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Phase I- Maximum Protection (Weeks 0 to 6)

  • Cast or boot for 6 weeks
  • Elevate the ankle above the heart
  • Non-weight bearing x 6 weeks
  • Multi-plane hip strengthening
  • Core and upper extremity strengthening

Phase II- Range of Motion and Early strengthening (Weeks 6 to 12)

  • Partial weight bearing based on healing and physician instruction
  • Orthotic insert to support arch
  • Active ankle ROM all planes
  • Isometric and early isotonic ankle
  • Foot intrinsic strengthening

Phase III- Progressive Strengthening (3 to 6 months)

  • Restoration of full range of motion all planes
  • Gradually wean out of boot and progress to full weight bearing
  • Normalize gait mechanics
  • Advance ankle and foot intrinsic strengthening
  • Proprioception training
  • Gradual progression to non-impact cardio-vascular and fitness activities

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