Helping your Ankle to Recover after being in a Cast

  • Reference Number: HEY-254/2014
  • Departments: Orthopaedics

Introduction

This leaflet has been produced to give you general information, following removal of your cast.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

Caring for your skin

Following removal of your cast you are likely to notice that your skin is very dry. To improve this it is advised that you place you lower leg in warm water for 5 – 10 minutes. Once removed from the water the dry skin should then rub off easily with a towel, do not be tempted to rub too vigorously as you may damage the skin. As soon as your lower leg is dry apply moisturising cream to the affected area. Repeat this process daily until your skin returns to normal.

Pain and swelling

Now that your cast has been removed, it is common to experience aching in the foot and ankle. You may feel some stiffness and, in cold weather, often may notice it looks a little blue in colour.

Pain and swelling Swelling may occur for several months particularly in the ankle therefore you must elevate your leg, when resting, above the level of your heart. Exercising your ankle will also help reduce swelling.

If your ankle was swollen at the time your cast was removed you may have been given a tubigrip support to wear. The tubigrip will normally be applied in a double layer, which has its fold near your toes and finishes around your calf.

Please note the following points:

  1. The two ends of the tubigrip should not meet; allow a 3 – 4 cm difference to prevent circulatory problems.
  2. Do not allow the tubigrip to wrinkle up in places again to prevent circulatory problems.
  3. Take the tubigrip off when you go to sleep and re-apply when you wake up.
  4. Remove the tubigrip if your toes become blue, more swollen, numb or if you have pins and needles.

Exercises

It is important that you exercise your ankle as soon as you can after your cast has been removed. By exercising and regaining normal movement the feeling of stiffness and pain will gradually reduce.

The ankle exercises will be most effective if practiced regularly and not just once per day. You should try to practice the exercises below 3 to 4 times every day:

1. While sitting, lift your foot a few centimetres off the floor and pull your toes and ankle up towards you.

Exercises - Part 1 - Step 1A To assist this movement, place a scarf or towel around your foot and pull your foot up by pulling the scarf with your hands. Hold this stretch for 10 seconds.
Exercises - Part 1 - Step 1B Now point your toes away from you. Hold the stretch for 10 seconds.

2. Remain in the same position and gently turn your ankle inwards then outwards.

Exercises - Part 1 - Step 2

Ensure the movement comes from your ankle and not the knee.

Hold the movement in each direction for 10 seconds.

3. Moving only from your ankle joint make a circle with your foot. Then repeat in the other direction.

4. Holding a chair, step backwards with your injured leg.

Exercises - Part 1 - Step 4

Keep this leg straight, with your toes pointing forward and the heel on the floor.

Now bend your other knee until you feel a gentle stretch in the calf of your injured leg. Hold this for 30 seconds.

5. From the position above move your injured leg forward but keep it slightly behind your other leg.

Exercises - Part 1 - Step 5

Ensure that your toes point forward and bend both knees, keeping the heel of your injured leg on the floor.

You should feel a gentle stretch in the calf of your injured leg. Hold for 30 seconds.

You may find that your toe and knee joints feel stiff too. Doing the exercises below will help to improve this:

1. Find a friction free surface, for example a wooden floor or a tea tray placed on your bed, so that your foot can slide easily.

Exercises - Part 2 - Step 1

Sit down and stretch your legs straight out in front of you. Rest your foot on the friction free surface and slide your foot up towards your bottom by bending your knee.

You may want to wrap a scarf around your heel so that you can assist by pulling either end of the scarf with your hand to bend your knee further.

2. Curl your toes as far as possible.

Exercises - Part 2 - Step 2A Hold for a few seconds and then stretch them up the opposite way.
Exercises - Part 2 - Step 2B Now try to spread your toes as wide as possible.

Walking

The hospital staff will tell you how much weight you can put through your leg and provide you with a walking aid if necessary.

Try to walk as normally as possible even if you are using a walking aid. When stepping forward, your heel should touch the ground first, followed by the outer border of your foot, then onto all of your toes.

Physiotherapy

Unless you decline or have almost full range of movement immediately after the cast has been removed you will be referred to physiotherapy out-patients to continue your rehabilitation.

At this appointment you will be assessed further. Initially you will be asked a series of questions which are all designed to help your physiotherapist plan the best course of treatment for you. You will then be examined; therefore it is advisable that you wear shorts or loose clothing so this can be done properly.

Following your assessment the physiotherapist, with your consent, will choose from a range of treatment techniques depending on your progress. In addition the physiotherapist will ensure you have exercises to practice at home. These exercises are vitally important to ensure you give yourself the best chance of a full recovery.

The aim of rehabilitation will be to get you back to normal life as quickly as possible. However, as every individual’s injury, lifestyle and recovery varies; it can be hard to give definite timescales for this. You should discuss this with your physiotherapist.

Contact numbers

If you have an urgent query regarding your symptoms, following the removal of your cast, please telephone the fracture clinic. If however the query is related to physiotherapy please telephone the physiotherapy team.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact:
Fracture Clinic: (01482) 674099.
Physiotherapy team: (01482) 674880.

You may be asked to leave a message; please clearly state a brief reason for the phone call, your full name, address and telephone number and someone will get back to you as soon as possible.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.