General Ankle Rehabilitation Protocol
  • Sports Medicine

  • Knee Surgery

  • Shoulder Surgery

  • Elbow Surgery

  • Hip Surgery

  • Ankle Surgery

  • Arthroscopic Surgery

General Ankle Rehabilitation Protocol

Phase 1: Acute Phase week 1


  • Decrease swelling
  • Decrease pain
  • Protect from injury
  • Maintain appropriate weight bearing status
  • Increase pain free ROM
  • Limit muscular inhibition


  • Modalities‐ electrical stimulation, ultrasound, phonophoresis,
  • Iontophoresis
  • Taping/compression wrap/ankle bracing, crutches if needed
  • Active range of motion in all planes (alphabet, circles, calf pumping)
  • Gentle isometric strengthening in all planes
  • Begin non‐weight bearing proprioception‐ seated BAPS

Phase 2: 1‐3 weeks


  • Full pain free range of motion
  • Pain free strengthening
  • Progress to weight bearing exercises
  • Begin proprioceptive training
  • Resume normal gait pattern


  • Continue with phase 1 exercises
  • Stretching in non‐weight bearing and weight bearing positions
  • Strenghening: 4 plane ankle Theraband
  • Towel sweeps
  • Foot Intrinsics‐towel crunches, tissue or marbles pickup)
  • Heel and toe raises
  • Trampoline (weight shifting and balance activities)
  • Quarter squats
  • Joint mobilization‐ dorsiflexion and plantarflexion
  • Proprioceptive training‐ seated BAPS, wobble board, single limb stance,
  • rocker board
  • Stationary bike
  • Modalities to reduce pain and inflammation
  • Aqua‐jogging in pool if available
  • Continue cold therapy

Phase 3: week 3‐5


  • Progress strengthening
  • Progress proprioceptive training
  • Increase endurance


  • Initiate Elliptical
  • Treadmill walking to jogging ( can incline treadmill)
  • Increase eccentric work
  • Leg press
  • Advance balance and proprioception exercises: single leg balance activities from stable to unstable surfaces with and without distractions ,standing BAPS with/without weights, wobble board, lateral shuffles, toe walk, heel walk, dynadisc, single leg trampoline ball catch, body blade, 5 point star, single leg squat
  • Agilities: begin lateral agility work Sportscord
  • Carioca

Phase 4: 5 weeks +


  • Regain full strength
  • Full Range of motion
  • Full balance/proprioception
  • Prevent future injuries
  • Return to participation in sport activity


  • Jogging progression
  • Advance single leg balance and proprioceptive exercises: single leg
  • squat on dynadisc, BOZU, dynadisc 5 point star
  • Agilities‐ grid hops, double hops, single hops, diagonals
  • Double leg hops, forward/backward/side to side
  • Single leg hops, forward/backward/lateral hops
  • Plyometrics: multidirectional jump drills

Note: As with all protocols, the designated time frames and exercises are for guidance only and should not limit the patient’s progress or make them worse.