Why is the ankle stiff after a cast?
A joint that has not moved for weeks loses movement. The ligaments and the capsule around it tighten, the calf muscle weakens, and the skin and tissues feel tight and sensitive.
When the cast or boot comes off, you see a thin, pale leg that looks smaller than the other. The ankle feels stiff and does not bend like before. This is expected and does not mean the injury has not healed.
What does the ankle feel like in the first weeks?
Most people notice a mix of these. The ankle is stiff, especially in the morning, and it will not bend up toward the shin or point down the way it used to.
Swelling appears by the evening, because blood and fluid pool in the foot when you are upright. The skin may look dry and flaky, and the foot may feel tender or tingly.
Most people feel afraid to put weight on the leg, and this is natural. Our page on ankle sprain covers a different, ligament-only injury, while this page is about recovering after a break or cast.
What is your surgeon’s job, and what is ours?
Your surgeon or doctor decides how much weight you can put on the ankle, what protection you need, and when. Their instructions always come first. Please bring any discharge notes and clinic letters to the first visit.
Our job is to help you regain movement, strength and confidence within those instructions. The glossary explains weight-bearing, a term you will hear at the clinic.
If something worries us, such as strong pain, a wound that is not healing or a foot that looks wrong, we tell you. We then ask you to contact your doctor.
What do we check at the first visit?
We start by listening to what happened and what you were told at the hospital. Then we test the whole leg.
- How far the ankle bends up, points down and moves side to side.
- Swelling, skin colour and warmth, compared with the other foot.
- Calf and foot strength.
- How you stand, shift your weight and walk.
- Whether you need a stick or a frame at present.
- The movements you need at home, such as the stairs and the squat toilet.
If anything points to a problem with healing, we pass this on and help you contact your doctor.
How does physiotherapy help?
Gentle, regular movement is the main tool. We bring the ankle back to bending, then rebuild the strength of the calf and the foot.
A plan can follow these steps.
- Control swelling with elevation, easy pumping of the foot and compression, if your doctor agrees.
- Regain movement with ankle circles, alphabet drawing and easy stretches, within comfort.
- Strengthen the calf and foot with bands and heel raises, once weight-bearing is allowed.
- Practise standing, weight shifts and walking, with a stick or frame if needed.
- Retrain balance and stairs, then the movements of your own home and work.
Recovery varies with the injury, your age and the time in the cast. We review progress each visit, and glossary entries on range of motion explain how we measure it.
What can I do this week?
These simple steps help while you wait for the first visit.
- Raise the foot on a cushion when sitting, higher than your hip if you can.
- Move the foot up and down within comfort, again and again through the day.
- Moisturise the dry skin gently, and look at the foot daily.
- Sit rather than stand during tasks like cooking and washing up, where you can.
- Follow your doctor’s weight-bearing instructions exactly.
If pain, swelling or colour change worry you, contact your doctor.
When should I see a doctor first?
Go to a doctor or the emergency department if the calf is swollen, hot, red and painful, because this can signal a blood clot. Go too if the foot is cold, white or blue, or numb.
See your doctor if the pain is getting worse, if there is fever, or if a wound is red, hot or leaking. Hospital Raja Permaisuri Bainun, Fatimah Hospital and Pantai Hospital Ipoh can see you for these.
How do home sessions in Ipoh work?
A physiotherapist comes to your house, looks at the bathroom floor, the stairs and the front step, and plans movement and strengthening around them. Everything starts at your own pace.
Visits are available across Ipoh now, and our Canning Garden centre is opening soon. Prices are quoted on WhatsApp after a short description. See how home physiotherapy works, and read about ankle fracture rehabilitation.