A common type of injury is an ankle fracture. It is formed due to motor activity a person with an excessive range of motion, as well as taking the leg into an uncharacteristic position. Rehabilitation after an ankle fracture is very important, since it is from it that correct purpose a person's future ability to walk depends on it. All the details of this period can be found in the article.

Doctors note that this injury is characterized by the following typical signs:

• Severe pain, crunching and hematoma in the damaged area;
• The formation of edema and loss of general performance of the limb.

Usually, pain appears in a person at the moment of impact, but most often the person is in a state of passion and may not feel it at all. Later, he experiences severe pain and is unable to step on his injured leg. If you do not consult a doctor in time, a person may develop pain shock.

If during the impact you could hear strong crunch, then this indicates that the bone is broken. If this is the case, the person will later experience swelling in the injured area. If damaged large vessels swelling may appear over the entire surface of the injured limb.

Appearance dark spots on the surface of the skin indicates the formation of a hematoma at the site of injury. It is formed if soft tissues available internal bleeding. This phenomenon leads to a decrease in the performance of the injured leg.

Types of Ankle Injuries

Doctors stand out the following types damage:

• Supination and pronation.
• Isolated. They are divided into lateral and medial. The lateral ones appear on the outside, and the medial ones on the inside ankles.
• Multiple. They are classified into bimalleolar and trimalleolar. The latter are characterized by separation of the rear part tibia.
• Injuries with ligament damage.
• Closed and open fractures.
• Ankle fracture with or without displacement.
• Damage with the presence of irregularities in the ankle ring. They form between the ankle fork and the ligaments. These fractures are also divided into stable and unstable. With a stable fracture, the damage affects only one ankle. Unstable fractures are characterized by double or triple malleolar fractures, as well as the presence of tears in the ligaments. Such injuries are also characterized by the presence of external subluxation in the foot.

Thus, when unpleasant signs Finally, the person should be taken to the hospital immediately. Only an experienced doctor based on examination, additional diagnostic procedures can deliver accurate diagnosis and prescribe appropriate treatment.

Rehabilitation after injury

Most people are often interested in the question of how long rehabilitation will take. Doctors note that if a person does not experience any complications after breaking an ankle and removing the cast, the recovery period will take from 1 to 2 months.

Complications that the patient may experience may include:

• The presence of swelling in the soft tissues;
• Decreased joint activity and lameness.

If the injury was accompanied by bone displacement and surgery was performed with a plate, the rehabilitation period will be extended to six months.

After removing the bandage, the patient is recommended to bandage the leg. An elastic bandage after a fracture is necessary to give the limb an optimal position. At first, the patient is prohibited from stepping on the injured leg while walking. He usually gets around on crutches. Only after 2 weeks a person is allowed to use a cane instead of crutches. If the patient does not know how to walk correctly with a cane, then this should be discussed with the attending physician in advance.

Remember that the severity of the injury will determine how your recovery from an ankle fracture will proceed and how long it will take.

Overall during rehabilitation period the following tasks are solved:

• We increase muscle tone and elasticity;
• We get rid of congestion and swelling in the leg and normalize blood supply and lymph outflow;
• We restore the mobility of the injured limb.

Only the attending physician can prescribe additional procedures necessary during the rehabilitation period.

Thus, the rehabilitation process after a displaced ankle fracture generally consists of the following important stages:

1. The patient undergoing physical therapy. He is also prescribed physiotherapy and massage;
2. Eating only healthy foods;
3. Applications for him medicines and wearing orthopedic devices.

Physiotherapy Basics

Initially, the patient is prescribed electromagnetic therapy. Next, mud baths are used, as well as acting on injured limb using ultrasound, electrophoresis and heating.

If the patient has a displaced fracture, he is prescribed oxygen and pearl baths, as well as the use of underwater massage, thermal baths, applications with ozokerite, paraffin and mud.

If there is severe pain in the ankle area, physiotherapy includes the use of UHF, electrophoresis, and the use of an Almag-type device.

When bone healing is slow, extracorporeal shock wave therapy is used.

Exercise therapy for a broken ankle is not performed for the following categories of citizens:

• If they have severe chronic diseases;
• When diseases appear in the circulatory system;
• With the development of neoplasms of both malignant and benign nature;
• With a tendency to heavy bleeding.

Massage technique

Typically, massage after an ankle fracture is prescribed to the patient after he has completed several courses of physiotherapeutic procedures. Massage makes muscles elastic, improves blood flow to the damaged area and lymph outflow, and also helps to work out better joint and restores limb mobility.

In general, massage for an ankle fracture is based on performing light circular and flexion-extension movements. It is done either by an experienced doctor or by the patient himself if he has knowledge of massage techniques.

The massage is performed in several stages:

1. With warmed hands, stroke the shin. Movements are made from below and move upward. You cannot press on the limb.
2. Next, the ankle is worked with knuckles or fingertips. Circles are drawn on it, it is rubbed and lightly pinched.

Also during recovery, the patient is given baths with aqueous solution sea ​​salt. To improve the healing process of the limb during massage, use various ointments and compresses.

Ointments and their recipes:

1. Mix: 50 ml olive oil, 15 mg copper sulfate, 20 mg of spruce resin and 1 finely chopped onion. The resulting paste is applied to the damaged area after a massage or bath.
2. Mix rose oil and mumiyo. The composition should be applied 3 times a day.
3. To get rid of bruises, fistulas and wounds in the first days after removing the bandage, many people recommend using badger fat.
4. In order to get rid of severe pain on problem area You should apply a compress with potato pulp.
5. Alcohol compresses are used to improve blood flow and get rid of swelling.

The patient undergoes about 5-10 sessions therapeutic massage using various ointments.

Stages of securing fixing bandages

Fixing devices are:

• Soft and elastic;
• Semi-rigid and rigid;
• Pressing and protective;
• Treating and corrective;
• Immobilizing.

Additionally, you can purchase orthopedic shoes and orthopedic insoles for your shoes. They help relieve swelling and prevent the development of flat feet.

Stages of physical therapy

One of the important components of the entire rehabilitation period is physical therapy. This is a complex special exercises, developing the limb and restoring mobility in it. Therapeutic exercises after an ankle fracture relieve swelling and reduce the risk of such phenomena as post-traumatic flat feet, bone deformities, and heel spurs.

Typically, physical exercise is prescribed by doctors in the first days after osteosynthesis with minimal load, but then it gradually increases. The first few days of leg development are carried out with a physician, who selects exercises and monitors the correctness of their implementation. When the patient has learned the entire complex, therapeutic exercises for a broken ankle are performed at home.

Exercises after an ankle fracture include:

• The patient flexes and extends his toes and grasps any small objects with them.
• Rolling a shady ball or small bottle between the soles of your feet.
• Rotation of the ankle joint: first counterclockwise, and then clockwise.
• Walking by rolling your feet from heel to toe.
• Performing adduction and deviation of the foot from the shin.
• Walking around the room in a half-squat.
• Performing the “bicycle” exercise.

A person at home should bend and straighten the ankle joint as often as possible.

If during exercise therapy after a fracture the patient develops unpleasant symptoms, then you should seek advice from a specialist.

A list of actions that a patient should not perform during rehabilitation:

• Jumping, running and leaning heavily on a limb and walking for a long time on the outside and inside of the foot;
• Raise a limb while overcoming obstacles;
• Ride a bike;
• Practice active sports

Often, doctors, when answering the question of how to develop a leg after a fracture, recommend that patients sign up for a swimming pool.

What to eat during recovery

Physical therapy after an ankle fracture is not the only way fast healing legs. The patient also needs to know how his nutrition should be structured during a fracture. Every day his diet should contain elements such as calcium, phosphorus, iron, as well as vitamins and mineral complexes. A specialist may also prescribe medications that increase the amount of calcium in the bones.

Failure to follow the recommendations of a specialist can lead to a person developing complications that are dangerous to his health, which can appear both during rehabilitation and after a certain period of time after it. Proper rehabilitation– is the key to rapid recovery and resumption of physical activity.

Ankle fracture is the most common injury. Recovery from a leg injury occurs in two stages. The first is treatment, and the second is the return of mobility to the ankle. Exercise after a broken ankle can return a person to old life without any consequences in the form of lameness.

Traumatologists call an ankle fracture one of the most common skeletal fractures. It happens in 20% of all fractures. The number of accidents increases in winter. People at risk for an ankle fracture include: overweight, athletes and children.

If you suspect an ankle injury, you should never step on your broken leg. This will only worsen the situation and displace the bone, which will cause difficulties during treatment. The leg must be fixed with plaster cast.

Rehabilitation for an ankle fracture is necessary based on the nature of the injury.

Damage classification:

• Fracture of the leg with displacement, without displacement;
• Open or closed fracture legs;
• Ankle fracture with ligament rupture;
• Bimalleolar, trimalleolar ankle fractures.

Competent treatment and rehabilitation stage will be the key to a life without disability in the future. When bone integrity returns, the physiotherapist recommends complex exercises After an ankle fracture, the ankle retains its mobility as a result. Therapeutic event carried out only under the supervision of professionals.

For fractures, the plaster cast is removed after 5-7 weeks. The duration of stay in a cast increases with displaced fractures and other complications. Recovery period takes up to 3 weeks. Based on x-rays fractures, the doctor draws up a calendar of exercise therapy exercises. The degree of bone fusion determines at what point physical therapy can begin.

Important! Refusal medical care in connection with any fractures and turning to non-professionals will lead to complete or partial immobility of the ankle.

Recovery plan

Factors influencing the recovery period:

• Patient's age;
• Severity of the fracture;
• Presence of contraindications;
• Possibility of following a diet with increased content calcium in the diet;
• Compliance with treatment conditions.

Exercises before removing the cast

The doctor prescribes exercises after 2 weeks of being in a cast. This is due to the fact that the injured ankle is immobilized for up to two months. Therefore, as soon as positive dynamics of bone fusion appears, rehabilitation begins.

Physical therapy for a fracture can reduce the recovery time after injury. The purpose of the classes is to improve blood circulation. They are carried out every other day so that the leg does not get tired. Before the exercise, the joint is warmed up by moving the fingers.

Crutches must be used to perform the exercises. Stepping on the injured leg is strictly prohibited. Negligence can damage the ankle joint; further treatment will only occur through surgery.

Therapeutic gymnastics for a fracture

• Lean your hands on the edge of the table and move the injured limb to the side while inhaling. As you exhale, return to the starting position. Takes up to 40 seconds;
• Focusing on the healthy leg, lift the affected leg as high as possible;
• Focusing on the healthy leg, take the affected leg back and lift it up to 10 times;
• Moving the toes of a broken leg.

Important! Gymnastics classes are carried out after permission and only under the supervision of the attending physician. Self-medication is prohibited.

The number of physical therapy sessions is related to the patient’s well-being. It is recommended to do exercises at least 3 times a day. Training time is increased gradually.

To reduce the load, crutches are purchased and used for up to 2 weeks. Then they refuse so as not to get used to it and develop an incorrect gait.

Types of rehabilitation measures

To bring everyone back vital functions It will take up to 25 days after the cast is removed. For full recovery Additional measures are prescribed, such as therapeutic exercises after an ankle fracture.

Once the bone has completely healed and the cast has been removed, the physical therapist may recommend recreational exercise. Loads and training time increase over time. An exercise plan is drawn up individually for each patient. Factors associated with fractures and severity are taken into account. Classes are held in specialized clinics and hospitals. After an ankle fracture, after the cast is removed, health procedures are prescribed.

Therapeutic gymnastics

Goals therapeutic exercises:

• Prevent lameness;
• Restore the motor ability of the ankle;
• Restore blood circulation;
• Prepare your leg for walking.

The efforts of doctors will be meaningless without the patient’s desire to return to his previous life. Workouts should not be skipped or done at home on your own without the doctor’s consent. It is advisable to wear orthopedic shoes.

Therapeutic gymnastics classes:

• Walking with emphasis on the entire foot. It is recommended to climb up the stairs. When descending, you need to be careful and stick to the railing;
• Squats. If possible, without lifting your heels off the floor;
• Walking alternately on heels and toes;
• Rolling a small ball or bottle with your foot;
• Trying to grasp a pen or pencil with your toes;
• Jumping in place and to the sides. It is recommended to remember the children's game of hopscotch;
• Side step running;
• Knead the inner and outside feet by standing on it;
• Jumping onto a small ledge;
• Raising the knee with a delay in the air;
• Swimming.

Therapeutic exercise helps to avoid flat feet, curvature of the foot, and relieves tissue swelling. During the first sessions, the patient receives only a small load. A chair is used for support. Exercises are done under the supervision of a trainer and are carried out daily.

Massage after an ankle injury

When massaging your legs:

• Blood circulation improves;
• Tissue swelling is relieved;
• Pain syndrome disappears;
• The motor function of the foot returns to normal.

After the cast is removed, massage sessions are performed. At the first visits, anesthetic gels are used. The ankle remains sensitive to pain even after healing. Recovery over time affects the number of massage sessions. They recommend 10 to 25 visits to a massage therapist.

The massage involves moving the palm of your hand around the leg with flexion and extension of the ankle. It includes:

• Kneading the foot;
• Rubbing the tendons.

To complete cure A bandage made of an elastic bandage is applied to the ankle. During treatment with massage, it is recommended to take baths in a solution of 15 g of salt per liter of water. The doctor additionally prescribes special ointments for rubbing the muscles. The attending physician allows you to do a massage yourself and not show up for the procedure. special cases: the patient does not have time to visit a massage therapist or the professional is absent. The patient educates himself simple methods massage: the leg is gently kneaded, shaken, stroked.

Self-massage in tandem with professional massage restores mobility to the leg much faster.

Physiotherapy for injuries

Physiotherapy is prescribed even before the cast is removed. When selecting procedures, all contraindications are taken into account. Therapy is aimed at:

• Strengthening bones;
• Relieving swelling;
• Restoration of blood circulation.

To treat the consequences, the following procedures are prescribed:

• Electrophoresis is aimed at accelerating the formation callus. Novocaine is used during the procedure. This reduces the dose of pain medications. The procedure normalizes blood flow. Electrophoresis is carried out daily for 10 days;
• Warming up;
• Mud baths are used for 1 month. Hydrotherapy restores the limb, increases muscle tone;
• Phonophoresis is carried out every 2 days. Aimed at relieving bone fragility;
• Magnetic therapy is aimed at preventing muscle atrophy. 10 procedures are carried out, one daily, prescribed while wearing a cast;
• Ultraviolet irradiation helps the absorption and production of vitamin D. This improves the absorption of calcium, which is necessary for bone healing.

Modern physiotherapeutic procedures help get rid of hematomas, blood stagnation and swelling. Rehabilitation period and time to return to normal life happens faster. Therefore, you should not ignore medical procedures.

When treating the consequences of a fracture, the following are prohibited:

• Strong physical activity;
• Walking on uneven terrain;
• Long walks;
• Wearing high heels and uncomfortable shoes;
• Active dance classes.

Exercises for a displaced ankle fracture

Just as with a non-displaced fracture, rehabilitation exercises are prescribed by the doctor while still in a cast. Classes are performed in the most gentle manner possible. The process must be controlled x-rays. The attending physician studies bone fusion over time. At the slightest sign of a slowdown in recovery processes, exercises are either canceled or adjusted.

Ankle fractures are among the most frequent injuries skeleton bones. At improper treatment and rehabilitation, some of them can lead to consequences that will last a lifetime. After such injuries, the patient may develop stiffness ankle joint, lameness, etc. To prevent their occurrence and fully restore the functions of the injured limb, the victim must promptly seek help from a specialist and follow all his recommendations for treatment and rehabilitation. In this article, we will introduce you to the main methods of rehabilitation after ankle fractures.

Event plan rehabilitation measures determined by the severity of the fracture, the patient’s age, the presence concomitant diseases and the presence of contraindications to restorative procedures. As a rule, it includes:

• rational nutrition with introduction to daily diet sufficient amounts of calcium-rich foods;
• physical therapy;
• massage courses;
• physiotherapeutic procedures;
• reception medicines;
• use of orthopedic accessories.

Longer and more complex rehabilitation awaits patients with complex ankle fractures, which are accompanied by displacement of bone fragments. Such injuries are combined with damage to blood vessels and nerves, and the complete restoration of the functions of the ankle joint and foot largely depends on the success of the comparison of fragments. With such fractures, the course of rehabilitation is always long and its success largely depends on the efforts and patience of the patient.

A rehabilitation therapy plan for ankle fractures is always tailored to each patient individually. The doctor takes into account all the characteristics of the injury, the age and condition of the victim. Based on the data from control X-rays, the specialist determines the start date for certain restoration measures.

What factors can influence the speed of recovery after injury?

One of the factors influencing the speed of recovery of leg function after injury is the complexity of the fracture.

The speed and completeness of recovery of ankle function after an ankle fracture may depend on the following factors:

• the age of the victim (the younger, the faster the recovery);
• absence of bone diseases: osteoporosis, osteopathy, chondrodysplasia, arthrosis, arthritis, etc.;
• compliance bed rest and doctor’s recommendations on physical activity;
• complexity of the fracture;
• volume of surgery;
• compliance with recommendations for rational nutrition;
• the completeness of prescribed rehabilitation measures and the systematicity of their implementation: physical therapy, massage, physiotherapy, wearing orthopedic devices.

Rational nutrition

Already in the first days after the injury, to accelerate the healing of the fracture and faster recovery, the patient is recommended to introduce into his diet a sufficient amount of foods that are rich in calcium and other microelements (copper, fluorine, bromine, magnesium, manganese). These include following products power supply:

• dairy products: cheeses, cottage cheese, feta cheese, milk and fermented milk drinks;
• meat;
• fish;
• eggs;
• nuts and seeds: hazelnuts, pistachios, almonds, walnuts, dill seeds, sesame seeds, mustard, etc.;
• cereals: buckwheat, oats, barley, etc.;
• legumes: soybeans, beans, peas;
• vegetables and leafy greens: cabbage, broccoli, sorrel, spinach and other greens;
• fruits and citrus fruits;
• syrup.

Therapeutic exercise

The time to start performing the first therapeutic exercises is determined by the doctor individually. Initially, they are done while a plaster cast is applied. These exercises help improve lymph flow and circulation, reduce swelling and speed up the healing process of bone tissue.

1. Slow movements of the ankle: circular movements, flexion and extension.
2. Tension of the muscles of the thigh and lower leg in a lying position (20-30 times).
3. Flexion and extension of the toes.
4. Hanging the injured leg from the bed, followed by lifting it to an elevated position.

After the patient is allowed to walk with crutches (you cannot step on the sore leg!), the following exercises are recommended:

1. Holding your hand on the back of the chair and leaning on your healthy leg, swing your injured leg in the direction opposite to your healthy leg.
2. While in the same position, lift the injured leg forward and backward.
3. Swing the injured leg in front of the healthy leg and then behind it.
4. In a lying position, pull your socks away from you, and then towards you.
5. Raise the leg straightened at the knee to an ever greater height.
6. Spread your socks out to the sides and then bring them together.

When performing exercises with swings, the raised leg should be held in the air for several seconds. Initially, the injured leg should be raised low (i.e., at a small angle). The load should increase gradually: the height of the leg lift during swings changes and the number of exercises increases.

While the injured leg is still in a cast, the patient is recommended to sleep, placing it on an elevated surface (for example, on an elastic cushion or pillow). To prevent bedsores, place a linen bag with cereal, sand or salt under the heel.

A week after removing the plaster cast, the doctor recommends that the patient more full complex therapeutic exercises. It is compiled by a competent physical therapy doctor, and the first sessions are conducted under the supervision of an experienced instructor. Subsequently, classes can be held at home. Some exercises are performed in water or using exercise equipment (treadmill, exercise bike, etc.). During this period, the patient should start wearing shoes with orthopedic insoles.

1. Squats with and without heels off the floor.
2. Jumping on two legs across a straight line.
3. Long jumps on one leg (first on the healthy one, and then on the sick one). After this, you should compare the results and strive to equalize them.
4. Jumping on the "classics".
5. Alternate walking on heels and toes.
6. Jumping on two legs onto a step (straight and sideways).
7. Running with side steps.
8. Rolling a ball with your foot on the floor.
9. Lifting and holding small objects with the toes.
10. Walking up the stairs.

Correct and systematic implementation of physical therapy exercises after an ankle fracture contributes not only to the restoration of joint function. Such exercises help reduce swelling, prevent the development of flat feet and possible curvature toes.

Massage

Massage improves blood circulation in the fracture area, improves metabolism in damaged tissues. This helps reduce swelling and relieve pain syndrome And speedy recovery functions of the affected limb.

In addition to physical therapy exercises after removing the cast, massage courses are recommended for all patients after a broken ankle. Its first sessions should be carried out by an experienced massage therapist. First, to eliminate unpleasant and painful sensations Anesthetic ointments or gels are used. Subsequently, the pain is completely eliminated and the use of such medications is no longer necessary.

Depending on the severity of the fracture, 10-20 massage sessions may be recommended for the course of treatment and rehabilitation. They should be carried out twice a day - morning and evening. After training by an experienced instructor, the patient can perform the massage independently. At the same time, he must comply with the force of influence recommended by the rehabilitator. After each session, an elastic bandage should be applied to the ankle area.

Massage after an ankle fracture helps:

• reducing swelling of the ankle and foot;
• improving blood circulation in the area of ​​injury;
• accelerating the restoration of joint functions;
• normalization of metabolism in the joint and muscles.

Physiotherapeutic procedures

Physiotherapeutic treatment begins immediately after removing the immobilizing bandage, but some procedures - ultraviolet irradiation, electrophoresis, UHF - can be prescribed while wearing a cast. The set of procedures is selected individually, taking into account indications and possible contraindications.

Physiotherapy after an ankle fracture is aimed at:

• improved blood flow;
• reduction of swelling of soft tissues;
• resorption of hematomas;
• anesthesia;
• activation of metabolic processes.

The physical therapy treatment plan may include the following procedures:

• electrophoresis with calcium preparations – 10-12 procedures daily;
• Ural Federal District – 10-12 procedures daily;
• UHF – about 10 procedures daily;
• magnetic therapy – 10-12 procedures daily;
• warm baths (water temperature 38°) – 30 minutes;
• ozokerite, paraffin and mud applications – every other day for 30 days;
• extracorporeal shock wave therapy– 1 time every 14-21 days, several procedures;
• infrared laser therapy– 8-10 procedures daily.

Taking medications

Reception medications, improving the process of bone regeneration, begin after applying a plaster cast. The patient may be prescribed:

• means for accelerating bone fusion (calcium preparations): Alcasta, Etalfa, Osteogenon, Rocaltrol, Calcium-D3 Nycomed forte, Natekal D3, Calcium-Sandoz forte, Vitrum, Osteomag, etc.;
• bioregulators and adaptogens: tincture of Eleutherococcus, tincture of ginseng.

Orthopedic accessories

After removing the immobilizing bandage, the patient is recommended to bandage the injured leg. elastic bandage. It must be performed in the morning without getting out of bed. The bandage begins to be applied from lower section feet. Each round should overlap the previous one by 2/3. Gradually, bandaging from the foot moves to the ankle area, and then is carried out to the upper third of the lower leg.

During rehabilitation to prevent development degenerative changes the patient may be recommended to wear various instep supports, bandages and orthoses. The selection of such devices is always individual and is recommended by a doctor who takes into account the characteristics of the fracture.

The mobility of the lower part of the foot is ensured by the coordinated work of several joints, which include the ankle (ankle joint). It consists of the bones of the foot and lower leg. Like any other complex joint, it has an articular capsule-bursa that covers the entire diarthrosis and contains a special fluid-exudate to lubricate and nourish the articular cartilage.

When visually examining the ankle, one can note its block-like shape. The joint is strong enough to withstand heavy loads. But even such a powerful structure can break under the influence of various factors.

According to statistics, fractures of this diarthrosis and foot bones are considered the most popular injuries to the human musculoskeletal system. Their percentage in relation to all fractures is 10-15%. Ankle fractures are usually intra-articular in nature. With this injury, various elements of the articulation can be damaged:

1. bones;
2. joint capsule;
3. ligamentous apparatus.

At the slightest suspicion of a fracture of the ankle joint, the victim must be immediately taken to medical institution, where first of all he will be sent for x-rays of the damaged area.

Patient's complaints external inspection and the results will help the doctor determine the diagnosis and prescribe treatment.

• If your ankle is broken, there is a high probability that surgery will be required to connect the broken pieces using a special metal structure.
• If at the time of the fracture the bones were not displaced and did not crumble into fragments, treatment can be done by applying a plaster cast or orthosis.

Rehabilitation after a fracture is usually divided into three phases:

1. Immobilization.
2. Functional period.
3. Training stage.

Immobilization - immobilization. When do bone fractures occur? lower limbs, the leg must be immobilized and rehabilitation measures can immediately begin.

Already at this stage, the patient can engage in therapeutic exercises and physical therapy. Of course, you can’t put any strain on your sore leg, but exercises are needed for a healthy leg, for your arms and body.

Doing therapeutic exercises during the period of immobilization after a fracture improves blood supply to the entire body in general and to the injured limb in particular.

The second stage of rehabilitation after a fracture is functional. It is aimed at restoring functionality in damaged joint. This period lasts from the moment the plaster cast is removed until the movement in the ankle is partially restored.

The exercises recommended to the patient help increase muscle strength, reduce muscle atrophy and joint stiffness. After the plaster is removed, the exercise therapy complex restores the functionality of the joint in all directions.

In addition, treatment consists of physiotherapeutic procedures:

• ozokerite;
• magnetic therapy;
• electrophoresis;
• massage.

A set of exercises for a fracture of the tibia joint in the second stage of recovery

All these exercises are performed lying down.

1. When performing this exercise, breathing should be free and the pace should be slow. Tighten your quadriceps muscle. Repeated 20-30 times.
2. Flexion and extension of the foot. The pace of execution is slow, breathing is free. Repeat 10-20 times.
3. Flexion and extension of the toes. The pace of execution is slow, breathing is free. Repeat 10-20 times.
4. Perform circular movements in both directions in the ankle joints. Breathing is free, the pace of execution is average. Repeat in each direction 10 times.
5. With maximum amplitude, bend the foot forward, then back. Breathing is free, the pace of execution is average. Repeat 10-20 times.
6. Alternating leg bending (toes towards you). Breathing is free, the pace of execution is average. Perform 10 times with each limb.
7. Rotating the entire leg from the hip as much as possible, raise the toes different sides. Breathing is free, the pace of execution is average. Repeat 10 times.
8. Alternately bend your legs at the hip joints until right angle, while you need to pull your socks towards you. Breathing is free, the pace of execution is average. Repeat with each leg 10 times.
9. Repeat exercise No. 1.
10. Raise the injured leg hip joint to a right angle. At the same time, bend and straighten your toes and feet in weight. Breathing is free, the pace of execution is average. Repeat 10 times.
11. Rest for about 5-10 minutes in a lying position with your legs raised up.

In addition to the fact that the patient must perform these exercises, he is recommended to give himself a massage. The procedure should be carried out twice a day in a sitting position. When performing a massage, the following techniques are used:

• kneading;
• stroking;
• shaking;
• squeezing.

Each technique should be repeated at least 10 times. You need to massage the ankle area especially carefully. You need to be no less careful when kneading your ankles and heels.

Massage should not cause pain and discomfort. In the morning, immediately after waking up, the sore leg needs to be knee joint bandage with an elastic bandage. When performing a massage and a set of exercises, the elastic bandage must be removed. Take it off before going to bed.

If there is severe swelling of the leg during sleep, it should be in an elevated position. Every night at night you need to prepare a bath for the affected leg, which is taken for 10-15 minutes. The water level should reach the knee, and its optimal temperature should be 36-37

A patient in water can perform various active movements of the ankle in all directions.

Training stage

The third period of treatment is training. To develop a joint after a fracture, it is necessary to perform exercise therapy, which include all kinds of walking options:

• on the heels;
• on socks;
• sideways;
• on the inner and outer edges of the feet;
• in half squats;
• crossed step.

To develop the ankle joint after a fracture, exercises are needed in which the foot rests on a round rocker; for this you can use a regular rolling pin. Development of the articulation of the lower leg occurs well when the limb is immersed in water; ideally, the patient can visit the pool.

It should be noted that recovery after an ankle fracture will not be complete without restoring your former gait.

During the third rehabilitation period, the injured leg must be bandaged with an elastic bandage. This measure is very useful for damaged shin joints. In addition, the patient is recommended to wear insoles. This is the only way to prevent flat feet.

Exercises on a treadmill and exercise bike are effective. Of course, the load on the injured limb should be selected correctly. At first, the patient must move with the help of crutches, and then gradually he can switch to walking with a cane.

The training period includes measured walking, running and jumping. IN therapeutic sessions If you have a fracture of the ankle joint, you can include walking over obstacles and dance movements. But all these exercises are allowed to be done only if the damaged lower leg is tightly secured with an ankle or elastic bandage.

You should wear an ankle brace or wrap your leg after an injury for at least eight months. Every victim who has sustained a fracture of the tibia joint must be aware that fast recovery and the return of lost functions is guaranteed only when performing daily training exercises and a complex of exercise therapy recommended by the attending physician.

The task of physical therapy in the third period is the final restoration of movements in the damaged joint and the normalization of the activity of the whole organism. Jumping, running and dismounts, as mentioned above, are permissible only when the joint is fixed

There are fractures of the outer ankle, inner ankle, two ankles, two ankles with marginal fracture tibia (the so-called trimalleolar fracture) without displacement or (more often) with displacement. They occur during lateral and rotational movements in the ankle joint with a violation of the normal amplitude: twisting of the foot, forced rotation of the lower leg with a fixed foot, etc. A displaced fracture of two ankles and the posterior edge of the tibia is usually combined with a dislocation of the foot.

Rice. 31. Plaster cast with stirrup

For non-displaced fractures, apply a plaster cast with a stirrup (Fig. 31) from the toes to the knee joint. After drying, it is prescribed therapeutic exercises and walking with crutches, stepping on the stirrup. The first period lasts until the plaster cast is removed. Its objectives are: restoring blood and lymph circulation in the injured leg, combating swelling, restoring muscle tone and mobility in joints free of plaster, sending impulses to the ankle joint. Against the background of general developmental and breathing exercises movements are performed in joints free of plaster, exercises aimed at strengthening the quadriceps femoris muscle, and ideomotor exercises for the ankle joint. The patient is taught to walk with crutches on a level surface, up stairs. Duration of classes is 20-25 minutes. They are held 3 times a day.

In the second period (after removal of the cast), the objectives of therapeutic exercises are: restoration of movements in the ankle joint, combating swelling of the injured leg, prevention of traumatic flat feet, development of foot deformities, growth of “spurs” (most often heel spurs), and curvature of the toes. For this purpose, immediately after removing the plaster, a custom-made instep support is inserted into the shoes. Against the background of general developmental and breathing exercises, various exercises are performed for the ankle joint in different starting points: lying on your back, on your stomach, sitting, standing; exercises in different options complicated walking: on toes, on heels, on the outer or inner arch of the feet, forward with your back, sideways, cross step, in a half-squat, etc.; exercises with your foot resting on a bar, on an exercise bike.

When the ankles are broken, swelling of the foot occurs anywhere. To combat swelling, it is recommended to lie for 10-15 minutes 3-4 times a day, raising your legs at an angle of 120-130° at the hip joints. 5 minutes after this, perform the following special exercises.
1. Contraction of the quadriceps thigh muscles - 20-30 times. The pace is slow. Breathing is free.

2. Flexion and extension of the feet - 10-20 times. The pace is slow. Breathing is free.

3. Flexion and extension of fingers - 10-20 times. The pace is slow. Breathing is free.

Rest pause 1-2 minutes.

4. Flexion and extension of fingers - 10-20 times. The pace is average. Breathing is free.

5. Circular movements of the feet - 10 times in each direction. The pace is average. Breathing is free.

6. Flexion and extension of the feet with a maximum amplitude of 10-20 times. The pace is average. Breathing is free.

7. Alternately bending the legs towards the stomach (toes “towards you”) - 10 times with each leg. The pace is average. Breathing is free.

8. Raising and bringing together the toes with maximum rotation of the entire leg - 10 times. The pace is average. Breathing is free.

9. Alternately raising straight legs to an angle of 90° at the hip joints (toes “towards you”) - 10 times with each leg. The pace is average. Breathing is free.
10. Contraction of the quadriceps muscles of the thigh - 20-30 times. The pace is slow. Breathing is free.
11. Raising the straight injured leg to an angle of 90° at the hip joint with simultaneous flexion and extension of the fingers and foot in weight - 10 times. The pace is average. Breathing is free.
12. Rest in a lying position with legs raised - 5-10 minutes.