Ankle ORIF (Bimalleolar) — Complete Exercise Program

Toe Flexion & Extension

Keeps the toes moving and blood flowing while the ankle is protected.

What it helps: Keeps the toes moving and the blood flowing while the foot heals.

1. Curl your toes downward, then straighten and spread them upward.
2. Move only the toes — keep your ankle still in the boot or cast.

Tips:

• A gentle way to stay active in the first weeks.

Commonly done as 15-20 repetitions, a few times a day.

Ankle Pumps

Improves circulation and helps reduce swelling.

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.

1. Flex your foot up, pointing your toes toward the ceiling.
2. Point your toes down, away from your body.

Tips:

• Move slowly and with control.

Commonly done as 20 repetitions, several times a day.

Quad Sets

Re-activates the thigh muscle and supports knee control.

What it helps: Wakes up the quadriceps — the big thigh muscles that support and control your knee. Getting them firing is the foundation of a strong, steady leg.

1. Sit or lie with your leg straight.
2. Tighten the muscle on top of your thigh, pressing the back of your knee down.
3. Hold briefly, then relax.

Commonly done as 2-3 sets of 10, a few times a day.

Glute Squeezes

Gently re-engages the buttock muscles.

What it helps: Wakes up the glutes — the big muscles that steady and support your hip. Getting them firing again is the first step toward a hip that feels stronger and carries you with less strain on the joint.

1. Lie or sit comfortably.
2. Squeeze your buttock muscles together.
3. Hold a few seconds, then relax.

Commonly done as 2-3 sets of 10, a few times a day.

Straight Leg Raises

Strengthens the thigh while protecting the joint.

What it helps: Builds quad and hip strength while the knee stays straight, so the muscle works hard without stressing the joint.

1. Lie down with one leg bent and the other straight.
2. Tighten your thigh and lift the straight leg a few inches.
3. Lower slowly.

Tips:

• Keep the knee straight as you lift.

Commonly done as 2-3 sets of 10, once or twice a day.

Heel Slides

Encourages early, gentle knee motion.

What it helps: Coaxes gentle bending back into the knee — restoring the motion you need for stairs, sitting, and getting in and out of a car.

1. Lie on your back with your legs straight.
2. Slowly slide your heel toward you, bending the knee.
3. Slide it back down.

Tips:

• Only go as far as is comfortable.

Commonly done as 2-3 sets of 10, a few times a day.

Seated Knee Extensions

Keeps the thigh strong while you stay off the foot.

What it helps: Keeps the thigh strong and the knee straightening well while you stay off your feet.

1. Sit in a chair with your foot supported.
2. Straighten your knee, lifting the lower leg.
3. Lower slowly.

Tips:

• Keep the movement at the knee, not the ankle.

Commonly done as 2-3 sets of 10, once or twice a day.

Walking with Crutches or Walker (Non-Weight-Bearing)

Safe, non-weight-bearing walking using crutches or a walker to protect the healing bone.

What it helps: Safe walking with crutches or a walker that keeps weight off the healing leg, protecting the bone while you stay mobile.

1. Keep all weight off the surgical foot, using your crutches or walker.
2. Take short, level trips as needed.
3. Keep the foot elevated when resting.

Tips:

• Follow your surgeon's weight-bearing instructions exactly in the early weeks.

Commonly done as needed.

Ankle Pumps

Improves circulation and helps reduce swelling.

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.

1. Flex your foot up, pointing your toes toward the ceiling.
2. Point your toes down, away from your body.

Tips:

• Move slowly and with control.

Commonly done as 20 repetitions, several times a day.

Ankle Alphabet

Traces the alphabet with the foot to restore ankle motion in every direction.

What it helps: Moves the ankle through its full range while you trace each letter — restoring motion in every direction.

1. With the leg supported, slowly "draw" each letter of the alphabet using your big toe.
2. Move from the ankle, keeping the leg still.

Tips:

• Move within a comfortable, pain-free range.

Commonly done as 1-2 sets of A–Z, a few times a day.

Gentle Ankle Range of Motion

Keeps the ankle moving comfortably to restore gentle motion.

What it helps: Eases motion back into the ankle so it stays supple, within the limits your surgeon sets.

1. Seated, slowly point your foot down and bring it back toward neutral.
2. Gently move the foot side to side.

Tips:

• Stay within a comfortable, pain-free range — avoid forcing the foot.
• Your care team can guide how much ankle motion is right for your recovery.

Commonly done as 2-3 sets of 10, as directed.

Toe Flexion & Extension

Keeps the toes moving and blood flowing while the ankle is protected.

What it helps: Keeps the toes moving and the blood flowing while the foot heals.

1. Curl your toes downward, then straighten and spread them upward.
2. Move only the toes — keep your ankle still in the boot or cast.

Tips:

• A gentle way to stay active in the first weeks.

Commonly done as 15-20 repetitions, a few times a day.

Quad Sets

Re-activates the thigh muscle and supports knee control.

What it helps: Wakes up the quadriceps — the big thigh muscles that support and control your knee. Getting them firing is the foundation of a strong, steady leg.

1. Sit or lie with your leg straight.
2. Tighten the muscle on top of your thigh, pressing the back of your knee down.
3. Hold briefly, then relax.

Commonly done as 2-3 sets of 10, a few times a day.

Straight Leg Raises

Strengthens the thigh while protecting the joint.

What it helps: Builds quad and hip strength while the knee stays straight, so the muscle works hard without stressing the joint.

1. Lie down with one leg bent and the other straight.
2. Tighten your thigh and lift the straight leg a few inches.
3. Lower slowly.

Tips:

• Keep the knee straight as you lift.

Commonly done as 2-3 sets of 10, once or twice a day.

Standing Hip Abduction

Strengthens the muscles on the side of the hip.

What it helps: Strengthens the outer-hip muscles that hold you steady whenever you're on one leg — which is every step you take. Stronger here, steadier hip.

1. Stand holding a counter for support.
2. Lift your leg out to the side, keeping it straight.
3. Lower slowly.

Tips:

• Keep your toes pointing forward.

Commonly done as 2-3 sets of 10-15, 1-2x daily.

Standing Hip Extension

Strengthens the muscles behind the hip.

What it helps: Strengthens the muscles behind the hip that power you forward with each step and help you stand tall — the engine of a strong, even stride.

1. Stand holding a counter.
2. Move your leg straight back without arching your back.
3. Lower slowly.

Commonly done as 2-3 sets of 10-15, 1-2x daily.

Resistance Band Ankle Strengthening

Strengthens the ankle in all directions with a band.

What it helps: Strengthens the ankle in every direction with a band, building the all-around support that steadies each step.

1. Loop a resistance band around your foot.
2. Push down, pull up, and turn the foot in and out against the band.

Tips:

• Move slowly and keep the motion controlled.

Commonly done as 2-3 sets of 10-15, daily.

Standing Calf Raises

Builds calf and Achilles strength in standing.

What it helps: Builds the calf strength that pushes you off the ground each step — key for a strong, springy stride.

1. Stand holding a counter.
2. Rise onto the balls of your feet.
3. Lower slowly.

Tips:

• Gradually shift more weight onto the surgical side over time.

Commonly done as 2-3 sets of 10-15, daily.

Mini Squats

Builds leg strength through a comfortable range.

What it helps: Builds hip and leg strength through a comfortable range, so everyday moves — sitting, standing, bending — take less out of your joints.

1. Stand holding a counter.
2. Bend your knees a small amount, keeping them behind your toes.
3. Return to standing.

Commonly done as 2-3 sets of 10, once or twice a day.

Sit-to-Stand

Builds the strength and confidence to rise from a chair.

What it helps: Trains the exact strength you use to rise from a chair, a toilet, or a car. Stronger here means more independence and less of a struggle on tough days.

1. Sit at the edge of a sturdy chair.
2. Lean slightly forward and stand up.
3. Lower yourself back down with control.

Tips:

• Use your arms for support as needed.

Commonly done as 2-3 sets of 8-10, once or twice a day.

Step-Ups

Builds strength for stairs and daily activity.

What it helps: Builds the leg and hip strength — and the control — for stairs, curbs, and everyday activity.

1. Step up onto a low step with your operative leg.
2. Step back down with control.

Tips:

• Hold a rail for balance.

Commonly done as 2-3 sets of 10, once or twice a day.

Stationary Bike

Builds motion and endurance with low impact.

What it helps: Keeps the joints moving and nourished while you build endurance — all with no pounding. One of the gentlest ways to stay active when a joint is sore.

1. Set the seat so pedaling is comfortable.
2. Pedal at an easy pace.
3. Increase your time gradually.

Commonly done as directed.

Single-Leg Balance

Improves balance and stability.

What it helps: Trains your hip and leg to stay steady when all your weight is on one side — which is most of walking. Better balance means a surer, more confident step.

1. Stand near a counter for safety.
2. Lift one foot and balance on the other leg.
3. Hold as able.

Commonly done daily.

Walking Program

Short, frequent walks build endurance and confidence.

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.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Progressive Walking in Boot

Gradually building walking tolerance in your boot as healing allows.

What it helps: Gradually builds your walking tolerance in the boot as healing allows — steady, protected progress back onto your feet.

1. Walk in your boot at a comfortable pace.
2. Slowly increase distance and time as you feel able and as cleared.

Tips:

• Let comfort and your surgeon's guidance set the pace.

Commonly done throughout the day.

Progressive Walking Program

Keep building your walking distance and pace.

What it helps: Keep building your walking distance and pace — steady gains in endurance and confidence on your feet.

Commonly done daily.

Cycling

Low-impact endurance and motion.

What it helps: Low-impact endurance that keeps the joints moving smoothly while you build fitness — easy on the body, good for the long run.

Commonly done as able.

Swimming

Low-impact, full-body conditioning.

What it helps: Full-body conditioning with the water carrying your weight, so your muscles work hard with almost no load on the joints.

Commonly done as able.

Elliptical Trainer

Low-impact cardio that is easy on the joints.

What it helps: Low-impact cardio that builds endurance and keeps the legs moving while staying easy on the joints.

Commonly done as able.

Single-Leg Balance

Improves balance and stability.

What it helps: Trains your hip and leg to stay steady when all your weight is on one side — which is most of walking. Better balance means a surer, more confident step.

1. Stand near a counter for safety.
2. Lift one foot and balance on the other leg.
3. Hold as able.

Commonly done daily.

Dynamic Balance Training

Challenges balance with movement to prepare for activity and sport.

What it helps: Challenges your balance with movement, preparing you for the unpredictable demands of daily life and activity.

1. Practice controlled single-leg balance, then add reaching or gentle movement.
2. Progress to uneven surfaces as able.

Tips:

• Keep support nearby as you progress.

Commonly done as 2-3 sets, several times a week.

Functional Strength Training

Task-based strengthening that rebuilds the movements of daily life and activity.

What it helps: Trains the real movements of daily life — lifting, carrying, squatting — with good mechanics, so everyday tasks feel easier.

1. Work through functional movements — squats, step-ups, lunges, and balance — as cleared.
2. Add resistance gradually.

Tips:

• Quality of movement first, then load.

Commonly done several times a week.

Heel Raises

Strengthens the calf and improves balance.

What it helps: Strengthens the calf and steadies your balance, rebuilding the push-off that drives walking.

1. Stand holding a counter.
2. Rise up onto your toes.
3. Lower slowly.

Commonly done as 2-3 sets of 10-15, once or twice a day.

Walking Program

Short, frequent walks build endurance and confidence.

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.

1. Take short walks at a comfortable pace.
2. Increase your distance gradually as you feel able.

Tips:

• Use your assistive device as directed.

Commonly done throughout the day.

Cycling

Low-impact endurance and motion.

What it helps: Low-impact endurance that keeps the joints moving smoothly while you build fitness — easy on the body, good for the long run.

Commonly done as able.

Swimming

Low-impact, full-body conditioning.

What it helps: Full-body conditioning with the water carrying your weight, so your muscles work hard with almost no load on the joints.

Commonly done as able.

Strength Training

Maintains and builds long-term strength.

What it helps: Builds and maintains long-term strength to keep you active, resilient, and independent.

Commonly done a few times a week.

Balance & Proprioception Drills

Sharpens balance and joint awareness.

What it helps: Sharpens your sense of where your joints are in space — the control that keeps you steady and prevents missteps.

Commonly done a few times a week.

Flexibility Exercises

Maintains a comfortable range of motion.

What it helps: Keeps your joints and muscles moving through a comfortable range, so you stay supple and move with ease.

Commonly done most days.

Hiking

Walking on trails and varied terrain as endurance and confidence return.

What it helps: Walking varied terrain builds endurance, balance, and confidence as you return to the outdoors.

1. Start with short, flat trails.
2. Build distance and add gentle inclines as comfort allows.

Tips:

• Supportive footwear and trekking poles can help early on.

Commonly done as cleared.

Low-Impact Recreational Activities

Enjoyable activities that protect your joint.

What it helps: Getting back to the activities you enjoy in ways that are kind to your joints — the whole point of building this strength.

Commonly done as you like.