With your heels together, move your toes apart to turn your foot outwards. Do this gently as long as it’s comfortable for you

3. Turn the feet in towards each other as in the picture, keep the legs still, moving from the ankle only.

Exercises from week 4 onwards

Ankle stretches

Repeat the following 5 times.

1. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of your calf. Hold for 30 seconds.

2. Point your toes down as far as they go. Use your other foot on top to apply some pressure to create a stretch on the top of your foot. Hold for 30 seconds.

Balance strategy exercises – for patients who could NOT stand on one leg before their injury

Step 1: Stand with your feet as close together as possible. Hold onto a firm surface (back of a chair or a table) for support. Hold this for 30 seconds.

Step 2: Follow step 1 above but remove your hand from the support so that you’re balancing. Hold this for 30 seconds.

Step 3: Still holding onto the support, put one foot in front of the other as close together as possible. Hold this for 30 seconds. If you feel confident with this exercise, try to keep your balance without holding onto the support.

Balance strategy exercises – for patients who could stand on one leg before their injury

Step 1: Hold onto a firm surface (back of a chair or a table). Try to stand on just your injured leg. Hold this for 30 seconds making sure it does not cause any pain. Once you can do this pain free, move onto step 2.

Step 2: Try to stand on just your injured leg without holding on to a support. Try to hold this for 30 seconds.

Advanced exercises for 6 weeks after your injury

Try these exercises if you have good balance.

Stage 1

Stage 2

For more about your injury and demonstrations of the exercises

Watch this video about Weber A fractures from Brighton and Sussex University Hospitals.

What is your injury?

You have broken a bone on the outside of your ankle. In some cases, this can cause your ankle to become unstable.

Image / Case courtesy of Assoc Prof Frank Gaillard, Radiopaedia.org. From the case rID: 9642

Healing

It normally takes 8 to 12 weeks for your first symptoms to settle. It will likely take longer if you smoke or have diabetes.

You may need an operation to help your injury heal. A consultant will need to assess your injury and the stability of your ankle before making a formal recommendation on whether your injury should be managed with or without surgery. You can find out more about having an operation on your ankle further down the page.

You may have ankle pain and swelling for up to 12 months after your injury. Swelling is often worse at the end of the day. Taking pain medication, elevating your ankle and using ice or cold packs will help. There’s more information about this at the top of this page.

Follow up

You’ll see a specialist and have a weight bearing (standing) x-ray 1 to 2 weeks after your injury. There’s a small chance that this type of fracture can move. If it does, you may need an operation. We’ll discuss any further treatment, including surgery, with you at the Fracture Clinic when you have your x-ray. The decision to have surgery is always your choice.

You can also book an open appointment at any time in the six months after your injury. Please call 01736 758892 to make an appointment.

Please contact the Fracture Clinic on 01872 253091 if:

• you’re unable to follow this rehabilitation plan
• you have any questions
• you haven’t heard from us about your follow up by 4 days after your injury
• you experience pain or symptoms other than at the site of the original injury or surrounding area
• you experience significant pain and stiffness after 12 weeks.

Your rehabilitation plan

Your specialist may give you a different rehabilitation plan based on your injury and circumstances.

For the first 6 weeks after your injury:

• you can put weight through your injured leg – early weight bearing (putting weight through your injured leg) helps speed up healing, so try to walk as normally as possible
• wear your boot when standing and walking – it will protect your ankle and make you more comfortable
• use crutches to take some weight off your foot
• wear a long sock in your boot
• take the boot off when resting at home and when doing your exercises
• you can also take the boot off at night, but if you get up to use the toilet in the night, it may be safer to sleep with the boot on
• start the initial exercises straight away (see below).

After 6 weeks:

• start the exercises below labelled ‘exercises from week 6 onwards’
• we’ll tell you when you can stop wearing your boot but it will be at least 6 weeks
• gradually increase your activity but avoid impact activity for 3 months (such as running, jumping and dancing)
• You may have mild discomfort and swelling for 6 to 12 months, especially after heavy tasks or long walks.

Exercises

Follow the exercises below without causing too much pain. This will prevent your ankle and foot from becoming too stiff and help the healing process. It will also promote circulation and reduce the risk of developing a blood clot (Deep Vein Thrombosis, or DVT).

Exercises to start straight after your injury

Do these initial exercises for ankle and foot range of movement 3 to 5 times a day.

1. Point your foot up and down within a comfortable range of movement. Repeat this for up to one minute.

2. With your heels together, move your toes apart to turn your foot outwards. Do this gently as long as it’s comfortable for you. Repeat 10 times.

3. Keeping your hip and leg still, turn your injured foot inwards towards the other foot, as shown in the picture. Repeat this 10 times.

Exercises from week 6 onwards

Ankle stretches

1. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of your calf. Hold for 30 seconds.

2. Point your toes down as far as they go. Use your other foot on top to apply some pressure to create a stretch on the top of your foot. Hold for 30 seconds.

3. Sit on a chair. Slide your foot under the chair as far as you can and then move your knee forward keeping the sole of your foot in contact with the floor. Hold for 30 seconds.

Balance strategy exercises – for patients who could NOT stand on one leg before their injury

Step 1: Stand with your feet as close together as possible. Hold onto a firm surface (back of a chair or a table) for support. Hold this for 30 seconds.

Step 2: Follow step 1 above but remove your hand from the support so that you’re balancing. Hold this for 30 seconds.

Step 3: Still holding onto the support, put one foot in front of the other as close together as possible. Hold this for 30 seconds. If you feel confident with this exercise, try to keep your balance without holding onto the support.

Balance strategy exercises – for patients who could stand on one leg before their injury

Step 1: Hold onto a firm surface (back of a chair or a table). Try to stand on just your injured leg. Hold this for 30 seconds making sure it does not cause any pain. Once you can do this pain free, move onto step 2.

Step 2: Try to stand on just your injured leg without holding on to a support. Try to hold this for 30 seconds.

For more about your injury and demonstrations of the exercises

Watch these videos from Brighton and Sussex University Hospitals:

• Weber B
• Weber C

What is your injury?

You have torn or ruptured the tendon at the back or your ankle.

Healing

This injury normally takes between 6 and 9 months to heal. Full rehabilitation can take more than 1 year, although there’s no guarantee that you’ll get back full function at the end of your rehabilitation.

After this injury, there is a 10-30% chance of re-rupture of the Achilles tendon over your lifetime. This happens because of repeated injury or stress to the tendon during healing. To help reduce the risk of re-rupturing your tendon, it’s very important that you follow this care plan and advice from your physiotherapist closely.

Follow up

A specialist physiotherapist will call you about a rehabilitation plan and explain how to adjust your boot. If you haven’t heard from us by 4 days after your injury, please call the Fracture Clinic. You may need an ultrasound. If you do, we’ll call you and ask you to come in.

If you are under 50 or biologically fitter, you’ll also need to be assessed urgently by a consultant or a member of the team in case you need an operation. These operations need to take place within 14 days of your injury. You can find out more about having an operation on your ankle further down the page.

Please contact the Fracture Clinic on 01872 253091 if:

• you’re unable to follow this rehabilitation plan
• you have any questions
• you do not receive your appointment details
• you’re struggling with your boot
• you experience pain or symptoms other than at the site of the original injury or surrounding area

You can also book an open appointment at any time in the six months after your injury. Please call 01736 758892 to make an appointment.

Wearing your boot

You will have been given a VACOped boot by the Emergency Department (ED) or Minor Injuries Unit (MIU). You can see how to fit your VACOped boot in this video.

The boot protects your ankle and will make you more comfortable. You must wear the boot all the time including in bed at night. Always wear a sock.

You’ll need to adjust the range of movement your boot allows in the weeks after your injury. Your rehabilitation plan below explains when and how.

Preventing a blood clot or Deep Vein Thrombosis (DVT)

You’re not allowed to do any exercises for a number of weeks. This puts you in a higher risk group for developing a DVT which can have very serious effects.

To reduce this risk, you have been prescribed a course of a blood thinner (anti-clotting medication). You’ll need to inject this at the same time every day for the first 4 weeks. We’ll show you how to do this.

If you have any questions about this, or if you have a reaction to the medication, please speak to your GP or district nurse.

You must dispose of your used injections safely into the yellow sharps bin provided. Once full, you can drop the sharps bin to the Fracture Clinic, your local Minor Injuries Unit or your GP practice where we can dispose safely of them.

Your rehabilitation plan

Your specialist may give you a different rehabilitation plan based on your injury and circumstances.

After your injury:

• do not stretch the calf or do any ankle exercises. This will disrupt tendon healing and your long term recovery.
• use your crutches and put some weight through your injured leg when you walk
• continue taking anti-clotting medication

After 2 weeks:

• adjust the range of your boot to between 20 and 30 degrees plantarflexion.
• This video shows you how to adjust the range of motion.

After 4 weeks:

• adjust the range of your boot to between 10 and 30 degrees plantarflexion.
• remove the boot throughout the day and gently move your ankle up and down within the range allowed by the boot. Do not push through any ‘stretch.’

After 5 weeks:

• keep the range of your boot between 10 and 30 degrees plantarflexion
• change into a flat sole
• regularly remove the boot throughout the day. Gently move your ankle up and down within the range allowed by the boot.

After 6 weeks:

• adjust the range of your boot between 0 and 30 degrees plantarflexion
• regularly remove the boot throughout the day. Gently move your ankle up and down within the range allowed by the boot
• rest your feet flat on the floor at an angle of approximately 90 degrees when sitting down
• smoothly and slowly raise and lower your heels whilst sitting

After 8 weeks:

• remove the boot at night
• try to gradually remove your boot during the day – this may take a week or two
• try walking short distances around your own home wearing a shoe
• wear bilateral heel raise pads, these should be given to you at the time your boot was issued or at a follow up fracture clinic appointment.
• start ‘later rehabilitation’ in discussion with the physiotherapy team. We will guide you through this at the right time
• But do not start any exercises until you have been guided by your physiotherapist.

What is your injury?

You have a hairline fracture on the outside of your ankle. Stress fractures are often caused through overuse, with or without a subtle bio-mechanical problem. Pain will usually have developed gradually over time, rather than at a specific point in time.

Healing

This injury normally takes up to 12 weeks to heal, but this may differ depending on your individual circumstances.

We recommend you also see a physiotherapist for a thorough biomechanical assessment of the forces going through your lower limb to cause a stress fracture.

It is important to note that continuing the activity that caused the pain will not allow your injury to heal and REST must be part of your overall treatment plan.

Follow up

Injuries like yours usually heal well on their own over time, so most people won’t need a follow up. If you do need a follow up, we’ll contact you by phone. You may need physiotherapy, which can be organised through your GP or the Fracture Clinic.

If you still feel you’d like to see someone, you can book an open appointment at any time in the six months after your injury. Please call 01736 758892 to make an appointment.

Please contact the Fracture Clinic on 01872 253091 if:

• you’re unable to follow this rehabilitation plan
• you have any questions
• you’re struggling to stop using your boot after 6 weeks
• you experience pain or symptoms other than at the site of the original injury or surrounding area
• you experience significant pain after 12 weeks.

Your rehabilitation plan

Your specialist may give you a different rehabilitation plan based on your injury and circumstances.

For the first 6 weeks after your injury:

• you can put weight through your injured leg – early weight bearing (putting weight through your injured foot) helps speed up healing, so try to walk as normally as possible
• you may find it easier to use crutches in the early stages
• wear your boot when standing and walking – it will protect your ankle and make you more comfortable
• wear a long sock in your boot
• take the boot off at night and when resting at home
• start the initial exercises straight away (see below).

After 6 weeks:

• stop using the boot and walk without it around your house
• resume day-to-day activities but respond to any pain you might experience
• build up to walking without the boot when you go outside or for longer walks
• start the exercises below labelled ‘exercises from week 6 onwards’.

After 8 weeks:

• stop using the crutches
• gradually increase your activity but avoid impact for 3 months (running, jumping, plyometrics and dancing)
• You might have mild symptoms for 3 to 6 months, especially after long walks or heavy tasks.

Exercises

Follow the exercises below without causing too much pain. This will prevent your ankle and foot from becoming too stiff and help the healing process. It will also promote circulation and reduce the risk of developing a blood clot (Deep Vein Thrombosis, or DVT).

Exercises to start straight away

Do these initial exercises for ankle and foot range of movement 3 to 5 times a day.
Repeat each of the following 10 times:

1. Point your foot up and down within a comfortable range of movement.

2. With your heels together, move your toes apart to turn your foot outwards. Do this gently as long as it’s comfortable for you

3. Turn the feet in towards each other as in the picture, keep the legs still, moving from the ankle only.

Exercises from week 6 onwards

Ankle stretches

Repeat the following 5 times.

1. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of your calf. Hold for 30 seconds.

2. Point your toes down as far as they go. Use your other foot on top to apply some pressure to create a stretch on the top of your foot. Hold for 30 seconds.

Balance strategy exercises – for patients who could NOT stand on one leg before their injury

Step 1: Stand with your feet as close together as possible. Hold onto a firm surface (back of a chair or a table) for support. Hold this for 30 seconds.

Step 2: Follow step 1 above but remove your hand from the support so that you’re balancing. Hold this for 30 seconds.

Step 3: Still holding onto the support, put one foot in front of the other as close together as possible. Hold this for 30 seconds. If you feel confident with this exercise, try to keep your balance without holding onto the support.

Balance strategy exercises – for patients who could stand on one leg before their injury

Step 1: Hold onto a firm surface (back of a chair or a table). Try to stand on just your injured leg. Hold this for 30 seconds making sure it does not cause any pain. Once you can do this pain free, move onto step 2.

Step 2: Try to stand on just your injured leg without holding on to a support. Try to hold this for 30 seconds.

For more about your injury and demonstrations of the exercises

Watch this video about distal fibula stress fractures from Brighton and Sussex University Hospitals.

What is your injury?

Your calf muscle has been overstretched, causing micro tears to the muscle itself. This can range from mild to severe. It causes pain, bruising and weakness in the muscle. It may be difficult to bear weight on your leg.

Healing

This injury normally takes up to 12 weeks to heal, but this may differ depending on your individual circumstances.

It is important to avoid standing on your tiptoes for the first 6 weeks while healing is taking place.

Follow up

Injuries like yours usually heal well on their own over time, so most people won’t need a follow up with orthopaedics. If you do, we’ll contact you by phone. We do recommend you see a physiotherapist. Your GP can refer you if we don’t follow up with you through the Fracture Clinic.

If you still feel you’d like to see someone, you can book an open appointment at any time in the six months after your injury. Please call 01736 758892 to make an appointment.

Please contact the Fracture Clinic on 01872 253091 if:

• you’re unable to follow this rehabilitation plan
• you have any questions
• you’re struggling to remove your boot
• you experience pain or symptoms other than at the site of the original injury or surrounding area
• you struggle to return to sport or exercise, or are still experiencing significant pain after 12 weeks

Your rehabilitation plan

Your specialist may give you a different rehabilitation plan based on your injury and circumstances.

For the first 2 weeks after your injury:

• you can put weight through your injured leg – early weight bearing (putting weight through your injured foot) helps speed up healing, so try to walk as normally as possible
• you may find it easier to use crutches in the early stages
• avoid standing on tiptoes
• start the initial exercises straight away (see below).

If you’ve been given a boot:

• wear it when standing and walking – it will protect your ankle and make you more comfortable
• wear a long sock in your boot
• take the boot off at night, when resting at home and when doing your exercises.

Between 2 and 12 weeks:

• start the exercises below labelled ‘exercises from week 2 onwards.’
• avoid standing on tiptoes until at least 6 weeks after your injury
• start walking without your boots and crutches around your house
• build up to walking without the boot and crutches when you go outside or for longer walks
• wear supportive shoes like trainers
• gradually increase your activity
• eventually stop using your boot and crutches
• you may still have some mild symptoms

Exercises

Follow the exercises below without causing too much pain. This will prevent your ankle and foot from becoming too stiff and help the healing process. It will also promote circulation and reduce the risk of developing a blood clot (Deep Vein Thrombosis, or DVT).

Exercises to start straight after your injury

Do these initial exercises for ankle and foot range of movement 3 to 5 times a day.
Repeat each of the following 10 times:

1. Point your foot up and down within a comfortable range of movement.

2. With your heels together, move your toes apart to turn your foot outwards. Do this gently as long as it’s comfortable for you

3. Turn the feet in towards each other as in the picture, keep the legs still, moving from the ankle only.

Exercises from week 2 onwards

Step 1: Hold onto a firm surface (back of a chair or a table). Try to stand on just your injured leg. Hold this for 30 seconds making sure it does not cause any pain. Once you can do this pain free, move onto step 2.

Step 2: Try to stand on just your injured leg without holding on to a support. Try to hold this for 30 seconds.

Ankle stretches from 3 weeks onwards

1. Sit with your leg straight out in front of you. Put a towel or bandage around your foot and pull it towards you. Feel a stretch in the back of your calf. Hold for 30 seconds.

2. Point your toes down as far as they go. Use your other foot on top to apply some pressure to create a stretch on the top of your foot. Hold for 30 seconds.

For more about your injury and demonstrations of the exercises

Watch this video about calf muscle tears from Brighton and Sussex University Hospitals.