Weight-Bearing After Ankle Surgery: Answers To Your Top 10 Questions

Now that we’ve established my thoughts on returning to “normal” after ankle surgery, I want to talk about a huge, critical, weighty milestone along that journey: weight-bearing.

As you likely know if you’re reading this, ankle surgery often comes with a non-weight-bearing diagnosis: 2 weeks non-weight bearing, 4 weeks, 6 weeks. For me, it was 7.5 weeks. Regardless of how long this seemingly endless saga on your back is, the news is overwhelming and inconvenient and sad.

Eventually we get home, settle in, and move through our stages of grief, ultimately accepting that the only way out is through. Whatever it takes — crutches, scooters, wheelchairs — Hulu, takeout, sobbing—is what we’ll do. All in the name of bearing weight on our pathetic little ankles once again (jk we love our ankles!!).

Before I get too far into my weight-bearing guidance, I want to show you a visual of my journey — getting from my first weight-bearing steps to walking unassisted.

Since I started creating content about broken ankles 8 years ago, I’ve gotten a lot of weight-bearing questions. Below I’ve answered the top 10. Like always, please know that every injury, body, and journey will of course have differences.

Ok let’s do this!

When did you start weight-bearing?

7.5 weeks after surgery. According to my doc, a typical range is 2–8 weeks, depending on the type of fracture and healing process.

Did it hurt when you started weight-bearing?

I wouldn’t say I had pain pain — more like sore muscles, weird tingling, pressure, and unfamiliar sensations. As well as some swelling, so icing/elevating was key! But any pain or weirdness was definitely overshadowed by the joys of being able to practice and make progress!

Was weight-bearing a progression or did you just start?

It was completely a progression for me, as instructed by my PT. My phases were:

• The boot + 2 crutches
• The boot + 1 crutch
• The boot and no crutches
• Then it was time to take the boot off and I brought the crutches back for 2 sneakers + 2 crutches
• 2 sneakers + 1 crutch
• And then I was fully weaned off the boot and the crutches and just had two sneakers

I spent about 3–5 days in each phase.

How do I get past my phobia/anxiety of starting to walk again?

Of course there’s not just one answer for that. In my experience, once the doctor/PT has says it’s ok, you just have to start. It’s hard and scary, and you might doubt yourself or find it hard to trust your instincts, but go slowly and have patience with yourself. You’ll get there.

Did you have a limp?

I didn’t limp, but that’s not because I couldn’t have. My PT told me early on that if I felt the need to limp, then I was doing too much too soon— meaning, that I should go back to the previous stage in my progression. My PT said that limps can become habitual, so just don’t ever start. You can find a great conversation on limping with physical therapist Ellen Grover when you join WeBroken.

Did your ankle start swelling again when you started walking?

It sure did, nothing a little ice and a compression sock couldn’t control though. But it’s a good thing! It means new muscles and parts of your ankle are working and blood is flowing. If you’re concerned though, call your doc/PT.

When you were learning how to walk again, how long did you practice each day? How often?

I didn’t have a set amount of time or cadence. I walked as much as I could indoors — around my apartment and around the carpeted hallways of my building. I went for as long as I could until I felt like I’d challenged myself enough, then I’d stop and ice/elevate. Maybe one session was it for the day, or maybe I rested and then went a few more times. It also totally depended on which stage I was at in the progression — those early days of bearing weight had me breaking a sweat in like 5 minutes. In my experience, the most active I could be without over-doing it, the better. And there might be some days when maybe you push too much, that’s ok, just rest and ice even more. It’s good to play with your limits within reason.

I’m not weight bearing yet, and my foot turns blue/purple when it’s not elevated, then goes back to normal when I elevate again. Is this normal?

Ha! It is normal! Gross and painful, but normal. When you’re not walking or putting pressure on the muscles down there, the blood just sort of pools and stagnates. I asked Dr. Richard Gellman about this in our interview and he shared tons of detail and the science behind it. Don’t worry, it fixes itself when you start weight-bearing. But if you’re concerned definitely call your doc.

How long did it take you to walk up and down stairs?

Because of the building I lived in, I was going up and down stairs from the beginning while I was freshly on crutches (carefully, because it definitely takes coordination!). Once I got rid of the crutches, stairs were definitely hardest to tackle but I used them as part of my walking practice. Going up stairs was relatively easy to cheat because I could avoid putting all the pressure on the healing foot by leading with the other one. But to cheat going down wasn’t possible — it either required leading with the injured foot, or leading with the normal foot and having good range of motion in the achilles/calf of the injured foot. So getting comfortable going downstairs definitely took more time. Stairs were sort of the last frontier to tackle, even after I was in two sneakers.

How long did it take you to be able to walk down stairs with your bad leg taking the first step? My dorsiflexion feels like it will never come back.

First of all, don’t call it a bad leg! It’s healing for you and that’s so, so good of it. That said, it definitely takes time to be comfortable with regular walking/pressure on that foot before leading with it on stairs — I was definitely in 2 sneakers by that point. It takes practice, trust, and mobility. For the dorsiflexion issue, take a few mins each day to walk up and down stairs slowly. I also highly recommend massage to work on that achilles and calf.

Hope you find this helpful! If you want tons more free broken ankle stuff, you can head to WeBroken, and you’ll also find some amazing exclusive content. And hey, if you just need to feel part of a community of other broken ankle peeps, you can join us on IG or on Reddit.

Happy healing to you!