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Aaron WeyMD, FAAOS, FACSAdult and Pediatric Spine Surgery
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Foot and ankle · Post-op rehabilitation protocol

Ankle Arthroscopy

After ankle arthroscopy: splint and crutches for ten days, then weight bearing as tolerated, running from month two, full activity at four months.

This is the rehabilitation plan I ask your physical therapist to follow after this operation. Bring it to your first therapy visit. It is a framework, not a prescription: your therapist adjusts the pace to how you are healing, and anything we discussed in the office takes precedence over what is printed here. If something on this page does not match what we talked about, ask me.

Physical therapist: please send progress notes to the office at (201) 836-1663 and call with any question about the plan.

Days 1–10

Exercises

  • L & U Splint – Watch for skin breakdown
  • Crutches – non weight bearing (NWB)
  • AROM hip and knee
  • Wiggle toes
  • Straight leg raise (SLR) x 4
  • Short arc quad (SAQ)
  • Upper body exercises (seated or bench only – no pushups)
  • LE stretches – Hamstring, quads, ITB, Hip flexors
  • Ice and Elevation

Goals

  • Pain management
  • Prevent swelling

Days 10–21

Exercises

  • Crutches – weight bearing as tolerated (WBAT), D/C when gait is normal
  • Continue appropriate previous exercises
  • Calf pumping, alphabet, rotations
  • Light Theraband ex x 4
  • Towel crunches and side-to-side
  • Seated BAPS, progress to double leg in standing
  • Stationary bike
  • Gastroc/Soleus Stretching
  • Ice as needed

Goals

  • Full range of motion (ROM)
  • Normal gait

Weeks 3–6

Exercises

  • Continue appropriate previous exercises
  • Theraband ex x 4 – Gradually increase resistance
  • Elgin
  • Steamboats (Theraband x 4 while standing on involved LE)
  • Mini-squats, Wall squats, Total gym
  • Double leg heel raises – Progress to single leg heel raises
  • Single leg BAPS, ball toss, and body blade
  • Forward, retro and lateral step downs
  • Knee extension and HS curl weight machines
  • Proprioception ex – Single leg BAPS, ball toss, body blade
  • Treadmill – Walking forwards and backwards
  • Elliptical trainer
  • Pool therapy – Chest or shoulder deep water running

Goals

  • Normal strength

Weeks 6–8

Exercises

  • Continue appropriate previous exercises
  • Leg press and hip weight machine
  • Fitter, slide board
  • Push-up progression
  • Sit-up progression
  • Treadmill – Walking progression program
  • Stairmaster
  • Pool therapy – Unrestricted

Goals

  • Walk 2 miles at 15 min/mile pace

Months 2–4

Exercises

  • Continue appropriate previous exercises
  • Running progression program
  • Agility drills / Plyometrics
  • Transition to home / gym program

Goals

  • Return to all activities
  • Pass a return-to-sport / fitness test at 4 months post-op

Abbreviations

AROM / AAROM / PROM: active / active-assisted / passive range of motion. ROM: range of motion. ER / IR: external / internal rotation. ABD / ADD: abduction / adduction. FLEX / EXT: flexion / extension. WBAT / PWB / TTWB / NWB: weight bearing as tolerated / partial / toe-touch / non-weight bearing. SLR: straight leg raise. HS: hamstrings. ITB: iliotibial band. UE / LE: upper / lower extremity. UBE: upper body ergometer (arm bike). BAPS: balance board. BFR: blood flow restriction training. PREs: progressive resistance exercises. D/C: discontinue. prn: as needed. POD: post-operative day. TENS: transcutaneous electrical nerve stimulation. ADLs: activities of daily living.

Source

Adapted from William Beaumont Army Medical Center, Physical Therapy Section, "Ankle Arthroscopy WB08", Revised August 2008, published by William Beaumont Army Medical Center (a work of the U.S. Government in the public domain). Original: Ankle Arthroscopy WB08.pdf. Army-specific wording in the original (APFT) was replaced with civilian equivalents.

This protocol is general guidance for the rehabilitation team and does not replace the specific plan, restrictions and follow-up we set together. Your own situation may differ: if anything here does not match what we talked about, what we talked about wins, so please ask me.