Healing
This normally takes approximately 4-12 weeks to heal.
Smoking will slow down your healing. We would advise that you stop smoking while your ankle heals. Talk to your GP or go to www.smokefree.nhs.uk for more information.
Pain and Swelling
Your ankle may be swollen and painful. Swelling is often worse at the end of the day. It is normal to have pain and swelling for up to 3 months after your injury.
Taking pain medication, elevating your ankle and using ice or cold packs will help. More information is on the next page.
Walking and your boot
If you are struggling to walk, you may be given a boot to help with your mobility. This can be worn for up to 4 weeks, it may be removed when you are comfortable to do so. Start by walking without the boot around your own home, build up to walking without it outside or for longer walks.
You are allowed to put weight through your foot. You may find it easier to use crutches in the early stages.
Exercises
It is important to start exercises as soon as possible. Instructions are on the next page.
Follow up
We do not routinely follow up patients with this injury as they recover well with self-management. If you fail to improve after 4-6 weeks, you can either contact your GP or you can self-refer to TIMS physiotherapy services if you have a Gateshead or Newcastle GP on 0191 445 2643, otherwise contact your GP for local services.
Caring for your injury: week 1-2
Using a cold pack will help with your pain. There is some evidence that early use of ice may impair healing. Therefore after 72 hours-the initial acute phase, you can use an ice pack or bag of frozen peas wrapped in a damp towel. Put this on your ankle for up to 15 minutes every few hours. Make sure the ice is not in direct contact with your skin. You may also find heat helpful, a hot water bottle with warm water (not boiling) or a heat pack on your ankle for up to 15 minutes every few hours. Some people find alternating between heat and ice helpful.
Try to rest your ankle, especially in the first 24-72 hours. Raise your ankle lying on your bed or sofa with cushions so that it is above the level of your heart. This will help to reduce your swelling.
Exercises
Early movement of the ankle and foot is important to promote circulation and movement.
Do these exercises 3-4 times a day. Start straight away, you do not need to push into pain.
Repeat this 10 times
Caring for your injury: week 3-6
It is normal to still have mild discomfort and swelling. This may continue for up to 3 months.
Activity and Exercise
Gradually increase your level of activity. You may need to avoid impact activity for 3 months if you still have swelling and pain. This Includes running, jumping, contacts sports and dancing.
You can now progress your exercises.
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 the calf. Hold for 30 seconds, complete 3 times x 3 daily.
2.Point your toes down as far as they go, place your other foot on top and apply some pressure. This will stretch the top of your foot. Hold for 30 seconds, complete 3 times x 3 daily.
Balance
If you have very poor balance and are prone to falling, please do not do this exercise.
Try to complete x 3 times a day.
Single leg balance
1.Hold onto a supportive surface and stand on your injured leg and hold for 10 seconds.
When you can do this comfortably, try the next exercise.
2.Try to stand on one leg without holding on to a support. Try to hold this for 30 seconds.
3.To progress you can try these exercises with your eyes closed. Make sure you are always in a safe environment with a support to hold if needed.
Strength
Repeat 10 times, 3 times per day.
Double calf raise
Hold onto a supportive surface with your legs hips width apart.
Keeping your knees straight, rise up on to your toes, and control the movement as you lower back down.
Frequently asked Questions
I am struggling with my boot. What do I do?
The boot has a thicker sole; this can make you feel uneven. Make sure you wear a supportive shoe or trainer on your uninjured foot. This will reduce stress on other joints.
When can I start driving?
You can return to driving when:
• You are no longer using your boot,
• You can walk comfortably and
• You can perform an emergency stop pain free.
Always test your ability to drive in a safe environment first.
How can I get a certificate for work?
You can get a fitness for work statement from your GP.
What do I do with my boot and crutches when I no longer need them?
We are not able to use boots again. These should not be returned to the hospital.
Crutches can be returned to the Fracture Clinic or A&E.
What do I do if I am not improving back to my previous level of activity?
If you feel you need exercise progression to return to higher levels of activity, TIMS (Tyneside Integrated Musculoskeletal Service) have advanced exercises and videos on their website to aid and guide your rehabilitation:
https://www.tims.nhs.uk/self-care/foot-ankle
Physiotherapy referral
If you feel you need further input you can self-refer to your local physiotherapy team if you are registered with a Gateshead, Newcastle or Durham GP or request your GP to refer you if you have a Sunderland GP, information can be found below:
If you are a registered patient of a Gateshead or Newcastle GP, the Tyneside Integrated Musculoskeletal Service (TIMS) will be your physiotherapy provider:
If you are a registered patient of Durham GP, the county Durham integrated MSK service will be your physiotherapy provider:
https://patient.inhealthcare.co.uk/selfenrol/v2/form
If you are a registered patient of South Tyneside and Sunderland, the Sunderland integrated MSK service will be your physiotherapy provider: