Ankle stabilisation
Phased post-operative rehabilitation following ankle ligament stabilisation, from cast/boot protection to plyometric and sport-specific training.
Typical timeframe: Functional return from ~16+ weeks
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Phase 01 · Weeks 1 – 2
Phase I
Goals
- Rest and recovery from surgery.
- Control swelling and pain.
- Increase ADL (activities of daily living).
- PWB (partial weight bearing) to FWB (full weight bearing) in cast / CAM boot.
- Sutures removed at 10 – 16 days.
- Back into a cast / CAM boot for another 4 weeks.
- Education: surgery, healing time, anatomy, rehab phases.
- Encourage ADL.
- Rest and elevation to control swelling.
- Control pain.
- Hip and knee AROM.
Phase 02 · Weeks 3 – 6
Phase II
Goals
- Allow healing while maintaining upper body, core and hip/knee strength and ROM.
- Weight bear as tolerated, with or without crutches in Air Cast Boot.
- Massage for swelling.
- Elevation to control swelling.
- At 6 weeks, after being removed from the cast: begin gentle AROM (active range of motion) ankle PF (plantar flexion) / DF (dorsiflexion) / eversion and toe flexion/extension.
- Stationary bicycle with Air Cast boot.
- Core exercises — abdominal recruitment, bridging on ball, ball reach, arm pulleys or theraband using diagonal patterns.
- Hip: AROM — strength: clam, side-lift, glut max, SLR (straight leg raise).
- Knee: AROM — strength: SLR, theraband press or leg machine.
- Stretching: glut max, glut med, piriformis, rectus femoris, hamstrings.
Phase 03 · Weeks 7 – 10
Phase III
Goals
- Weight bearing with pain and swelling controlled.
- Use ankle brace and start rehab.
- Stationary bicycle.
- AROM: begin inversion/eversion; continue with ankle PF/DF, toe flex/extension.
- Continue with core exercises — progress to standing exercises.
- Continue hip strength exercises.
- Continue knee strength exercises.
- Manual mobilization to joints not part of ligament reconstruction.
Phase 04 · Weeks 11 – 12
Phase IV
Goals
- Full ROM.
- In regular shoe.
- Still wearing the ankle brace.
- Control swelling +/- pain with elevation or modalities as required.
- AROM in WB.
- Manual mobilization as required.
- Muscle stimulation — intrinsics, invertors/evertors if required.
- Gait training.
- Continue strengthening core, hips and knees.
- Proprioceptive training: single-leg stance on even surface.
Phase 05 · Weeks 13 – 16
Phase V
Goals
- Full ROM in WB.
- Good single leg balance.
- Near full strength in lower extremity.
- Still to use the ankle brace for certain sport-specific activities (e.g. basketball).
- Proprioceptive training: single-leg stance on even surface with resistance to arms or WB leg; double-leg stance on wobble board.
- Strength: toe raises, lunges, squats; hopping, skipping, running.
- At 14+ weeks: manual mobilizations if required.
Phase 06 · From week 16
Phase VI
Goals
- Full functional return to work and/or activity.
- Continue to build endurance.
- Work-specific or activity-specific training.
- Plyometric training.
Last reviewed: 2025-10-15.
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Have questions about your recovery?
Every patient is different. If you would like a tailored plan or need to clarify any of these instructions, book an appointment with the East Coast Orthopaedic Physiotherapy team.
General guide only. These resources are intended as a general guide. Please follow the instructions of your treating surgeon and physiotherapist — your individual recovery plan may differ.