Comprehensive Foot and Ankle Care Guide: Optimising Recovery After Surgery

Congratulations on taking the first step towards regaining mobility and conquering discomfort by undergoing foot and ankle surgery! As you embark on this crucial journey to recovery, it's essential to prioritize post-operative care to ensure a smooth and successful healing process. Whether you've had corrective surgery, ligament repair, or any other procedure related to your foot and ankle, the right care can significantly impact your rehabilitation progress.

This comprehensive guide will provide you with valuable insights into optimising your recovery. From physiotherapy exercises to R.I.C.E techniques for reducing swelling and the importance of non-weight bearing walking, this article will equip you with the knowledge and tools to make your recovery journey as comfortable and effective as possible.

Things to take note

Weight bearing status – Adhere to the weight bearing status at all times unless otherwise advised by your doctor/physiotherapist.

Non-weight bearing: What is it, and why?

If you are advised to go on ‘non-weight bearing’ status, it means that you cannot put any weight on the injured/operated leg; not even for a quick second, whether you are seated or standing. This is usually for a certain period of time, until your doctor has allowed you to do so. This restriction is so that your bones have time to go through the healing process, without having to carry the weight of your body too soon.

R.I.C.E. to reduce pain and swelling:

Rest – do not put weight on your affected limb until your doctor has allowed you to do so.

Avoid activities that cause more pain or discomfort.
Appropriate rest helps to protect injured tissue from further injury and prevents delay in healing.

Ice – apply ice for 15 to 20 minutes, 3-5x/day.
Compress – compression of affected limb. E.g. Bandage, elastic wrap.
Elevate – your lower limb at or above the level of your heart to encourage circulation back to the body.

Non-weight bearing: How do I walk?

With both hands holding onto your axillary crutches, place both crutches 1 foot-length forwards, slightly wider than shoulder width apart. Imagine a line drawn from the left to right crutch.
With your stronger/unaffected leg, hop forward onto the imaginary line between the crutches.
Ensure that your non-weight bearing leg is off the ground at all times.

If using a walking frame, similar principles apply.

Non-weight bearing: How do I manage stairs?

Stand close to the step.
Using your arms, push down on the hand grip of the crutches and move your strong leg up onto the step.
Lift and place both crutches up onto the same step.

Straighten the affected leg in front of you.
Place both crutches onto the next step below you.
Using your arms, push down on the hand grip of the crutches and move your strong leg forward onto the lower step.

Purpose of exercises

Maintain range and strength of your lower limbs.
Optimize blood circulation, facilitating wound and bone healing.
Facilitate walking with or without gait aid.

Outpatient Physiotherapy will be arranged when you are ready to start rehabilitation to regain foot and ankle movement and strength. When your doctor has changed your weight bearing status, your outpatient physiotherapist may also progress your walking to the next stage (i.e. teach you the pattern of walking depending on your new weight bearing status, or change your walking aid).

You may be advised to do some of the following exercises by your therapist.
Please check with your therapist if you are unsure of how to carry them out.

All exercises should not result in more pain. If so, stop the exercise, and inform your therapist.

Exercises for your Lower limb

Adhering to your physiotherapy plan diligently will accelerate your healing process, minimise the risk of complications, and help you regain normal function in your foot and ankle.

1. Toe wriggling Flex and extend your toes. Repeat 10 times hourly.
2. Ankle pumps Bend your foot up and down at your ankle. Repeat 10 times hourly.
3. Inner range quads With a rolled towel under knee, slowly lift your leg into full extension. Repeat 10 times, hold 10 seconds.
4. Seated knee extension From your seated position, with your knee bent, slowly lift your leg into full extension. Repeat 10 times, hold 10 seconds.
5. Straight leg raise Lying on your back with your knee straight, lift your affected leg off the bed. Repeat 10 times, hold 10 seconds.
6. Hip abduction Lie on your side and bend your lower knee. Lift your affected leg, keeping your knee straight. Repeat 10 times, hold 10 seconds.
7. Single leg bridging Lie on your back with your knees bent. Straighten your affected leg and lift it off the bed. with your non-affected leg bent. Tighten your buttocks and lift your buttocks off the bed. Repeat 10 times, hold 10 seconds.

Your foot and ankle surgery marks a significant milestone in your journey towards improved mobility and reduced discomfort. By embracing physiotherapy exercises, employing the R.I.C.E technique to reduce swelling, and following the guidelines for non-weight bearing walking, you are taking essential steps to optimize your recovery.

Remember, each person's healing process is unique, and patience is key during this time. Listen to your body and communicate regularly with your medical team to ensure that your recovery remains on track. At Singapore General Hospital's Physiotherapy Department, we are committed to providing you with the best possible support on your path to recovery. Together, let's pave the way to a healthier, happier, and more active future!