Post-Ankle Ligament Injury: Essential Rehab for Normal Walking Recovery

After ankle ligament injury surgery, what rehabilitation is needed to restore normal walking?

Hello, doctor.
I have been discharged for two months now.
Due to the injury on my right ankle from a car accident (with a ligament tear and some bone loss, and blood circulation has not fully recovered), I have been using crutches to assist with walking.
Although the attending physician mentioned that I could start practicing weight-bearing when I was discharged, I was hesitant because my ankle was still very swollen.
Last week, during a follow-up appointment, the doctor said I could start bearing weight.
I would like to ask what rehabilitation exercises I can do at home to practice walking, and is it normal to experience pain during home rehabilitation? Also, after rehabilitation, will I be able to walk normally again, or will I still have a limp? Thank you, doctor, for answering my questions.

Yu Mo, 10~19 year old female. Ask Date: 2022/10/07

Dr. Wang Zhaomin reply Rehabilitation

You can perform joint exercises and practice standing while stepping at home, but you should still use assistive devices to aid in the rehabilitation process.
There may be discomfort and pain during this process; however, if you experience unbearable sharp pain, do not push yourself.
Each individual's condition is different, and recovery varies based on many factors.
Please visit a rehabilitation department for evaluation and to arrange for rehabilitation therapy, where professional physicians and therapists can provide on-site guidance to prevent injury.

Reply Date: 2022/10/07

More Info

After an ankle ligament injury, especially one that involves both ligament damage and bone loss, a structured rehabilitation program is crucial for restoring normal walking ability. Given your situation, where you have been using crutches for support and have experienced swelling and circulation issues, it’s important to approach your recovery with care and patience.

Understanding Your Injury
Ankle ligament injuries can vary significantly in severity. In your case, the combination of ligament rupture and minor bone loss complicates the healing process. The swelling you experienced is common after such injuries, and it can impede your ability to bear weight and perform rehabilitation exercises. The fact that your doctor has cleared you to start putting weight on your ankle is a positive sign, indicating that your injury is healing.

Rehabilitation Steps
1. Gradual Weight Bearing: Start by practicing weight-bearing exercises. Begin with standing on your injured leg while holding onto a stable surface for support. Gradually increase the time you spend standing as your comfort level improves.

2. Range of Motion Exercises: Gentle range of motion exercises are essential. Try moving your ankle in circles, pointing your toes, and flexing your foot up and down. These movements help maintain flexibility and prevent stiffness.

3. Strengthening Exercises: Once you can bear weight without significant pain, start strengthening exercises. Resistance bands can be useful for this. Exercises like ankle dorsiflexion (pulling your toes towards you), plantarflexion (pointing your toes), inversion (turning your foot inward), and eversion (turning your foot outward) can help rebuild strength in the ankle.

4. Balance Training: Incorporate balance exercises, such as standing on one leg or using a balance board. This will help improve proprioception, which is crucial for preventing future injuries.

5. Walking Practice: As you gain strength and confidence, practice walking. Start with short distances and gradually increase as you feel more comfortable. If you experience pain, it’s essential to listen to your body and not push through it.

Pain Management
Experiencing pain during rehabilitation is not uncommon, especially after an injury like yours. However, it’s important to differentiate between normal discomfort and pain that indicates a problem. Mild discomfort during exercises is generally acceptable, but sharp or severe pain should be addressed. If you find that your pain is significant, it may be wise to consult your healthcare provider for advice on pain management strategies or adjustments to your rehabilitation program.

Long-Term Recovery
Regarding your concern about whether you will return to normal walking or if you will have a limp, this largely depends on the extent of your injury, your adherence to rehabilitation, and your body’s healing response. Many individuals can return to their pre-injury level of function with diligent rehabilitation. However, some may experience lingering effects, such as a slight limp or discomfort, particularly if the injury was severe.

Conclusion
In summary, your rehabilitation should focus on gradually increasing weight-bearing activities, improving range of motion, strengthening the ankle, and enhancing balance. Pain during rehabilitation can be normal, but it’s crucial to monitor its intensity and consult with your healthcare provider if it becomes problematic. With a dedicated approach to your rehabilitation, there is a good chance you can regain normal walking ability. Always remember to follow your healthcare provider's recommendations and adjust your rehabilitation plan as needed based on your progress.

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