When Is It Safe to Start Running After an Ankle Fracture?

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If you have suffered a fractured ankle and had to have surgery with plates and screws to reduce the fracture, you may wonder when you can return to running. Some amount of healing must take place initially, but over time, one of your goals may be to return to running after your fracture. Is there a safe way to determine when to start running after ankle surgery, and can a physical therapist help? How long does it take before you can hit the road and get back to running after an ankle fracture?

A broken ankle can be a painful and scary experience. You may need to have a surgery called an open reduction internal fixation (ORIF) to fix the fracture. Many times, however, your ankle can be reduced without surgical intervention. Either way, you most likely will have to wear a cast on your leg for quite some time to allow things to heal properly. This period of immobilization is necessary to ensure your ankle heals properly. One of the problems with immobilization after an ankle fracture: your ankle gets weak and the muscles around the joint get tight.

After an ankle fracture or ankle surgery, you most likely will have a difficult time walking and driving a car. And it may be quite some time before you can get back to running. With the help of a physical therapist, you should eventually be able to resume your normal activities.

Common Impairments After an Ankle Fracture

Common impairments that you may need to work on after an ankle fracture include:

  • Swelling
  • Pain
  • Loss of range of motion (ROM)
  • Decreased strength
  • Scar tissue tightness (if you have had surgery)
  • Decreased balance and proprioception
  • Difficulty walking and running

You may initially be required to walk with an assistive device like a walker or crutches after breaking your ankle. Your physical therapist can help you choose the correct device. They can also make sure that your assistive device is properly sized for you and that you are using it properly.

Your physical therapist can work with you to help you improve some of these impairments. He or she may prescribe exercises designed to increase ankle ROM. Strengthening and plyometric exercises may be done to ensure that the muscles that support your ankle are strong, and a biomechanical ankle platform system (BAPS) board may be used to help improve balance and proprioception in your injured leg.

Wolff's law states that bone grows in response to the stresses that are placed upon it. Your physical therapist will help you progress through the proper stages of weight-bearing to make sure that adequate and appropriate stress is placed on your healing ankle.

So When Can I Start Running After an Ankle Fracture?

Everyone is different, and many factors may limit your ability to return to running after an ankle fracture or surgery. These include:

  • The severity of the break
  • Whether or not surgery was performed
  • The success of physical therapy
  • The amount of effort you put into your rehabilitation
  • A little bit of luck

In general, you can attempt to start running about three to four months after your injury. By this time, the bones in your ankle should be well healed and your ROM and strength should be close to normal. You can progress your running mileage as long as your pain is minimal and your ROM and strength remain excellent.

By six to nine months after your injury, you should be able to run without problems.

Again, everyone is different and every injury is different. Some people are able to run much sooner after breaking their ankle. Unfortunately, some people continue to be limited by pain, loss of ROM or limited strength long after their injury and may take longer to return to running. And there are some people who can never get back to running, even after putting in their best effort to regain normal mobility and strength around their ankle.

You must work closely with your doctor and physical therapist to be sure that running is safe for you and to set realistic goals and expectations after an ankle fracture. This includes having a realistic idea of your injury and your own personal capabilities.

A Word From Verywell

An ankle fracture can be a painful injury, and it may take considerable time and effort to return to your previous level of activity. If you are a runner who has suffered an ankle fracture, chances are you are eager to return to running as soon as possible. Working with your doctor and physical therapist can ensure that you create a solid plan for you to quickly and safely return to running.

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  3. Del buono A, Smith R, Coco M, Woolley L, Denaro V, Maffulli N. Return to sports after ankle fractures: a systematic review. Br Med Bull. 2013;106:179-91 doi:10.1093/bmb/lds039

  4. Beckenkamp P, et al. Prognosis of physical function following ankle fracture: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2014;44(11): 841-51. doi:10.2519/jospt.2014.5199

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