Total Ankle Arthroplasty — 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.

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 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.

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.

Upper Body Conditioning

Keeps your arms and shoulders strong — helpful for crutches and staying active.

What it helps: Keeps your arms and shoulders strong — especially helpful for using crutches and staying active during recovery.

1. Using light hand weights or a resistance band while seated, work through gentle arm and shoulder movements.

Tips:

• Stay seated and supported while you're non-weight-bearing.

Commonly done a few times a week.

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.

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.

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.

Seated Heel Slides

Encourages gentle ankle and knee motion while seated.

What it helps: A supported way to ease motion back into the knee and ankle while you stay comfortably seated.

1. Sit with your foot flat on the floor.
2. Slide your heel back toward the chair, bending the knee and ankle.
3. Slide it forward again.

Tips:

• Keep it slow and within comfort.

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

Toe Raises & Toe Curls

Re-activates the small muscles of the foot.

What it helps: Re-activates the small muscles of the foot that support your arch and balance.

1. Seated with your foot flat, lift your toes up while keeping the heel down.
2. Then curl the toes down, as if gripping a towel.

Tips:

• A towel under the foot adds a gentle challenge.

Commonly done as 2 sets of 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.

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.

Core Strengthening

Supports posture and overall stability.

What it helps: Builds the core that holds your trunk steady, supporting your posture, your back, and everything you do on your feet.

1. Perform gentle core exercises as directed.

Commonly done a few times a week.

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.

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.

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.

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. 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.

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 holding a counter for support, feet hip-width apart.
2. Slowly shift your weight toward the surgical side, then back to center.
3. Progress to holding more weight on that side as comfort allows.

Tips:

• Keep support nearby and let comfort guide how much weight you shift.

Commonly done as 2-3 sets of 10, 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.

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.

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.

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.

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.

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.

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.

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.
2. Step up sideways onto the step with the surgical leg, then lower slowly.
3. Keep your knee tracking over your foot.

Tips:

• Start with a low step and progress the height gradually.

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

Resistance Band Strengthening

Adds gentle resistance to build strength.

What it helps: Adds gentle, adjustable resistance to build strength steadily as you recover.

1. Use a band for hip or leg exercises as directed.
2. Move slowly through the range.

Commonly done a few 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.

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.

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 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.

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.

Core Strengthening

Supports posture and overall stability.

What it helps: Builds the core that holds your trunk steady, supporting your posture, your back, and everything you do on your feet.

1. Perform gentle core exercises as directed.

Commonly done a few times a week.

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.