Broken Ankle Recovery Time: Best Treatment & Rehab
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.
The goal of this guide:
To show you what to expect with your broken ankle recovery time.
In 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 things.
This means that one of the ankle joint bones or broken 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:
A range 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. This can be very important initially to prevent further tissue loss and stabilize the tissue with open or high-risk fractures.
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:
Three bones 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 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 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 definitely 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 centerline 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 is broken.
If the lateral, posterior and medial malleolus are all broken, a tri-malleolar fracture is then termed.
Foot Doctors can also classify the ankle fracture based on the severity:
If there is a fracture, which is not displaced. This is called the nondisplaced fracture.
If there is over 1 to 2 mm of motion, this is now called a displaced fracture.
If there are 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 tough 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 an avulsion fracture. This is not considered a classical ankle fracture.
Broken Ankle Swelling:
Swelling can occur with an 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. This cannot be easy to notice sometimes! Ligaments to worry about here are the ATFL, PTFL, and CFL.
Broken Ankle X-ray:
An X-ray or CT scan is needed 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 broken 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 plaster cast or a fiberglass 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 than 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 the 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.
The 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 a more difficult 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 a less difficult 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, you 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 and then 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 meantime 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 the 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 cannot 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 a 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 sit-down job, there are ways to get people back to work quicker, but this can be impossible 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:
$122.99
$284.00
Price not available
Price not available
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):
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
Price:
$76.43
$42.00
$35.99
$13.99
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.
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.
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!
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.
Affiliate Link (Buying through these links will connect you to Amazon):
It would help if you transitioned to a rigid ankle support brace after you are out of a cast or walking boot.
These are our favorite braces.
These stability braces are meant for when you immediately leave the immobilizing boot.
Best Ankle Stability Braces (Not for Compression):
The Best Overall Brace For Fit & Support.
Most Supportive Premium Brace.
Best Budge Supportive Brace.
Price:
$54.99
Price not available
$29.97
Overview:
Amazing brace, best fit and support combination: If you can afford it.
This is the best brace for pure support, but it can’t fit in more snug shoes.
Outstanding brace for the price point. This is a figure 8 strap with laces, soft interface.
Pros:
Amazing brace. Best reviews and best fit. This is the Ferrari of braces if you can afford it.
This is a very highly rated, great reviewed brace. The support and stability is top notch for athletics. Very durable and does it’s job.
Amazing reviews with proven track record. This is very soft and supportive in your shoe.
Cons:
The only downside besides cost, is complexity. This brace must be left or right. Not interchangeable. It is also for post-injury situations and good support. Not for compression!
The brace may be a little too big for a more snug shoe. This requires some room to fit and would be the main complaint. Hard interface along the padding.
The main downside is the durability and the ability for the material to give out. Great at first but maybe 3-4 months of continuous use prior to failure.
Important Tips:
Make sure to choose left vs. right. This is a high level brace mean specifically for injury support. This is not for compression or non-injury situations. It will be too tight.
This is a fantastic and supportive brace. Just make sure that your shoe will have some room for it to fit. Most good running shoes should let it fit.
This is an excellent starter brace if you have never had a brace before. It is a little longer to put with the straps and laces.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Ankle Stability Braces (Not for Compression):
The Best Overall Brace For Fit & Support.
Price:
$54.99
Overview:
Amazing brace, best fit and support combination: If you can afford it.
Pros:
Amazing brace. Best reviews and best fit. This is the Ferrari of braces if you can afford it.
Cons:
The only downside besides cost, is complexity. This brace must be left or right. Not interchangeable. It is also for post-injury situations and good support. Not for compression!
Important Tips:
Make sure to choose left vs. right. This is a high level brace mean specifically for injury support. This is not for compression or non-injury situations. It will be too tight.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Ankle Stability Braces (Not for Compression):
Most Supportive Premium Brace.
Price:
Price not available
Overview:
This is the best brace for pure support, but it can’t fit in more snug shoes.
Pros:
This is a very highly rated, great reviewed brace. The support and stability is top notch for athletics. Very durable and does it’s job.
Cons:
The brace may be a little too big for a more snug shoe. This requires some room to fit and would be the main complaint. Hard interface along the padding.
Important Tips:
This is a fantastic and supportive brace. Just make sure that your shoe will have some room for it to fit. Most good running shoes should let it fit.
Affiliate Link (Buying through these links will connect you to Amazon):
Best Ankle Stability Braces (Not for Compression):
Best Budge Supportive Brace.
Price:
$29.97
Overview:
Outstanding brace for the price point. This is a figure 8 strap with laces, soft interface.
Pros:
Amazing reviews with proven track record. This is very soft and supportive in your shoe.
Cons:
The main downside is the durability and the ability for the material to give out. Great at first but maybe 3-4 months of continuous use prior to failure.
Important Tips:
This is an excellent starter brace if you have never had a brace before. It is a little longer to put with the straps and laces.
Affiliate Link (Buying through these links will connect you to Amazon):
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 to start walking differently to take pressure off your ankle, but the problem is that you 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:
Best Heel & Ankle Compression Braces:
Best Premium Brace (Support & Compression)
Budget Brace With Some Compression & Some Support.
Price:
Price not available
$22.49
Overview:
This is The Top Level Brace – Does Compression, Support & Great Fit.
This brace attempts mild compression and mild support.
Pros:
Excellent brace: Best overall mix of compression & support, and it still fits in most shoes! If you have a chronic injury and need to wear normal shoes => This is the BEST CHOICE.
Good rating at 4.3 with 2,000 reviews. It is cost effective and gives some support with some compression. Does both ok, but excellent when price is factored in.
Cons:
Expensive. It doesn’t do any single thing the best. There are cheaper and more supportive braces, there are cheaper and more compressive braces. But no braces combine the two and still fit in a shoe.
Does not really do anything well. Weak support and not the best compression. Meant as an assist for chronic pain and low activity. Not for an acute injury.
Important Tips:
This is a high durability brace for everyday use. If you have chronic arthritis or pain with a high need for activity, this is your brace to use! **Gel inside seems to deteriorate after daily washing at about 1 year old**
This is mean for lower activity and better fit than a true supportive brace. Don’t use this for an acute sprain or injury.
Affiliate Link (Buying through these links will connect you to Amazon):
This is The Top Level Brace – Does Compression, Support & Great Fit.
Pros:
Excellent brace: Best overall mix of compression & support, and it still fits in most shoes! If you have a chronic injury and need to wear normal shoes => This is the BEST CHOICE.
Cons:
Expensive. It doesn’t do any single thing the best. There are cheaper and more supportive braces, there are cheaper and more compressive braces. But no braces combine the two and still fit in a shoe.
Important Tips:
This is a high durability brace for everyday use. If you have chronic arthritis or pain with a high need for activity, this is your brace to use! **Gel inside seems to deteriorate after daily washing at about 1 year old**
Affiliate Link (Buying through these links will connect you to Amazon):
Budget Brace With Some Compression & Some Support.
Price:
$22.49
Overview:
This brace attempts mild compression and mild support.
Pros:
Good rating at 4.3 with 2,000 reviews. It is cost effective and gives some support with some compression. Does both ok, but excellent when price is factored in.
Cons:
Does not really do anything well. Weak support and not the best compression. Meant as an assist for chronic pain and low activity. Not for an acute injury.
Important Tips:
This is mean for lower activity and better fit than a true supportive brace. Don’t use this for an acute sprain or injury.
Affiliate Link (Buying through these links will connect you to Amazon):
Studies have shown that 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:
Price not available
$28.60
$149.99
$19.99
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:
Price not available
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
A giant container of value size biofreeze.
Price:
$149.99
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):