When to Start Running After an Ankle Fracture

I recently evaluated a patient who had suffered a severe ankle fracture. She broke her tibia and fibula, which are the two bones of your leg that are part of the ankle joint. Her fracture was so bad that a surgical procedure called an open reduction internal fixation (ORIF) was required to help hold the pieces of bone together so normal healing can occur.

The patient walked into my clinic with crutches. Her weight bearing status was written on her prescription from her surgeon: Non-weight bearing. This means that she is not allowed to put weight on her foot or ankle, so she needs to use the crutches to walk.

After evaluating her I started to work on her scar mobility and range of motion (ROM). I instructed her in a home exercise program so she could work on ROM and scar management herself. I asked her if she had any questions.

"Just one," she said. "When can I run again?"

I had to step back and chuckle a bit. Here is a patient who recently had major surgery to correct the alignment of her ankle after a severe fracture. She is unable to put weight on her foot and needs crutches just to walk. And she was worried about running.

So when is a good time to start running after an ankle fracture? The answer is different for everyone. I explained to the patient that we need to focus on walking first. Then I explained that it takes about eight weeks for bone to heal, then another few weeks after that to be sure that the bones are completely healed. And still it may take considerable time to restore normal gait and stride after such a severe injury. Conservatively, it may be 6 to 9 months (or longer) after her injury before running can be attempted.

If you have a broken ankle, be sure to work closely with your physical therapist to gain normal range of motion and strength and to restore normal functional walking. If you want to get running again, discuss this with your therapist and set realistic goals that you can attain.

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