Exercises after an ankle fracture: from cast to full strength

Published October 31, 2026 · Updated November 1, 2026 · Protocol Archive Editorial

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Exercises after an ankle fracture: from cast to full strength

Talk to your doctor first. General education, not medical advice.This content is general education, not medical advice, diagnosis or treatment. Get approval from your physician or another qualified healthcare provider before starting any exercise program, especially if you have a medical condition, a recent injury or surgery, are pregnant, or take medication. Stop and seek medical advice if an exercise causes pain, dizziness, chest discomfort or shortness of breath. You choose to exercise at your own risk. Read the full medical disclaimer.

Last checked: October 2026 · Protocol Archive Editorial · General information, not medical advice

An ankle fracture is a break in one or more of the bones that make up the ankle joint. Some are treated in a cast or walking boot, and others need surgery to hold the bones in place. Either way, the ankle is usually protected for several weeks while the bone heals.

After that time in a cast or boot, it is normal for the ankle to be stiff, swollen and weak, and for the calf muscles to have shrunk. Exercise helps restore movement, strength and balance so you can walk normally again.

Bones usually take 6–8 weeks to heal, but they keep strengthening for up to a year. Most people return to normal activities within 3–4 months, and swelling can take longer to settle completely.

Your surgical team comes first. Your fracture clinic’s or surgeon’s instructions on how much weight you can put through the ankle, and for how long you wear a cast or boot, come first. Putting weight on a healing fracture too early can make the bones move out of place, so only use the stages on this page once your team says they are right for you.
On this page

  1. Stage 1: While in a cast or boot
  2. Stage 2: Restore ankle movement
  3. Stage 3: Rebuild strength and balance
  4. Videos
  5. What to expect
  6. When to get help
Usually the first 4–6 weeks (as set by your fracture clinic)

Stage 1: While in a cast or boot

Keep the knee, hip and toes moving, keep the thigh and buttock muscles working, and control swelling.

  1. Quad Sets (Quadriceps Setting)

    Do this without using your hands. It keeps the thigh muscle working while the ankle is immobilized.

    Typical dose: Tighten the thigh to press the back of the knee down into the bed, 10 reps, 3–4 times a day1,2

  2. Glute Sets (Buttock Squeezes)

    A simple way to keep the hip muscles active while you are less mobile.

    Typical dose: Squeeze your buttocks together, then relax, 10 reps, 3–4 times a day1,2

  • Also move your toes as much as the cast allows and fully bend and straighten your knee a few times a day.1,2,5
  • Keep the foot raised for much of the day and avoid letting it hang down for long periods, to help control swelling.1,2
  • Use crutches or a frame exactly as you have been told. Do not put more weight through the leg than your fracture clinic allows.1,6
Once the cast or boot is off, or your team allows ankle movement

Stage 2: Restore ankle movement

Loosen the stiff ankle in every direction and reduce swelling.

  1. Ankle Pumps

    Keep the knee straight. Some soreness is expected, but work only to a comfortable level.

    Typical dose: Point the foot up toward you, then away, holding each position for about 10 seconds, 10 reps, 3–5 times a day3,4

  2. Ankle Alphabet

    Turning the sole of the foot in and out is part of normal ankle movement and is often stiff after a fracture.

    Typical dose: Slow circles or letters, 10 in each direction, 3–5 times a day2,3,4

  3. Knee-to-Wall Ankle Mobility (Dorsiflexion)

    A progression for when you are allowed to put weight through the foot. Practice daily until the ankle bends nearly as far as the other side.

    Typical dose: Toes toward a wall, heel down, move the knee forward to touch the wall, 10 reps, daily2

  • Do not push into sharp pain. Mild discomfort or a little extra swelling during exercise is acceptable if it settles later the same day.3
  • Once any wounds have fully healed, NHS fracture services suggest bathing the ankle in warm water for about 10 minutes, then drying it and applying moisturizer.1,2
  • Many people are referred to physical therapy at this point for a longer-term program.1,4,6
As you improve and are allowed full weight

Stage 3: Rebuild strength and balance

Rebuild the calf muscles and the balance you need to walk normally, use stairs and return to activity.

  1. Toe Stand Strength Exercise

    Start with weight shared between both feet.

    Typical dose: Holding something stable, rise onto your toes and slowly lower your heels, 10 reps, a few times a day1,2

  2. Single-Leg Calf Raise

    Add this once you feel confident on both feet. Compare with the uninjured side.

    Typical dose: Holding a support, 10 reps on the injured leg, once a day when two-leg raises feel easy1

  3. Stand on One Foot Balance Exercise

    When it feels easier, try sliding a cloth around the standing leg with the other foot. Balance often takes a long time to recover.

    Typical dose: Holding a support, balance on the injured leg for up to 30 seconds; practice daily1,2

  • Practice ankle bending and single-leg balance daily until the injured ankle is nearly as good as the uninjured one.2
  • Reduce crutches gradually as you feel confident and safe: two, then one (held in the hand opposite the injured leg), then none. Walk heel to toe.1

Want this as a checklist? Turn these exercises into a printable home program with videos and daily check-offs. Adjust the list and doses with your clinician.

Make it a home program

Printable handout (PDF, 2 pages). The exercises on this page with typical starting amounts, boxes for your surgical team or physical therapist to write your plan, and a 6-week tracker. Only do what your team has cleared.

Download PDF A4 size Large printEn español: PDF · A4

Watch the exercises

Every exercise above links to its own page with a video and step-by-step instructions. Here are two to start with.

Play video
Quad Sets (Quadriceps Setting). Full steps, cues and safety notes: Quad Sets (Quadriceps Setting) page.
Play video
Ankle Pumps. Full steps, cues and safety notes: Ankle Pumps page.

What to expect

These are what published guidance usually says. Your own recovery may be faster or slower.

Question What sources say
Time in a cast or boot Usually about 4–6 weeks, but your fracture clinic decides this and how much weight you can take.1,3,5
Bone healing Most ankle fractures take at least 6 weeks for early healing and 10–12 weeks for complete healing. The bone keeps strengthening for up to a year.4,6
Return to normal activities Most people return to normal activities within 3–4 months. Very active lifestyles and complex injuries can take longer.2,6
Swelling and stiffness Swelling and discomfort can last 6–9 months or up to a year, and some stiffness is common. Raising the leg helps.2,3,4
Driving Only once you can walk comfortably and do an emergency stop safely, with enough movement and strength to control the pedals. Check with your fracture clinic.3,4

What to avoid or change for now

  • Putting more weight through the ankle than your fracture clinic or surgeon has allowed.
  • Pushing into sharp pain during exercises.
  • Cutting your cast or pushing anything down it; contact the cast clinic if it rubs.
  • Contact sports and high-strain activities until your clinician clears you.
  • Letting the foot hang down for long periods while swelling is high.

When to get help

  • Throbbing pain and swelling in one calf or thigh, sometimes with red or darkened skin, can be a blood clot. Get medical help the same day, and call 911 if you also feel short of breath or have chest pain.7
  • Your wound becomes red, swollen or itchy, or there is a bad smell or discharge from under the cast. These can be signs of infection; contact your fracture team promptly.4,5
  • A very high temperature, or feeling hot, cold or shivery. Get urgent care.5
  • The pain in your ankle is getting worse rather than better. Contact your fracture team or get urgent care.3,5
  • Your leg, foot or toes feel numb or like they are burning. Get urgent care the same day.5
  • Your toes look swollen or turn blue or white, or the cast feels too tight. Get urgent care the same day.5

For a medical emergency, call 911 (US and Canada), 999 (UK), 000 (Australia) or 112.

Next steps

Related guides: After rotator cuff repair, After shoulder replacement, After ACL reconstruction, or see all conditions.

Need a physio or physical therapist? How to find one in the US or UK, including direct access and checking registration.

More exercises: browse the free exercise library, every one with a video.

Frequently asked questions

When can I start exercising after a broken ankle?

Toe, knee, thigh and buttock exercises usually start while you are in the cast. Ankle exercises start once your fracture clinic removes the cast or boot or allows movement.

When can I walk on a broken ankle?

It depends on the type of fracture and whether you had surgery, so your fracture clinic or surgeon will tell you. Putting weight on too early can make the fracture fragments move.

Is it normal for my ankle to still swell months later?

Yes. Swelling and some discomfort can last 6–9 months or up to a year after a fracture, and usually improve slowly. Raise the leg when it is swollen.

How long does it take to recover from an ankle fracture?

Bones usually heal in about 6–12 weeks, and most people are back to normal activities within 3–4 months. Full recovery from some fractures can take longer.

Are the exercises different if I had surgery?

The early exercises are similar, but your surgeon may set different weight-bearing and timing rules. Follow your surgical team’s plan and keep the wound clean until it has healed.

Sources

  1. United Lincolnshire Hospitals NHS Trust: Ankle fracture exercises
  2. Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust: Ankle fracture advice (clinical therapy)
  3. NHS Western Isles: Getting your ankle moving after your cast is removed
  4. Chelsea and Westminster Hospital NHS Foundation Trust: Advice and information following ankle fracture surgery
  5. NHS: Broken ankle
  6. AAOS OrthoInfo: Ankle fractures (broken ankle)
  7. NHS: DVT (deep vein thrombosis)

Last checked October 2026. Found something out of date? Email hello@protocolarchive.com.

This guide summarizes published hospital, health-service and professional-body advice listed under Sources. It is general information, not medical advice, and does not replace an assessment by your own clinician, whose plan may differ for good reasons. Stop an exercise and get advice if it causes sharp or worsening pain. Protocol Archive is independent and is not affiliated with the NHS, AAOS or any hospital or video publisher named on this page.

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