Ankle Surgery Recovery: A Long, Arduous Process

STACK Expert Mo Skelton explains the process and challenges of recovering from ankle surgery.

Ankle Injury

Recovery from ankle surgery can be a real bear. First, you've got an average of six weeks in a cast. Once you're done with that, you still have about six more weeks of avoiding weight-bearing activities like running.

Here's what to expect if you get sidelined with a fracture or other ankle injury that requires surgery. But first, an anatomy lesson. The ankle joint is a physical union of three bones. Many times, at least two of them are broken and must be repaired. Along with this, the joint itself may be dislocated and there is usually damage to soft tissue including ligaments, joint capsule and tendons.


The lower leg has several "compartments," with muscles and bones that have variable amounts of blood flow and swell very easily. When blood collects in a compartment, that part of the leg swells, making it a challenge to recover. You are fighting against gravity. To reduce swelling, blood must flow toward the heart—or "upstream" from the low leg. Decreasing the swelling is easier if you can move—but you can't move after ankle surgery. Your options are to elevate the leg higher than your heart when lying down, apply HyperIce units or lift your leg while in a swimming pool.

Scar Tissue

Scar tissue is present after all surgeries, but with the ankle, many times the scar is longer due to the amount of damage. You may have up to three incisions that cause scar tissue. Scar tissue does not function like a muscle. It does not contract, it is not flexible, and for a long time it can be painful. All of this presents challenges for an athlete. The scar tissue must be mobilized—moved by skilled hands or an instrument—to heal properly. The less scar tissue in a muscle, the more functional the area can be.


Stiffness begins immediately after the injury and becomes worse after surgery with immobilization, swelling and scar tissue. It is the primary roadblock to full recovery.

If some of these challenges have been met, the next move is to improve joint mobility and localized flexibility. Skilled hands can help mobilize the joint. To improve dynamic mobility, try bodyweight Squats with small weight plates under your heels. When this becomes easy, move the plates to under your toes. This will further improve depth of squatting and ankle mobility. For flexibility, it's important to stretch your calves and foam roll them to restore good movement.

Loss of Strength and Power 

If—and this is a big if—all the swelling is gone, the scar tissue is minimal, mobility is restored and you have good flexibility, then you're ready for the final step: fully restoring strength and power. There is no magic in this. It is hard work and it takes patience. You'll spend countless hours in the weight room—under the bar in the squat rack, inside a trap bar Deadlifting, performing plyometrics—then hitting the track to work on speed and agility.

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