Table of ContentsView AllTable of ContentsWhat Is a Total Ankle Replacement?Physical Therapy GoalsControlling Pain and SwellingRestoring Range of MotionWork on Gait Training and BalanceBuilding Strength
Table of ContentsView All
View All
Table of Contents
What Is a Total Ankle Replacement?
Physical Therapy Goals
Controlling Pain and Swelling
Restoring Range of Motion
Work on Gait Training and Balance
Building Strength
While each person’s situation is unique, most post-operative therapy contains several specific interventions. This article will discuss the purpose of this surgery and explain the rehab protocol typically recommended following the procedure.
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Your ankle joint is the section of your lower leg where the shinbone (tibia) meets thetalusbone on the top of your foot.
Occasionally, the slippery surface (known asarticular cartilage) that coats the ends of these bones begins tothin or deteriorate. As this process becomes more advanced, it can lead to significant pain, disability, and difficulty walking.
During an ankle replacement procedure, anorthopedic surgeon(a specialist in the joints and bones) removes the damaged ends of the tibia and talus bones and replaces them with an artificial metal covering. Apolyethylenecomponent is also secured in between these two structures to help the new joint endings move smoothly on one another.
What Is Ankle Replacement Surgery?
Total Ankle Replacement Physical Therapy
Outpatient physical therapy(PT) is typically initiated several weeks after your ankle operation.
PT can last for five months or more, depending on your circumstances. Your physical therapist will usually focus on a number of different areas in order to maximize your outcome.
The common focuses of PT treatment when you are recovering from this surgery, include the following:
Post-operative pain and swelling are also normal occurrences after a total ankle replacement. It is not unusual for an ankle to be swollen even six to 12 months after the operation.
While your surgeon will normally prescribe medication to help manage your discomfort early on, physical therapy also plays an important role in addressing these symptoms.
Treatments likeelectrical stimulation(mild electrical pulses applied to muscles), icing, and vasopneumatic compression (an inflatable sleeve used to create pressure around the limb) are commonly utilized in the early days of physical therapy to reduce your pain or swelling. These modalities are typically used in conjunction with other therapy treatments such as stretching.
Early on after your procedure, your ankle is typically very stiff. This is due to a number of factors including the inflammation and swelling that occur after surgery and the time spent immobilized in a boot afterward.
Your physical therapist will employ several tactics to help improve your range of motion or how far your ankle joint can rotate and flex.
What Is Joint Mobilization?
After multiple weeks of staying non-weight bearing on the affected ankle, your surgeon will clear you to begin walking on your leg again. When this occurs, your physical therapist will work with you toimprove your overall gait (step) patternand eliminate any limping. They will also help you transition from using crutches or a walker to walking independently once again.
What’s more, after multiple weeks of reduced movement and lack of bearing any weight on the affected ankle, the muscles that surround the ankle have oftenatrophiedor weakened, which can impact your balance.
When you are allowed to begin placing weight through the leg, your PT will typically initiateproprioceptive(sense of joint position) training aimed at improving your overall ankle stability.Your physical therapist will recommend strengthening exercises at the appropriate time.
After working on these techniques in physical therapy, balance exercises will be added to your home program and will be progressed as you improve from week to week.
How a BAPS Board Is Used in Physical Therapy
The muscles in your leg, ankle, and foot are typically quite weak due to the arthroplasty surgery and the subsequent time spent in a splint or boot. These structures not only play an influential role in your balance but also affect your ability to stand, walk, and go up or down the stairs.
Because of this, regaining the strength and power in these muscles is a critical goal of rehab.
In the first few weeks of PT, your physical therapist will focus on gentle strengthening exercises, like isometrics, which lightly turn on the muscles but avoid irritating the surgical site.
As time goes on and weight-bearing is allowed, these gentle moves are typically replaced with more challenging ones, usingresistance bandsand standing exercises to accelerate your strength gains.
Ultimately, higher-level sport-specific exercises may be attempted, though caution must be taken to avoid any high-impact movements as these can affect the lifespan of your ankle replacement.
Shoulder-Strengthening Exercises
Summary
Total ankle replacement surgery is a major procedure and it will take some time to fully recover. Physical therapy can be critical to regaining movement in your ankle and restoring your full mobility. Your physical therapist will work with you to control pain and swelling, restore the ankle’s range of motion, train on your walking gait and balance, and rebuild strength in the surgical leg.
A Word From Verywell
Recovering from a total ankle replacement is a challenging task and progress can seem slow at times. That said, in many individuals, this procedure can significantly improve your overall pain and function over time, so do your best to have patience with yourself during your recovery.
During the rehabilitation process, physical therapy plays a critical role in your ability to regain your independence. Because of this, it is important to keep open communication with your PT and to stay compliant with the program they design for you. Ultimately, this will help maximize your chances of a successful outcome after surgery.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Total ankle replacement.Lawton CD, Butler BA, Dekker RG, Prescott A, Kadakia AR.Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade.J Orthop Surg Res. 2017;12(1):76. doi:10.1186/s13018-017-0576-1Massachusetts General Hospital.Physical therapy guidelines for total ankle arthroplasty.UW Health Orthopedics and Rehabilitation.Rehabilitation guidelines following total ankle arthroplasty.
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Total ankle replacement.Lawton CD, Butler BA, Dekker RG, Prescott A, Kadakia AR.Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade.J Orthop Surg Res. 2017;12(1):76. doi:10.1186/s13018-017-0576-1Massachusetts General Hospital.Physical therapy guidelines for total ankle arthroplasty.UW Health Orthopedics and Rehabilitation.Rehabilitation guidelines following total ankle arthroplasty.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Total ankle replacement.Lawton CD, Butler BA, Dekker RG, Prescott A, Kadakia AR.Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade.J Orthop Surg Res. 2017;12(1):76. doi:10.1186/s13018-017-0576-1Massachusetts General Hospital.Physical therapy guidelines for total ankle arthroplasty.UW Health Orthopedics and Rehabilitation.Rehabilitation guidelines following total ankle arthroplasty.
Cleveland Clinic.Total ankle replacement.
Lawton CD, Butler BA, Dekker RG, Prescott A, Kadakia AR.Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade.J Orthop Surg Res. 2017;12(1):76. doi:10.1186/s13018-017-0576-1
Massachusetts General Hospital.Physical therapy guidelines for total ankle arthroplasty.
UW Health Orthopedics and Rehabilitation.Rehabilitation guidelines following total ankle arthroplasty.
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