When to introduce range of motion?
Now that we have been given the all clear to weight bear on our leg, one of the most common and important questions is when can we start moving the ankle joint.
A closed reduction within a cast is designed to immobilise the joint to allow for adequate bone healing, however the secondary effects include muscle atrophy, increase joint & muscle stiffness as well as loss of control and coordination at the ankle. The time frame of immobilisation can vary from 1 week up to 12 weeks depending on the fracture. However if you are given the option of a removable CAM boot, your orthopaedic specialist will often encourage early range of motion exercise within a fairly reasonable time frame. The CAM boot is designed to immobilise the leg in a fixed position for the majority of the day to stimulate bone growth, but has the option of being removed for sleep.
By having 2-5 minutes allocated at the end of the day for range of motion exercises before you go to sleep there can be a marked reduction in the overall stiffness present. This can be started as early as 3-4 weeks from the date of injury.
**note** You should avoid inversion and eversion until you are closer to the removal date of the CAM boot and focus more onto plantar flexion and dorsiflexion for your early range of motion exercises. When out of the boot you can work into all planes of movement as guided by your physio.
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