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Ankle ORIF (Trimalleolar) Starter Exercise Guide
A short starting program — 8 exercises drawn from the full 45-exercise program. These are the movements most people begin with.
Before you begin. This is general guidance, not a personal prescription. If your surgeon or therapist has given you a different program or different limits, follow theirs.
1. Elevation & Swelling Control
What it helps: Bringing the leg up reduces swelling and supports healing in the early weeks — simple, and it speeds your comfort.
How often: several times a day.
- Lie back and prop the foot above the level of your heart on pillows.
- Rest like this regularly through the day, especially after being up.
- Use ice as directed by your surgeon.
Tip: Elevation is one of the most helpful things you can do early on.
2. Toe Flexion & Extension
What it helps: Keeps the toes moving and the blood flowing while the foot heals.
How often: 15-20 repetitions, a few times a day.
- Curl your toes downward, then straighten and spread them upward.
- Move only the toes — keep your ankle still in the boot or cast.
Tip: A gentle way to stay active in the first weeks.
3. Ankle Pumps
What it helps: Keeps blood moving to reduce swelling and the risk of clots while you're less active — small, frequent, and important early on.
How often: 20 repetitions, several times a day.
- Flex your foot up, pointing your toes toward the ceiling.
- Point your toes down, away from your body.
Tip: Move slowly and with control.
4. Gentle Ankle Range of Motion
What it helps: Eases motion back into the ankle so it stays supple, within the limits your surgeon sets.
How often: 2-3 sets of 10, as directed.
- Seated, slowly point your foot down and bring it back toward neutral.
- Gently move the foot side to side.
Tip: Stay within a comfortable, pain-free range — avoid forcing the foot.
5. Ankle Alphabet
What it helps: Moves the ankle through its full range while you trace each letter — restoring motion in every direction.
How often: 1-2 sets of A–Z, a few times a day.
- With the leg supported, slowly "draw" each letter of the alphabet using your big toe.
- Move from the ankle, keeping the leg still.
Tip: Move within a comfortable, pain-free range.
6. Ankle Circles
What it helps: Gently moves the ankle in every direction so it doesn't stiffen as it heals.
How often: 2 sets of 10 each way, daily.
- Seated with the leg supported, slowly circle the foot in one direction.
- Then circle it the other direction.
- Move smoothly through a comfortable range.
Tip: Keep the circles gentle and pain-free.
7. Standing Weight Shifts
What it helps: Gently retrains you to load each leg evenly and confidently — the first step back to steady, balanced walking.
How often: 2-3 sets of 10, daily.
- Stand holding a counter, feet hip-width apart.
- Slowly shift your weight from one foot to the other.
- Keep the movement smooth and controlled.
Tip: Let comfort guide how much weight you shift onto the surgical side.
8. Walking Program
What it helps: Comfortable, frequent walking keeps the joints loose, builds your stamina, and rebuilds confidence on your feet. Little and often beats long and tiring.
How often: throughout the day.
- Take short walks at a comfortable pace.
- Increase your distance gradually as you feel able.
Tip: Use your assistive device as directed.
See the complete 45-exercise program, phase by phase.
Recovery reading
Browse all exercise guides · Condition guides · Recovery education library
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These are general exercise guides, not a personal prescription. The repetitions and frequency shown are what's commonly used — your own surgeon or therapist may advise something different, and their guidance comes first.