Brostrom Procedure (Lateral Ankle Ligament Reconstruction) — 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.

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 tall in a chair with your back supported and your foot resting on a low stool.
2. Straighten your knee, lifting the lower leg until it is level with your thigh.
3. Hold for a moment, then lower it slowly back down to the stool.

Tips:

• Let your thigh do the work — the lift comes from straightening the knee.
• Your foot can stay relaxed. There is no need to hold it in any particular position.

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

Hip Abduction

Strengthens the outer hip while you stay off the foot.

What it helps: Strengthens the outer-hip muscles that keep your hip level and steady — strength you can build without putting any weight through your healing foot.

1. Lie on your side with the surgical leg on top and both legs straight.
2. Rest your head on your lower arm and your upper hand on the floor in front of you.
3. Lift the top leg a comfortable distance, keeping it in line with your body.
4. Lower slowly.

Tips:

• Keep your toes pointing forward, not up toward the ceiling — that is what keeps the work in the outer hip.
• Don't let the leg drift forward as it rises.
• A moderate lift done well beats a high one done badly.

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

Core Activation

Gentle core engagement to support posture and balance while you recover.

What it helps: Switches on the deep core muscles that stabilize your pelvis and spine, giving your hips a solid platform to move from.

1. Lie or sit comfortably.
2. Gently draw your belly button toward your spine.
3. Hold a few seconds while breathing normally, then relax.

Tips:

• Avoid holding your breath.

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

Walking with Assistive Device & Boot

Short, protected walking in your boot or cast with crutches or a walker.

What it helps: Short, protected walking in your boot with crutches or a walker — safe, gradual time back on your feet.

1. Use your crutches, walker, or knee scooter as directed.
2. Bear weight only as your surgeon allows.
3. Take short, level walks.

Tips:

• Follow your weight-bearing instructions closely in the early weeks.

Commonly done throughout the 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.

Seated Heel Raises

Gently activates the calf while seated and protected.

What it helps: Gently activates the calf while seated and protected — an early step toward push-off strength.

1. Sit with your feet flat on the floor.
2. Lift your heels, rising onto the balls of your feet.
3. Lower slowly.

Tips:

• Keep the weight comfortable across the foot.

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

Theraband Plantarflexion

Gently rebuilds the downward push of the ankle using a resistance band.

What it helps: Rebuilds the downward push of the ankle that powers walking and stairs.

1. Sit with your leg out in front and loop a resistance band around the ball of your foot.
2. Hold the ends and slowly press your foot downward against the band, like pressing a gas pedal.
3. Return slowly to the start.

Tips:

• Keep the motion smooth and within a comfortable, pain-free range.

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

Theraband Dorsiflexion

Strengthens the muscles that lift the foot, using a resistance band.

What it helps: Strengthens the muscles that lift your foot, so you clear the ground cleanly and don't catch your toes.

1. Sit with your leg out and loop a band around the top of your foot, anchored in front of you.
2. Slowly pull your foot up toward you against the band.
3. Return slowly to the start.

Tips:

• Keep the motion smooth and within a comfortable range.

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

Standing Weight Shifts

Builds comfort bearing weight evenly through both feet.

What it helps: Gently retrains you to load each leg evenly and confidently — the first step back to steady, balanced walking.

1. Stand at a counter with your hands resting lightly on it, feet hip-width apart.
2. Slowly shift your weight over one foot, then over the other.
3. Keep the movement smooth and controlled.

Tips:

• Both feet stay flat on the floor throughout — this is a shift of weight, not a step.
• Your hands are there for balance, not to hold you up.
• Let comfort guide how much weight you shift onto the surgical side.

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

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.

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.

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.

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.

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.

Tips:

• Keep the movement small — this is not a deep squat.
• If bending under your own weight is not available yet, standing up from a higher chair asks the same muscles with less load.

Commonly done as 2-3 sets of 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.
• Going up stairs one foot at a time, holding the rail, is this exercise at this stage. If that is how you manage stairs at home, you are already doing it.

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

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. Sit with the leg straight out in front of you.
2. Loop a resistance band around your foot and hold both ends in your hands.
3. 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.

Single-Leg Weight Shifts

Builds confidence putting weight through the new ankle joint.

What it helps: Builds confidence loading one leg fully — an early step toward steady single-leg standing and walking.

1. Stand with a counter to one side, one hand resting on it, feet hip-width apart.
2. Slowly shift your weight over the surgical side, then back to centre.
3. Both feet stay flat on the floor throughout — this is a shift of weight, not a step.
4. Hold a little longer on that side as comfort allows.

Tips:

• Your hand is there for balance, not to hold you up.
• Neither heel should lift — if one does, shift less far.
• Let comfort guide how much weight you put through the surgical side.

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

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.

Tips:

• Holding the counter with one or both hands still counts. Letting go comes later, if it comes at all.

Commonly done daily.

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.

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.

1. Step on with your feet flat on the pedals and take hold of the moving handles.
2. Start with low resistance and let your legs trace smooth ovals, keeping your heels down.
3. Stay upright rather than leaning your weight onto the handles.
4. Build the time first and the resistance later.

Tips:

• Your feet never leave the pedals, which is what makes this gentler on the joints than a treadmill.
• The moving handles bring the arms in. The fixed centre bars are there instead if you would rather steady yourself.
• Ten easy minutes is a reasonable place to start.

Commonly done as able.

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.

1. Walk on level ground at a comfortable pace, landing on the heel and rolling through the foot.
2. Add a few minutes to the walk before you add speed or hills.
3. Go a little further each week rather than a lot further in one day.

Tips:

• Turning back while you still feel good is how the distance builds.
• Supportive shoes make more difference than the route does.
• The three figures here are the same walk with a longer stride, not a faster one - an even stride matters more than pace.

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.

1. Set the saddle so your knee stays slightly bent at the bottom of the pedal stroke.
2. Begin with light resistance on flat ground, pedalling smooth, full circles.
3. Build the time you ride before you build the resistance or the hills.

Tips:

• Many people start on a stationary bike and move outdoors, as drawn here, once balance and confidence are back. The pedalling is the same either way.
• A saddle set too low is the usual reason a hip or knee feels cramped while riding.
• Your surgeon can say when getting onto a road bike is reasonable for you.

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.

1. Step on with your feet flat on the pedals and take hold of the moving handles.
2. Start with low resistance and let your legs trace smooth ovals, keeping your heels down.
3. Stay upright rather than leaning your weight onto the handles.
4. Build the time first and the resistance later.

Tips:

• Your feet never leave the pedals, which is what makes this gentler on the joints than a treadmill.
• The moving handles bring the arms in. The fixed centre bars are there instead if you would rather steady yourself.
• Ten easy minutes is a reasonable place to start.

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.

1. Wait until any wound is fully healed and you have been cleared to swim.
2. Start with a few easy lengths, resting between them.
3. Build the distance gradually across sessions rather than within one.

Tips:

• The picture shows front crawl. Which stroke suits you depends on which joint was operated on, and your care team can say which to begin with.
• The water carries most of your weight, so a session can feel easier than it was - judge it by how you feel the next day.
• Walking in chest-deep water is a gentler place to start than swimming lengths.

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.

Tips:

• Holding the counter with one or both hands still counts. Letting go comes later, if it comes at all.

Commonly done daily.

Lateral Step-Ups

Strengthens the leg and ankle with controlled side-to-side stepping.

What it helps: Strengthens the leg and ankle with controlled side-to-side stepping, building stability in every direction.

1. Stand beside a low step or block, feet level with it.
2. Step up sideways onto the step, leading with the leg nearest it.
3. Lower slowly back down under control.
4. Keep the knee tracking straight over the middle of the foot.

Tips:

• Start with a low step and add height only as it gets easy.
• Coming down slowly is where most of the work is — don't drop onto the floor.
• A wall or counter within reach is fine while you build confidence.

Commonly done as 2-3 sets of 8-12, daily.

Balance Board Training

Challenges the ankle's steadiness on a gently unstable surface.

What it helps: Challenges the ankle to react and steady itself on an unstable surface — the control that helps prevent rolls and falls.

1. Stand near a counter for support and place both feet on a balance or wobble board.
2. Slowly tilt the board forward, back, and side to side under control.
3. Progress toward more movement as your steadiness improves.

Tips:

• Keep a hand or fingertip on support until you feel secure.

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.

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.

1. Step onto a wobble board with your feet either side of the centre, near a counter you can reach.
2. Bring the board level and hold it there - the work is in the small corrections.
3. Then tip it slowly side to side, and forward and back, under control.
4. Step off and rest before repeating.

Tips:

• A wobble board tips under you; a balance pad only gives. That is what makes this the harder of the two, and it is worth being steady on the pad first.
• Keep something solid within reach the whole time.
• Small, slow corrections teach more than big ones.

Commonly done a few times a week.

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.

1. Set the saddle so your knee stays slightly bent at the bottom of the pedal stroke.
2. Begin with light resistance on flat ground, pedalling smooth, full circles.
3. Build the time you ride before you build the resistance or the hills.

Tips:

• Many people start on a stationary bike and move outdoors, as drawn here, once balance and confidence are back. The pedalling is the same either way.
• A saddle set too low is the usual reason a hip or knee feels cramped while riding.
• Your surgeon can say when getting onto a road bike is reasonable for you.

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.

1. Wait until any wound is fully healed and you have been cleared to swim.
2. Start with a few easy lengths, resting between them.
3. Build the distance gradually across sessions rather than within one.

Tips:

• The picture shows front crawl. Which stroke suits you depends on which joint was operated on, and your care team can say which to begin with.
• The water carries most of your weight, so a session can feel easier than it was - judge it by how you feel the next day.
• Walking in chest-deep water is a gentler place to start than swimming lengths.

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.

1. Work the major muscle groups two or three times a week, leaving a day between sessions.
2. Use a weight you can lift with good form for the whole set - the last repetition should feel hard, not impossible.
3. Lower slowly. The controlled way down is where much of the benefit sits.
4. Add a little weight only once the current one feels comfortable.

Tips:

• The dumbbell squat shown is one example. Which exercises suit you depends on the joint you are recovering from, and your program will say.
• Breathe out on the effort rather than holding your breath.
• Muscle soreness a day or two later is expected. Pain in the joint itself while you lift is a sign to lighten the weight.

Commonly done a few times a week.

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.

Tips:

• Holding the counter with one or both hands still counts. Letting go comes later, if it comes at all.

Commonly done daily.

Agility Drills

Cutting, pivoting, and change-of-direction work for sport readiness.

What it helps: Rebuilds the quick cutting and change-of-direction control your body needs before returning to sport.

1. Practice controlled side-to-side and figure-eight movements.
2. Build speed gradually.

Tips:

• Start at submaximal effort and progress.

Commonly done as cleared.

Balance Exercises

General balance work to steady your gait.

What it helps: Steadies your gait and sharpens your balance, helping you move with confidence.

1. Practice standing balance near support.
2. Progress as you feel steady.

Commonly done daily.

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. Keep a steady, comfortable pace and turn back while you still feel good.
3. Build distance and add gentle inclines as comfort allows.

Tips:

• Supportive footwear and trekking poles can help early on.

Commonly done as cleared.

Return to Recreational Activities

Easing back into the hobbies and activities you enjoy.

What it helps: Easing back into the sports and activities you love, at a pace your body is ready for — the reward for the strength you've built.

1. Reintroduce low-impact activities you enjoy, as cleared by your surgeon.
2. Gardening, walking, swimming and gentle cycling are good places to start.
3. Start with shorter sessions and build duration and intensity gradually.
4. Listen to your body and progress steadily.

Tips:

• Ramp up gradually — avoid sudden big efforts.
• A flare after activity means ease back, not stop entirely.
• Working at waist height — a raised bed, a bench, a table — takes a lot of bending out of a hobby.

Commonly done as tolerated.