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Rehabilitation

Dorsiflexion of foot after broken ankle

05/14/2008

Question:

I am in physical therapy for a torsion ankle fracture which occurred about 3 months ago. I fractured the medial malleolus (repaired with one screw) and my fibula and tore the IOL (IOL fibula-tibia tacking screw recently removed about 3 weeks ago). I was on cructches and wore a foot brace for 9 weeks after my initial surgery. Every since my initial surgery I have been trying to dorsiflex my foot. At first I was told by my doctor that my inability to dorsiflex was due to swelling. Then when my swelling went down, I was told that it was the fibula-tibia screw. Now that the screw has been removed I still can`t dorsiflex eventhough the swelling appears minimal and my ankle can be flexed in all other directions easily. It feels totally like there is some type of impingement when I dorsiflex and pain occurs in the anterior portion at the the ankle joint. Is this normal at this stage? I have been following doctors and PT advise about exercizing and stretching it for months and have not seen any improvement. Any info would be greatly appreciated. This service is awesome in that I haven`t been able to get any straight answers from my doctor or at the physical therapy clinic he prescribed for me (apparently just PT assistants there at a exercize health club). Thanks.

Answer:

It is not unusual for dorsiflexion to take a long time to return. Do continue to stretch because the scar tissue can be tough to stretch out and break up. Your physical therapist might also try joint mobilization to assist this process. On a side note, physical therapy assistants should not be working alone. They should always be working with a physical therapist. Some health clubs employee PTs and PTAs but most employ personal trainers. Personal trainers are not PTs. Make sure you know who is treating you and what their credentials are.

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Response by:

Tammy S Wadsworth, PT MS OCS Tammy S Wadsworth, PT MS OCS
Sports Medicine Team Member
Clinical Instructor at The School of Allied Medical Professions
College of Medicine
The Ohio State University