Broken Ankle Rehabilitation: Exercises, Recovery and Physiotherapy

A broken ankle can affect much more than the bone. Time in a cast or walking boot can leave the joint stiff, the calf weaker and walking less confident. A clear rehabilitation plan helps you understand when to move, when to bear weight and how to rebuild strength without rushing the fracture.

This guide explains typical broken ankle recovery, early exercises, physiotherapy and warning signs. Your fracture clinic's instructions take priority because treatment varies with the bones involved, the stability of the fracture and whether you had surgery.

What is a broken ankle?

An ankle fracture is a break in one or more of the bones around the ankle joint. It may involve the fibula on the outside, the tibia on the inside or back of the ankle, or several areas at once. Some fractures remain stable and can be managed in a boot. Others are displaced or unstable and may need the bones realigning, a cast or surgery with plates and screws.

Because these injuries are not all the same, two people with a “broken ankle” may receive very different advice. NICE says that people having non-surgical treatment for a stable fracture involving one ankle bone may be advised to bear weight as tolerated immediately. That recommendation does not apply to every fracture. If your team has told you to avoid weight-bearing or limit it, follow that restriction until they change it.

How long does a broken ankle take to heal?

The NHS says a broken ankle usually takes around six to eight weeks to heal, although it can take longer. Bone healing is only one part of recovery. Stiffness, weakness, altered balance and swelling often continue after the cast or boot comes off, particularly following a complex fracture or surgery.

A realistic outline is:

• First two weeks: pain and swelling are often most noticeable. The priorities are protecting the fracture, elevating the leg, moving the toes and knee, and following wound or cast advice.
• Weeks two to six or eight: the fracture continues to unite. Weight-bearing and ankle movement depend on your individual plan. Walking may still require crutches or a frame.
• Weeks six to twelve: many people gradually regain ankle movement, walking quality, calf strength and confidence once medical review allows progression.
• Three months and beyond: heavier work, running, jumping and sport need more strength, balance and impact tolerance. More complex fractures can take many months to feel normal.

These are broad milestones, not deadlines. Progress depends on fracture stability, surgery, general health, smoking, pain, swelling and the physical demands of your job or sport. A temporary rise in swelling after doing more can be common, but the overall trend should improve.

What can you do while wearing a cast or boot?

Follow the exact instructions from your hospital or fracture clinic. They should tell you how long to wear the cast or boot, whether it can be removed and how much weight you may place through the leg. Do not copy another person's weight-bearing plan.

The NHS advises gently moving your toes and bending your knee while the ankle is immobilised to help reduce stiffness. If permitted, simple options may include:

• regularly wiggling and spreading the toes;
• bending and straightening the knee;
• tightening the thigh and buttock muscles without moving the ankle;
• short, safe walks with the prescribed walking aid and weight-bearing limit;
• resting with the ankle raised to help manage swelling.

Keep a plaster cast dry and never push objects underneath it. Check the skin around a boot for rubbing. If you had surgery, follow the wound-care instructions and do not start ankle exercises until the treating team says the wound and fracture are ready.

Exercises after a broken ankle

Exercise selection should match the stage of healing. Ask the fracture clinic when ankle movement and strengthening can begin, especially after surgery or a period of non-weight-bearing.

1. Restore comfortable movement

Once the cast is removed or the boot can be taken off for exercise, common starting movements include slowly bringing the foot towards you and pointing it away, drawing small circles and moving the foot gently side to side. NHS fracture services commonly advise short, regular sessions rather than forcing a long stretch.

Movement may feel stiff, but it should stay controlled. Reduce the range or repetitions if pain becomes sharp or symptoms remain clearly worse the following day. Do not force the ankle past a restriction given by your surgeon or fracture clinic.

2. Rebuild walking

When weight-bearing is allowed, practise an even step pattern over short distances. A physiotherapist can help set the height and sequence for crutches, then reduce support as strength and confidence return. Walking further while limping heavily is rarely a useful progression; improve quality before adding a large increase in distance.

3. Strengthen the ankle and calf

Later exercises may include light resistance-band work, seated calf raises, standing double-leg calf raises and eventually single-leg calf raises. Progress is based on control and symptoms rather than a fixed week. The recovering side commonly needs time to regain calf endurance after immobilisation.

4. Retrain balance and everyday function

Supported weight shifts, tandem standing, single-leg balance near a stable surface, sit-to-stand practice and controlled step-ups can prepare the ankle for stairs and uneven ground. People returning to running or field sport will also need hopping, landing and change-of-direction work when the fracture is healed and lower-level tasks are comfortable.

How can physiotherapy help after an ankle fracture?

A physiotherapist can review swelling, ankle movement, calf strength, balance, walking and the demands of your work or sport. Treatment may include:

• a staged home exercise plan that respects weight-bearing and movement restrictions;
• help using and gradually reducing crutches or a walking frame;
• mobility and strengthening exercises;
• balance and confidence training;
• progression towards stairs, work, driving, running or sport;
• advice to return to the fracture clinic, GP or urgent care if progress or symptoms are concerning.

Online physiotherapy can be useful for reviewing movement, walking, exercise technique and progress when the fracture has been medically assessed and the rehabilitation restrictions are clear. Wound problems, a tight cast, circulation changes, a suspected clot or a new injury need appropriate face-to-face medical care.

When can you return to work, driving and sport?

There is no single safe date. A desk-based role may be possible earlier if you can travel safely and elevate the leg. Work involving prolonged standing, ladders, lifting or uneven ground usually needs more healing and physical capacity. Discuss adjustments or a phased return with your employer and clinical team.

For driving, you must be out of any driving restriction, able to control the vehicle safely and perform an emergency stop without pain or hesitation. Check with your treating clinician, insurer and the DVLA rules relevant to your circumstances. Driving while wearing a cast or boot may be unsafe.

Return to sport should follow function as well as the X-ray or calendar. Before impact activity, you would usually want comfortable brisk walking, useful ankle movement, good calf strength, controlled single-leg balance and no substantial reaction after lower-level exercise. Build duration, speed and direction changes in stages.

If your injury was diagnosed as a ligament injury rather than a fracture, see our guide to sprained ankle recovery and exercises. If balance or confidence remains a concern, our falls-prevention guide explains practical strength and balance measures.

Broken ankle warning signs

Get help from NHS 111 if pain is getting worse, you develop a high temperature or feel hot and shivery, the foot or toes become numb or feel as though they are burning, or the cast feels too tight. Swollen toes that turn blue or white, a bad smell or discharge under a cast, or rubbing from a boot also need prompt advice.

Seek urgent assessment for a wound that is increasingly red, hot, wet or oozing, especially with fever or feeling unwell. Sudden severe pain, marked tightness, weakness, pins and needles, or a pale, cold or blue foot may indicate a circulation or pressure problem and should not wait for a routine physiotherapy appointment.

Immobilisation and lower-limb injury can increase the risk of a blood clot. Ask for urgent GP help or contact NHS 111 for new throbbing calf or thigh pain with one-sided swelling, warmth or colour change. Call 999 or go to A&E if these symptoms occur with chest pain or shortness of breath.

Frequently asked questions

Is swelling normal after a broken ankle?

Some swelling is common during healing and can continue after the boot or cast is removed. It often rises after standing or walking. Elevation, pacing and the exercises advised by your team may help. Sudden, severe or rapidly worsening swelling, particularly with calf pain, colour change or breathlessness, needs urgent assessment.

Should I push through ankle pain?

No. Mild stiffness or manageable discomfort can occur when movement and loading restart, but sharp pain, loss of function or symptoms that remain substantially worse suggest the dose is too high or the ankle needs review. Follow the restrictions from your fracture clinic.

Do plates and screws have to be removed?

Metalwork is often left in place. Removal is considered only in particular circumstances, such as persistent irritation, infection or another surgical reason. Discuss symptoms with the orthopaedic team rather than assuming the metalwork is the cause.

Sources

• NHS: Broken ankle (accessed 6 November 2026).
• NICE NG38: Fractures (non-complex): assessment and management (accessed 6 November 2026).
• NHS: Deep vein thrombosis (DVT) (accessed 6 November 2026).
• North Tees and Hartlepool NHS Foundation Trust: Ankle fracture (accessed 6 November 2026).
• Chelsea and Westminster Hospital NHS Foundation Trust: Advice following ankle fracture surgery (accessed 6 November 2026).

Last reviewed: 6 November 2026. This article provides general information and does not replace an individual medical assessment. Stock photographs are commercially licensed images already hosted by YourPhysio.