An ankle arthroscopy (keyhole surgery) can be performed to address a stiffness or impingement at the back of your ankle joint. Posterior impingement syndrome can occur as a result of soft tissue, bony spurs known as osteophytes or an extra bone known as an os trigonum becoming pinched at the back of the joint. Your surgeon will have made a decision as to the exact cause and removed the tissue responsible based on your scans and what was seen during your operation.

Phase one

The first phase of your recovery will be focused on managing your swelling and pain and early mobilization to prevent excessive ankle stiffness developing.

You will be provided with elbow crutches to help with balance and stability when weight-bearing and walking.

Under normal circumstances, we will encourage you to take full weight through your ankle as your pain and strength allow. However, if your surgeon has performed significant work to the bony joint surfaces they may ask you to take only partial weight through the operated leg for 2-4 weeks after surgery.

Regular icing and compression of the ankle is encouraged at this stage to improve swelling and bruising.

Your physiotherapist will guide you through some initial activation exercises for your ankle and foot muscles which will help to support your knee and prevent excessive muscle wasting post-operatively.

Phase two - The second phase of your recovery will focus on enabling you to walk with a more normal gait pattern, increase your ankle range of motion as quickly as possible and strengthen your ankle and foot muscles.

Weaning off your elbow crutches is normally completed 2-3 weeks after surgery. This stage may be prolonged if you have been asked to take only partial weight through your operated leg post-operatively.

Regular stretching of the ankle in to dorsiflexion (foot up position) and plantarflexion (foot down position) is encouraged to regain full range of motion by six weeks post-surgery.

Once any acute pain from the surgery and significant ankle joint swelling has gone, your physiotherapist will prescribe more appropriate strengthening exercises.

At this stage, many of the exercises will be non-weight bearing and exercises will be prescribed to target each of the ankle muscles: ankle plantarflexion muscles (which help to propel you forwards and upwards when walking), ankle dorsiflexor muscles (which pull your feet and toes up) and ankle invertor and evertor muscles (which stabilize your ankle from side to side). Weight-bearing exercises such as wall slides, squats and lunges and heel raises may also commence gradually to begin strengthening your operated leg muscles in weight-bearing positions.

Phase threeThe third phase of your recovery will begin once your walking pattern has normalized and you have enough strength and flexibility in your operated ankle to start more complex movements and impact work. Typically, the initial part of this phase will involve light impact work such as walking or jogging on the treadmill and increasing the vigour of previous exercises such as squats, lunges and heel raises. Your physiotherapist will guide you appropriately but under normal circumstances once the strength of your operated leg is equal to your non-operated leg, activity or sport-specific rehabilitation exercises can be commenced. This may include progression to sprinting, jumping and rotational movements depending on the sport desired.

The Game Ready Ice Machine, electric muscle stimulator, AlterG anti-gravity treadmill, Hydro Physio aqua-jogger, sports exercise equipment such as the Concept2 rower, plus Circle’s Return to Sport Assessment Service may help rehabilitation following an ankle arthroscopy for posterior impingement syndrome

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