Is Mild Ankle Swelling Normal After Fibula Fracture Recovery?

Three months have passed since the fracture, and there is slight swelling during exercise?

Dear Doctor: I had a fibula ankle fracture and was in a cast for 6 weeks without surgery.
After that, I used a single crutch for 2 weeks, and now I am walking without any assistive devices.
It has been 3 months and 2 weeks since the injury.
Around the 10th week, I had an X-ray which confirmed that there is callus formation around the fracture site, but the fracture line is still visible with a slight displacement of 1mm.
The fracture is a diagonal one at the distal end of the fibula.
However, my calf strength is still only about half of what it should be.
I have been using some calf raise machines at the gym to strengthen my calf muscles.
After exercising, I notice slight swelling in my ankle, but when I walk, I don't feel any abnormal sensations.
The swelling subsides naturally after resting.
Is this swelling considered normal? Or should I avoid exercising my calf muscles in this manner? (The machine I use is a seated calf raise machine, and I lift about 30-40 kg, while my body weight is 95 kg.)

Niu, 30~39 year old female. Ask Date: 2017/11/28

Dr. Shi Guozheng reply Orthopedics

It is normal for a fracture to take over three months to heal, and you can continue to engage in light activities.
Typically, bone healing requires a solid foundation and takes about six months, so gradual improvement is expected.
If the muscles are not trained, they may atrophy, which will slow down the recovery process later on.

Reply Date: 2017/11/28

More Info

Mild ankle swelling after a fibula fracture recovery can be a common occurrence, especially in the context of your recent rehabilitation and physical activity. When you sustain a fracture, the body goes through a healing process that includes inflammation, which can lead to swelling. This is particularly true in the early stages of recovery, but it can persist even after the initial healing has begun, especially when you start to engage in physical activities.

In your case, you mentioned that you had a fibula fracture and were in a cast for six weeks, followed by two weeks of using crutches. After three months and two weeks post-injury, you are now engaging in exercises to strengthen your calf muscles. It is not unusual for some swelling to occur when you start to increase your activity level, particularly if you are using weights or machines that put stress on the ankle and surrounding muscles.

The presence of mild swelling can be attributed to several factors:
1. Increased Activity: As you begin to use your ankle more, especially with resistance training, the muscles and soft tissues around the ankle may still be adjusting to the increased load. This can lead to temporary swelling as the body responds to the new demands placed on it.

2. Fluid Accumulation: After an injury, the body may retain fluid in the affected area as part of the healing process. This can be exacerbated by prolonged periods of inactivity or by certain movements that put strain on the ankle.

3. Muscle Weakness: You mentioned that your calf strength is still only at half of what it should be. Weakness in the surrounding muscles can lead to instability in the ankle joint, which may contribute to swelling as the body compensates for the lack of strength.

4. Inflammation: Even after the fracture has started to heal, there may still be some residual inflammation in the area, which can contribute to swelling.

As for your exercise routine, it is essential to listen to your body. If you notice that the swelling increases significantly or is accompanied by pain, it may be a sign that you are overdoing it or that the ankle is not ready for that level of activity. It is advisable to gradually increase the intensity of your workouts and to incorporate rest periods to allow for recovery.

Here are some recommendations to manage mild swelling:
- Rest and Elevation: If you notice swelling after exercising, take some time to rest and elevate your ankle. This can help reduce swelling and promote circulation.

- Ice Therapy: Applying ice to the swollen area can help reduce inflammation and provide relief.

- Compression: Using a compression bandage can help manage swelling by providing support to the ankle.

- Gradual Progression: Continue to strengthen your calf muscles, but do so gradually. Consider consulting with a physical therapist who can guide you on appropriate exercises and ensure that you are not putting undue stress on your ankle.

- Monitor Symptoms: Keep track of any changes in swelling, pain, or mobility. If you notice any concerning symptoms, such as increased pain, significant swelling, or changes in skin color or temperature, it is important to consult your healthcare provider.

In conclusion, mild ankle swelling after a fibula fracture recovery can be normal, especially as you increase your activity level. However, it is crucial to monitor your symptoms and adjust your exercise routine as needed to ensure a safe and effective recovery. If you have any concerns about your healing process or the swelling, do not hesitate to reach out to your healthcare provider for further evaluation and guidance.

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