Phase 1: Week 1-2
• Goals:
◦ Control swelling
◦ Pain Management
• Non weight bearing in below the knee cast
• Sutures removed at 10-14 days
• Rest and elevation critical to control swelling
• Exercises:
◦ Begin Hip and Knee active range of motion exercises
◦ Straight leg raises
◦ Upper body exercises (seated or bench only)
◦ No push-ups
Phase 2: Week 3-4
• Non weight bearing in below the knee cast
• Continue elevation to control swelling
• Exercises:
◦ Continue with exercises started during Phase 1
◦ May begin core exercises
Phase 3: Week 4-6
• Partial weight bearing with crutches and walking boot
• Exercises:
◦ Progress to stationary bike with walking boot
◦ Begin gentle active foot and ankle range of motion (plantar flexion/dorsi
flexion): Perform 30 repetitions twice daily
◦ Begin seated calf raises: Perform 15-20 repetitions twice daily
Phase 4: Week 7-8
• Begin full weight bearing with walking boot as tolerated
• Begin gentle eversion and inversion of foot and ankle: 30 repetitions twice daily
• Continue with exercises started during Phase 1 and 2
Phase 5: Week 9-12
• Begin full weight bearing with AFO or ankle brace as tolerated
• Exercises:
◦ Begin active range of motion with theraband or towel
◦ Begin proprioception and balance exercise
◦ Begin double leg toe raises
◦ Continue previous exercises
Phase 6: Week 13-16
• Emphasize
◦ Strengthening:
▪ Single leg toe raises
▪ Lunges
▪ Leg Press/Squats
▪ Hoping (begin at 14 weeks)
▪ Jogging (begin at 14 weeks)
▪ Plyometrics (begin at 16 weeks)