How to develop a leg after an ankle fracture

The development of the leg after an ankle fracture should be phased. Doctors do not promise a quick recovery, as this can harm the joint at the time of recovery. Patients already in the hospital need to carefully master the set of exercises, and at home be patient and follow the goal of fully restoring the movements lost as a result of an injury. How to develop a leg after an ankle fracture - the doctor of exercise therapy will tell you.

Directions of rehabilitation and its features

High-quality rehabilitation after an ankle fracture is very important, because according to statistics, every third patient with such an injury has complications. This means that the recovery period has passed with errors or ended prematurely. After all, the fusion of bone tissue is only half of the rehabilitation, the most important thing is to establish tissue trophism, lymph flow, normal blood circulation, and strengthen muscles. Only with such a full-scale restoration can we say that the rehabilitation was successful. If you neglect the recommendations of the doctor, then complications may appear:

• hygroma;
• soreness;
• contracture.

The development of the leg after a fracture in the ankle area is carried out in three directions. All of them are interconnected and cannot replace one another or be excluded. The complex action is aimed at the fastest possible recovery of the patient. Rehabilitation of the ankle fracture field includes the following types:

• physiotherapeutic effect;
• massage;
• therapeutic gymnastics.

Restoration of the ankle joint poses the following tasks:

• increase the mobility of the injured joint;
• strengthen the muscle tone of the lower extremities;
• eliminate puffiness that appears during the fracture and recovery;
• restoration of elasticity of ligaments;
• the resumption of the volume of motor activity, which was before the fracture.

Recovery is different for each person. It depends primarily on objective indicators - the age of the patient, the nature of the injury, the presence of complications associated with the fracture, the presence of bone displacement, nutrition, the fact of surgical intervention. With proper recovery, it is possible to cope with the consequences of an injury, but the recovery process is most difficult and residual in elderly patients. This is primarily due to degenerative-dystrophic processes in the tissues, which do not allow the articular elements to fully recover.

Contraindications or restrictions during rehabilitation

Recovery after a fracture has contraindications, most of them are relative. It is not recommended to carry out rehabilitation in the following cases:

• in the presence of metal plates or spokes in the fracture area;
• if the patient has a general serious condition;
• at elevated body temperature;
• in case of a tendency to bleeding;
• during pregnancy and lactation (separate procedures are not recommended);
• with decompensated chronic diseases;
• with pulmonary tuberculosis in the active stage;
• in the presence of neoplasms.

With timely and proper rehabilitation, an integrated approach will reduce the recovery time of the limb. But do not neglect contraindications and strictly follow all the doctor's recommendations.

Joint load

An ankle fracture is a serious injury, so the load on the injured limb is dosed and strictly on time. It depends on the type of fracture received:

• if the fracture is isolated and no displacement of bone fragments is observed, then the first minimum load can be given in a week;
• if fragments with displacement are diagnosed, then loading is allowed for such an injury no earlier than after two weeks;
• for patients whose injury required surgical intervention, it is possible to load the leg only after three weeks;
• when a tibia element is torn off, it is allowed to load the limb no earlier than two months later.

First stage of rehabilitation

At the first stage of rehabilitation, the ankle joint must be spared two days after the injury. At this time, the leg remains motionless, but it must be periodically lowered from the bed so as not to provoke swelling. If the leg is not plastered, but only placed in an orthosis, then from the third day you can start the massage. The main purpose of massage at this stage is to activate blood circulation.

It is also recommended to start physiotherapy from the third day. Among the activities, UHF, magnetotherapy and laser therapy are of great benefit. Ultraviolet irradiation is applied. From the end of the second week, electrophoresis is added, the time of the UHF session is increased, and myostimulation, infrared pulsed irradiation, and shock wave therapy are also recommended. By choosing a particular one. The treatment regimen, doctors take into account the presence of contraindications and the expected effectiveness of the procedure.

Therapeutic gymnastics after an ankle fracture at the initial stage is aimed at involving in the work of those parts of the limb that are not fixed with a plaster or orthosis. These are elements of general strengthening physical education necessary to maintain normal metabolism in tissues.

The second stage of rehabilitation

The second stage lasts from the time of removal of the plaster cast until the partial restoration of movements in the injured limb. It is called functional, since it is in this period that the main task is to return the lost functions. Not all patients know how to develop a leg after an ankle fracture, but in this case, a doctor and medical staff who control the patient's rehabilitation will come to the rescue.

Depending on the complexity of the injury and the amount of damage, a plaster cast is applied for a period of four to twelve weeks, so patients should tune in to a long rehabilitation. Full recovery of movements is directly related to the nature of the injury, therefore, even with minimal damage, doctors focus on a rehabilitation period of one to three months, and even more with complex fractures.

During this period, all three areas of rehabilitation are also involved. Among the physiotherapeutic effects on the limb are used:

• ultraphonophoresis;
• thermal applications;
• electromyostimulation;
• underwater shower with massage effect.

All procedures are prescribed in a course of ten visits. Massage is essential during the recovery phase. Key actions are directed precisely at the development of the ankle joint. The main goal of gymnastics after an ankle fracture is to increase the range of motion after a fracture and restore muscle strength. The development of the joint goes in all directions of movement.

A set of exercises

You need to perform exercises in the second stage of rehabilitation every other day to give the muscles and joints the opportunity to rest. Later, the doctor will advise you to do some elements daily, it depends on the speed of recovery of the limb, the general state of health of the patient. Exercises begin to be performed while standing, focusing on a healthy leg. The set of exercises consists of the following elements:

1. Leg swings are performed crosswise. The main purpose of this exercise is to strengthen the inner surface of the thigh. When performing movements, it is necessary to rest against the wall, or put a chair with a back in front of you. Support at this stage is very important, because any inaccurate movement can lead to injury. The legs are straightened, the weight of the body is transferred to a healthy leg. The raised injured leg is wound towards the healthy one in order to cross with it. The height of the lift from the floor is no more than 20 cm. In the maximum position, you need to hold your leg for a couple of seconds and return it to the opposite position. The rest time between swings is about thirty seconds.
2. Swings to the side involve primarily strengthening the upper side of the thigh. Be sure to have an emphasis before doing the exercise. With the straightened leg, emphasis is placed on the floor surface, the injured leg is retracted at the level of the thigh to the side, leaning forward slightly, after which it is brought to the side behind the healthy limb. After holding the sore leg for 2 seconds, it is slowly returned to its normal position. Two swings are performed per minute, i.e. the time for a break is about 25-30 seconds.
3. Lifting the knee - first of all, it concerns the diseased limb. Standing next to a wall or chair, you need to rest as firmly as possible on the floor surface with your entire foot. The healthy leg is straight and stable, the diseased limb is relaxed, the knee is not tense. Raise the injured leg slowly, bending the knee joint gradually. Ideally, the angle of the leg should be 90 degrees, and the leg itself should be raised parallel to the floor. Holding the leg for a few seconds, gently return it to its original position. Rest enough to restore strength, the next rise is done in about half a minute.
4. Raising the legs back - identical to the previous exercise, in which the leg is brought back in the same position. The main mistake of all those who perform these movements is the deflection of the body in the lumbar region. Two swings are performed per minute. You need to repeat the exercise from one to four times.

All exercises after an ankle fracture are done slowly, measuredly. This will make it possible to maintain the safety of movements, not to load or injure an already damaged joint.

The second set of exercises is performed in a supine position. Patients are recommended:

• tension of the quadriceps muscle (20-30 times);
• flexion and straightening of the foot (10-20 repetitions);
• flexion and extension of the toes (10-20 times);
• circular movements of the ankle in different directions (10 times);
• flexion of the foot back and forth with maximum amplitude (20 repetitions);
• pulling the socks towards you, bending the legs to the stomach (10 times);
• breeding socks on the sides (10 times);
• bending the legs to an angle of 90 degrees in the hip joint (if possible 10 times);
• bending the legs in the hip joint with simultaneous flexion and straightening of the fingers (at least 10 repetitions).

Exercises are recommended to be divided into sets of several movements. It is best to group, starting with 2-3 exercises, so as not to put a lot of stress on the joints. An obligatory element of gymnastics is rest. It is done between sets, taking 5-10 minutes of time to relax.

After exercise, you can do a massage. At home, the most elementary movements are performed. Power for everyone. These are stroking, kneading, shaking and squeezing. Each movement is done ten times. The ankle is worked out carefully, movements should not bring pain or discomfort. Pay special attention to the heel and ankles. During the day, the ankle is still bandaged with an elastic bandage or held by an orthosis for some time, but for the duration of the massage and exercise therapy, the leg is allowed to rest.

If edema appears after exercise, this is possible and you should not worry, but it is still recommended to deal with edema. At night, a pillow is placed under the leg, or the legs soar in water of 36-37 degrees, immersing them knee-deep in the bath. While the legs are steaming, it is recommended to develop the diseased limb in water.

Third stage

The purpose of the third stage is the maximum expansion of movements. This stage is also called training, since it is he who brings the movements of patients as close as possible to normal. The complex of physiotherapy exercises begins with walking on toes and heels. It is also necessary to focus on the outer or inner edge of the foot. The leg is moved to the sides on the heels, they walk in a cross step. Useful walking up the stairs, in a semi-squat.

To effectively increase the amplitude of such exercises will not be enough - this is only one of the stages of recovery, but far from the main one. In order to fully develop it is necessary to apply mechanotherapy:

• exercises on a stationary bike;
• rolls of a gymnastic stick;
• use of an ankle rocker.

At the third stage, doctors recommend connecting classes in the pool. Water removes excess load from the human body, while giving him the opportunity to easily and naturally develop the ankle joint.

During the treatment, the patient's ankle was in a forced position with limited movement for a long time. Not surprisingly, after the removal of the cast, patients feel constrained and cannot walk as they did before the injury. To restore motor activity in the form of support, crutches and a cane are used, after which work on an exercise bike begins. The exercise bike is initially set to an easy walking stage, but over time the pace increases. All classes are supervised by an instructor. Proper walking is extremely important, since the bone elements that have fused after a fracture must be in a physiological position. Otherwise, complications may develop.

During the recovery phase, all exercises should be performed with a well-fixed ankle. It is used on average for another 8-9 months after the injury has occurred. To restore the leg to patients, the doctor will recommend a special orthosis - its fixation force is less than that of an orthosis in case of injury, but it allows you to keep all the articular elements in a normal position. If the state of health is normal, then jumping and running are added to the exercises at the end.

A set of exercises

The movements performed at the final stage of limb recovery have two goals:

• strengthen the muscles of the injured limb;
• eliminate residual effects after a fracture.

The duration of classes is increased to 45 minutes. They are performed 2-3 times a week. Ideally, by the end of the final stage, the ankle should be fully prepared to perform the normal load that was before the leg injury.

Therapeutic exercise after an ankle fracture consists of the following movements:

• rolling from heels to toes - performed 5-7 times in one set;
• adduction of the foot and its breeding, simultaneously with stepping on the heel - 5 times;
• transferring body weight - to begin with, the sore leg is loaded for 2-3 seconds, then you need to bring the time to 10 seconds;
• swaying the limb with subsequent relaxation - three times;
• half-squats - done at least 6-8 times on the entire foot and on the heels the same amount;
• movement on the surface with emphasis - on the toes and heels 15 times, the same number on the outside of the foot;
• with the support of the support, lunges are recommended 10 times;
• walking with hands on the belt - at a normal pace for 20 seconds, on heels and on toes - 15 seconds each, the same amount of time with side steps and cross step;
• stepping over a stick for two minutes, the distance should increase over time;
• with an emphasis on a gymnastic rail or chair, it is necessary to rise and fall on the heels 5-7 times;
• in a sitting position - pulling socks forward - 4-6 times;
• squatting with the body and springy movements in the knee joint for 2-3 minutes.

The third stage is very responsible, so it is important to work not only on the osteoarticular elements, but also on the muscles. With regular exercise, the muscles will quickly restore their tone and become support for damaged joints. With weak muscles, there is a risk of re-injury or complications. To increase muscle strength perform the following exercises:

• squats on a fitball - for the exercise you will need a special ball (fitball), which has great strength and is able to withstand body weight. The main exercise for the muscles is performed in the form of squats so that the ball is under the buttocks. You do not need to sit down completely - when you touch the ball, unbend your body and straighten up. Then repeat the movements again. The most important condition for the high-quality performance of the exercise is that the angle at the knees should form at 90 degrees;
• exercise on the platform - usually performed in the clinic, but you can buy such a device at home. On an unstable surface, standing with a healthy leg, you need to hold out as long as possible, then attach the injured limb and learn how to balance. You can complicate and diversify the exercise by throwing the ball against the wall;
• jumping is a rather hard but effective way to recover. A line is drawn on the floor, along which it is necessary to jump on its different sides. With this exercise, both the femoral muscles and the muscle complex of the calves and ankle are strengthened. The exercise is performed at the latest stage after the permission of the doctor;
• a roller is widely used to strengthen muscles. One of the effective exercises on the roller is to stand on its surface with a healthy foot, and then swing to the side and back. In order to give the muscles a greater load and stability training, it is recommended to slightly bend the leg standing on the roller.

Rehabilitation after an ankle fracture - gymnastics, physiotherapy and massage - will help to cope with the consequences of the injury and return the patient to a normal rhythm of life. The most important thing is the correct and timely execution of all exercises.