Broken Ankle Recovery Time: Best Treatment & Rehab 2021
Broken Ankle Recovery Time: Severe dislocations may require surgery, but stable fractures require 6-8 weeks in a cast, then a walking boot or shoe brace.
Goal of this guide:
- To show you what to expect with your broken ankle recovery time.
- At the end we offer some long term home treatment to assist in helping you get better faster!
This is a Dislocated and Broken Ankle. This is about as bad as it gets and this patient did need a rod placed up through their ankle to stabilize the injury.
Table of Contents
Broken Ankle Overview:
- The terms ankle fracture and broken ankle are basically the same thing.
- This means that one of the bones of the ankle joint or broken, you can have multiple breaks with dislocations, or just one break in one area with no dislocation.
This is the same broken and dislocated ankle joint from the AP view. This patient did end up having a fused ankle after initial stabilization.
There are different types of breaks:
- There is a range that can go from minimal breaking in only one spot of the ankle, versus a complete crushing and destruction of the ankle.
- Obviously the more severe complete crushing would take much longer to heal, if ever.
- The more damage an ankle sustains, the more likely you are to need surgery.
This is external fixation stabilizing the broken and dislocated ankle joint. With open or high risk fractures, this can be very important initially to prevent further tissue loss and stabilize the tissue.
Even if not broken, there could be ligament damage:
- The tricky thing with ankle fractures, is that you may also have been damaged ankle joint ligaments.
- The ligaments of the ankle hold the bones together and in the correct position.
- The problem with the broken ankle is, that you can develop long-term arthritis even if it does heal.
- The idea is to have the bones heal in a perfectly correct position, and reset the cartilage as much as possible, to prevent future rubbing and damage.
Ankle Joint Anatomy:
There are three bones that make up the ankle joint:
The talus:
- This is the top of the foot as it connects to the ankle joint.
- This is a bone that fits in between the tibia and fibula above it.
- This bone can move up and down for the most part, but not side to side within the ankle joint.
The fibula:
- This is the smaller bone that makes up the ankle joint.
- This bone only takes about 15% of the pressure of the fracture.
- If you simply have a small crack through here, you can get away without doing surgery.
- But if there is a severe fracture here, it may need to have to be replaced and fixed back into position.
- The fibula makes up the lateral malleolus, this holds that outside of your ankle together. This holds the talus inside the lateral malleolus.
Tibia:
- This is the shinbone, and much of the top half of the ankle joint.
- This takes about 85% of the pressure of the ankle joint.
- This bone is broken significantly, you may definitly need surgery, and have a long healing time.
What is the Ankle Joint?
- The tibia has two major components that make up the ankle joint: these include the medial malleolus in the posterior malleolus.
- These are the prominences that wrap around the talus and hold it into position.
- The medial malleolus is towards the center line of your body, and the posterior malleolus is the back of your ankle.
Classification of ankle joint fractures:
- Doctors can classify the severity of the fracture, and the specific location of the fracture.
- Specifically, if both the tibia and the fibula are broken, this is called a bi-malleolar fracture.
- Because both the medial and lateral malleolus are broken.
- If the lateral, posterior and medial malleolus are all broken, this is then termed at tri-malleolar or fracture.
Foot Doctors can also classify the ankle fracture based on the severity:
- If there is a fracture, which is not displaced. This is simply called the nondisplaced fracture.
- If there is over 1 to 2 mm of motion, this is now called a displaced fracture.
- If there is more than a few different cracks, the bone can almost crack into dust. This is referred to as a comminuted fracture. This is the most serious of fractures.
- If the fracture is open to the skin, this is called an open fracture.
- For example, the fracture can be called an open displaced fracture. This can also be a tri-malleolar fracture.
Causes of a broken ankle:
The most common causes of a broken ankle include:
- Twisting or rotating your ankle.
- Rolling your ankle down and inward.
- Tripping or falling.
- Severe fall injury.
- A severe impact during a car accident or collision.
- Bending or twisting during the sports game.
Broken ankle symptoms:
- Sometimes it could be difficult to realize if you have a broken ankle, because it is just a much more severe sprained ankle.
- Like mentioned earlier, damaging the ligaments can sometimes be more serious than a broken ankle.
The symptoms of a broken ankle that would lead you to believe it is broken rather than sprained include:
1)A history of trauma:
- A recently twisted or rolled ankle.
- Tripping or falling.
- Severe impact & falling may cause it.
2)Immediate pain directly after the trauma:
- Severe pain.
- Swelling of the affected area.
- Bruising.
- Tender to the touch.
- Inability to bear weight on the ankle.
- Obvious deformity on the ankle.
Do I Have A Sprained Or Broken Ankle?
It is impossible to tell for sure if there is a broken bone. But some signs make a broken bone more likely:
- Gross deformity.
- Dislocation of the ankle.
- Inability to move the ankle.
- Cracking noise during the injury.
Sometimes it is very difficult to tell if you have a sprained ankle or a broken ankle. In this case there is an avulsion of the ankle ligaments leading to a avulsion fracture. This is not considered a classical ankle fracture.
Broken Ankle Swelling:
Swelling can occur with any ankle injury. It does not necessarily confirm that a bone is broken.
Swelling is common in:
- Inversion ankle sprains.
- High ankle sprains.
- Deep vein thrombosis.
- Lymphedema.
- Venous insufficiency.
This is a minor fracture of the fibula. The patient avulsed the ligament from the tip of the fibula. Ligaments to worry about here are the ATFL, PTFL and CFL. This can be very difficult to notice sometimes!
Broken Ankle X-ray:
- An X-ray or CT scan is need to know the full extent of the break for sure.
- It is impossible to be 100% certain whether an ankle injury is a fracture or not without it.
- Even if it does not seem broken, an X-ray is usually still a good idea to make sure!
This is a patient who had ankle surgery many years ago. The screws crossing the fibula and tibia are proken after walking. for many years. These are stable and not causing this elderly patient many issues.
Broken Ankle Cast vs. Broken Ankle Surgery:
1)Broken Ankle Cast:
- The general rule is that if no bones are displaced or ligaments ruptured a broken ankle can be treated with a cast.
- The downside is, if proper healing is not attained, arthritis may set in during the future.
Indications for a broken ankle cast include:
- Non-displaced break.
- Less that 1-2mm of displacement
- Under 10 degrees of angulation deformity.
- No ligament rupture.
- No incongruity of the talar mortise.
2) Broken Ankle Surgery:
- Surgery is usually needed if there is bone displacement or ruptured ligaments.
- Without surgery there is a much greater risk of degenerative joint disease (ankle arthritis).
- Mal-union & non-union of the fracture fragments are also very possible.
Indications for broken ankle surgery:
- A displaced break.
- More than 1-2mm of displacement.
- Over 5-10 degrees of angulation.
- Ligamentous rupture.
- Incongruity of the talar mortise.
- Widening of the medial or lateral clear space of the ankle joint.
Broken Ankle Walking Boot Vs. A Cast:
1)Broken Ankle Cast:
This is usually needed in more severe situation where the podiatrist does not want to risk you walking on the fracture.
- Impossible to take the cast off.
- Better compliance.
2)Broken Ankle Walking Boot:
These are usually dispensed in less severe situation. Theoretically if the patient does not take the walking boot off, this should have the same offloading & healing capacity.
- They do come off.
- Can take it off to shower.
- Can take it off during bed.
- Otherwise should not walk on it.
Broken Ankle Recovery Time:
- Broken ankle recovery time definitely depends on the severity.
- A severely displaced ankle fracture will require surgery, possible plates and screws. This can require 2-3 weeks to heal the incision site, then a cast for 6-8 weeks.
- If surgery is not necessary, then a cast may be required for 6-8 weeks, then a walking boot for a further 3-4 weeks.
- X-rays are used in the mean time to check the progress of the fracture.
- It is important not to start walking too early or you may develop arthritis or a deformity of the ankle.
Broken Ankle Rehab:
- Broken ankle rehab is usually performed through physical therapy.
- Broken ankle rehab can take up to 6-12 months to regain your flexibility and normal walking from the time of the fracture.
- We find best results with orthotics, bracing and offloading following removal of the cast.
- The key is to find where your joints and ligaments are staying tight and make sure they do not stay that way permanently.
Ankle fracture recovery time on average is 6 weeks in a cast and 6 weeks in a walking boot. We then have patients spend 6 more weeks in a lace-up ankle brace or custom brace.
Traumatic Injury Treatment:
- If you have a traumatic injury such as a severe bruise or broken bone, or even a ruptured tendon: consider protecting your foot!
- The best way to do this is of course to see your podiatrist and get evaluated with an x-ray and potential MRI or CT scan.
- If you are unable to do so it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for very long period of time when they suffer a traumatic injury, unfortunately there is no other way around us in labor jobs.
- If you have a sitdown job there are ways to get people back to work quicker, but this can be very difficult otherwise.
Ankle Fracture Best Boots:
- A cast may be indicated initially, but gradually there are some benefits to a removal air cast.
- This has recently been shown to be more and more beneficial for ankle fractures.
- Our favorite fracture boots and their supplies:
Best Fracture Scooters
Best Value & Best Seller Knee Rolling Scooter.
Best All Terrain Heavy Duty Scooter.
Best Crutch Free Walking Device.
Best Elevating Specific Postop or Swelling Pillow
Price:
$107.99
$268.99
Price not available
$49.99
Overview:
Very good reviews at 4.5/5 with 3,000+ reviews. Great Price.
Excellent overall reviews at 4.4/5 with 1,300+ reviews. Great heavy duty all terrain.
Decent reviews at 3.9/5 with 4,000+ reviews. NOT for everyone!
Very good reviews at 4.7/5 with almost 2,000 Reviews. Simple job but does it well.
Pros:
Great reviews, great price overall, what more can you ask for?
Good for offroad, grass and dirt. This is the better choice for heavy and tall patients over 6 foot and heavy.
This is great for athletic and mobile people. We have found success for younger and more physically capable people.
Great pillow for the first 1-2 weeks after foot or ankle fracture and surgery. Decreased pain and swelling.
Cons:
Least durable and no real off-road capabilities.
It is more costly than the economy version.
DO NOT get this if you are older, have poor balance and poor mobility. Higher fall risk.
Basically it is a pillow that costs $50, if you are tight on money, don't get it.
Crucial Tips:
These can be tough on the knee and the lower back. Combine with physical therapy.
If you are a bigger person at over 6ft tall, consider this. If you need to be at work or outside, this is great option.
This is better for very mobile and physically capable people. Do not get this if you have poor weight control or poor balance.
It can be very effective and does a great job, but if you are tight on cash, use it on a better boot or scooter.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Scooters
Best Value & Best Seller Knee Rolling Scooter.
Price:
$107.99
Overview:
Very good reviews at 4.5/5 with 3,000+ reviews. Great Price.
Pros:
Great reviews, great price overall, what more can you ask for?
Cons:
Least durable and no real off-road capabilities.
Crucial Tips:
These can be tough on the knee and the lower back. Combine with physical therapy.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Scooters
Best All Terrain Heavy Duty Scooter.
Price:
$268.99
Overview:
Excellent overall reviews at 4.4/5 with 1,300+ reviews. Great heavy duty all terrain.
Pros:
Good for offroad, grass and dirt. This is the better choice for heavy and tall patients over 6 foot and heavy.
Cons:
It is more costly than the economy version.
Crucial Tips:
If you are a bigger person at over 6ft tall, consider this. If you need to be at work or outside, this is great option.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Scooters
Best Crutch Free Walking Device.
Price:
Price not available
Overview:
Decent reviews at 3.9/5 with 4,000+ reviews. NOT for everyone!
Pros:
This is great for athletic and mobile people. We have found success for younger and more physically capable people.
Cons:
DO NOT get this if you are older, have poor balance and poor mobility. Higher fall risk.
Crucial Tips:
This is better for very mobile and physically capable people. Do not get this if you have poor weight control or poor balance.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Scooters
Best Elevating Specific Postop or Swelling Pillow
Price:
$49.99
Overview:
Very good reviews at 4.7/5 with almost 2,000 Reviews. Simple job but does it well.
Pros:
Great pillow for the first 1-2 weeks after foot or ankle fracture and surgery. Decreased pain and swelling.
Cons:
Basically it is a pillow that costs $50, if you are tight on money, don't get it.
Crucial Tips:
It can be very effective and does a great job, but if you are tight on cash, use it on a better boot or scooter.
Affiliate Link (Buying through these links will connect you to Amazon):
Ankle Fracture Best Scooters:
- Crutches can be very difficult on the inside of the armpits, this can cause significant pain, especially considering how long it takes to heal the broken ankle.
- These are favorite knee scooters and walking devices:
Best Fracture Boots & Covers
Best Tall Boot
Best Short Boot
Best Fracture Boot Balance Device
Best Cast Shower Cover
Best Weather Walking Cover
Price:
$68.99
$45.05
$29.99
$15.99
$27.99
Overview:
Excellent reviews at 4.6/5 with over 800+ Reviews:
Very good reviews. This is 4.3/5 ratings on over 3,000+ reviews.
Outstanding reviews: 4.3/5 for 1,000+ reviews! Prevents hip, knee and back pain.
Amazing Reviews at 4.6/5 at 500+ reviews. Best reviewed and cost effective bag.
Great reviews at 4.1/5 with 200+ overall reviews.
Pros:
It has an air bladder for extra cushion. It is tall for extra support, as well as air bladder.
Excellent lower cost walking boot. With a orthotic and cushion, it really keeps pressure off of your ankle.
This works great to balance the opposite foot. This prevents the back, hip and knees from having any pain.
It is very effective but not perfect. The price is really good and it has excellent reviews.
Great cover for walking around in snow and rain, it is great at what it does!
Cons:
The inner sleeve can ride lower and the plastic around the rim can irritate the boot.
Less support with the less than full length boot. It is more comfortable but less supportive.
Does not work that great for slippers and less supportive shoes.
It can still leak, so be careful!
It is still not fully water proof.
Crucial Tips:
Make sure your lift the cushioning material along the hard plastic rim. Make sure to keep it pumped up. Use an orthotic and a lift on the other side.
Use a lift for the other foot to prevent back and hip problems. Also use an orthotic for the flat foot bed.
This is very cost effective and well worth it. Just make sure both shoes have good supportive orthotics.
Just be careful with this is not perfect. It can still get wet underneath.
Great cover for outdoors. Good at what it says it will do.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Boots & Covers
Best Tall Boot
Price:
$68.99
Overview:
Excellent reviews at 4.6/5 with over 800+ Reviews:
Pros:
It has an air bladder for extra cushion. It is tall for extra support, as well as air bladder.
Cons:
The inner sleeve can ride lower and the plastic around the rim can irritate the boot.
Crucial Tips:
Make sure your lift the cushioning material along the hard plastic rim. Make sure to keep it pumped up. Use an orthotic and a lift on the other side.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Boots & Covers
Best Short Boot
Price:
$45.05
Overview:
Very good reviews. This is 4.3/5 ratings on over 3,000+ reviews.
Pros:
Excellent lower cost walking boot. With a orthotic and cushion, it really keeps pressure off of your ankle.
Cons:
Less support with the less than full length boot. It is more comfortable but less supportive.
Crucial Tips:
Use a lift for the other foot to prevent back and hip problems. Also use an orthotic for the flat foot bed.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Boots & Covers
Best Fracture Boot Balance Device
Price:
$29.99
Overview:
Outstanding reviews: 4.3/5 for 1,000+ reviews! Prevents hip, knee and back pain.
Pros:
This works great to balance the opposite foot. This prevents the back, hip and knees from having any pain.
Cons:
Does not work that great for slippers and less supportive shoes.
Crucial Tips:
This is very cost effective and well worth it. Just make sure both shoes have good supportive orthotics.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Boots & Covers
Best Cast Shower Cover
Price:
$15.99
Overview:
Amazing Reviews at 4.6/5 at 500+ reviews. Best reviewed and cost effective bag.
Pros:
It is very effective but not perfect. The price is really good and it has excellent reviews.
Cons:
It can still leak, so be careful!
Crucial Tips:
Just be careful with this is not perfect. It can still get wet underneath.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Fracture Boots & Covers
Best Weather Walking Cover
Price:
$27.99
Overview:
Great reviews at 4.1/5 with 200+ overall reviews.
Pros:
Great cover for walking around in snow and rain, it is great at what it does!
Cons:
It is still not fully water proof.
Crucial Tips:
Great cover for outdoors. Good at what it says it will do.
Affiliate Link (Buying through these links will connect you to Amazon):
Home Treatment For Ankle Joint Rehab:
- After you are out of a cast or walking boot, you should transition to a rigid ankle support brace.
- These are our favorite braces.
- These stability braces are meant for when you immediately leave the immobilizing boot.
Table could not be displayed.
Broken Ankle Physical Therapy:
- Physical therapy is definitely needed to optimize recovery.
- The dangers of not having physical therapy following an ankle fracture are the lack of joint flexibility.
- It is very easy at the beginning to simply start walking differently to take pressure off your ankle, but the problem is that your keep walking that way even after the fracture heals.
- In our opinion this is the number one reason for long term problems, the joint contractures that develop can lead to knee, hip and back issues that then last a very long time.
- People may then need further surgery for those issues.
- Physical therapy can usually last for 3-4 weeks depending on injury coverage and severity of the fracture.
What If I have Pain 6+ Months Later?
- These are compression braces that should help you long term.
- These are meant more for compression and fit, rather than absolute stability:
Table could not be displayed.
Pain Relief Options:
- Consider menthol as an alternative to icing.
- Studies have shown that the pain relief can last 2x as long.
- This is safer than long term NSAIDs or other pills.
Best Foot & Ankle Muscle/Ligament Pain Relief Products
Best & Proven Pain Relieving Gel.
Roll On Version of Biofreeze Gel.
A giant container of value size biofreeze.
Menthol Based Ointment with Hemp Extract
Price:
$32.88
$31.43
$151.82
$24.99
Overview:
The Proven and Scientifically Published Menthol Based Gel
Same as biofreeze gel, but the roll-on is prefered by some people for their feet, less messy.
8.1 lbs(3.67 kg) of Value Sized Biofreeze!
This is an alternative cream: Basically Biofreeze + hemp extract.
Pros:
Scientifically proven to loosen up and relief pain up to 2x longer than Ice. Less effort than ice and great reviews. 900+ 5 star reviews on Amazon.
The roll-on application of this biofreeze can be easier to apply. Less overall mess.
If you know you already love it and trust the reviews. This is a great value that lasts a long time.
It has great reviews, loved by the all natural crowd. 100s of 5 star reviews with a near perfect rating.
Cons:
Don't put this on open sores or mucous membranes, it will burn! It can run out quick and doesn't prevent pain, just helps it.
Not as easy to spread in other areas, main difference is the roll on applicator, same solution.
A gigantic bottle that could fall over and injure you! Seriously this could be too big in some situations.
Basically looks like menthol(active Biofreeze ingredient), but with hemp extract SKYROCKETING the price.
Important Tips:
Menthol is the active ingredient in this and other hemp based creams. It works similar to ice, but once you apply it you can just move on rather than waiting 20 minutes. **Works great to get your through the night if you have pain sleeping**
Roll-on method is best for the bottom of the feet. No other real advantage. Most patients like it prior to bed for easy sleeping without foot pain.
If you know you love it, this stuff works all over the sore areas in your body not just your foot. I have had many people get me to order this for them in the past and LOVED IT!
The hemp extract is almost nothing and likely a marketing gimmick. It's basically Biofreeze with some hemp extract raising the price.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Foot & Ankle Muscle/Ligament Pain Relief Products
Best & Proven Pain Relieving Gel.
Price:
$32.88
Overview:
The Proven and Scientifically Published Menthol Based Gel
Pros:
Scientifically proven to loosen up and relief pain up to 2x longer than Ice. Less effort than ice and great reviews. 900+ 5 star reviews on Amazon.
Cons:
Don't put this on open sores or mucous membranes, it will burn! It can run out quick and doesn't prevent pain, just helps it.
Important Tips:
Menthol is the active ingredient in this and other hemp based creams. It works similar to ice, but once you apply it you can just move on rather than waiting 20 minutes. **Works great to get your through the night if you have pain sleeping**
Affiliate Link (Buying through these links will connect you to Amazon):
Best Foot & Ankle Muscle/Ligament Pain Relief Products
Roll On Version of Biofreeze Gel.
Price:
$31.43
Overview:
Same as biofreeze gel, but the roll-on is prefered by some people for their feet, less messy.
Pros:
The roll-on application of this biofreeze can be easier to apply. Less overall mess.
Cons:
Not as easy to spread in other areas, main difference is the roll on applicator, same solution.
Important Tips:
Roll-on method is best for the bottom of the feet. No other real advantage. Most patients like it prior to bed for easy sleeping without foot pain.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Foot & Ankle Muscle/Ligament Pain Relief Products
A giant container of value size biofreeze.
Price:
$151.82
Overview:
8.1 lbs(3.67 kg) of Value Sized Biofreeze!
Pros:
If you know you already love it and trust the reviews. This is a great value that lasts a long time.
Cons:
A gigantic bottle that could fall over and injure you! Seriously this could be too big in some situations.
Important Tips:
If you know you love it, this stuff works all over the sore areas in your body not just your foot. I have had many people get me to order this for them in the past and LOVED IT!
Affiliate Link (Buying through these links will connect you to Amazon):
Best Foot & Ankle Muscle/Ligament Pain Relief Products
Menthol Based Ointment with Hemp Extract
Price:
$24.99
Overview:
This is an alternative cream: Basically Biofreeze + hemp extract.
Pros:
It has great reviews, loved by the all natural crowd. 100s of 5 star reviews with a near perfect rating.
Cons:
Basically looks like menthol(active Biofreeze ingredient), but with hemp extract SKYROCKETING the price.
Important Tips:
The hemp extract is almost nothing and likely a marketing gimmick. It's basically Biofreeze with some hemp extract raising the price.
Affiliate Link (Buying through these links will connect you to Amazon):
Get Great Shoes:
- Getting a great supportive pair of shoes will make sure that there is pressure removed from your ankle and foot long term.
- This is especially important if you are flat footed and your foot starts to turn outward against the lateral aspect of the shoe.
- Consider shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
