Ankle mobilization after injury

Last summer I got a pretty severe injury on my right leg. I broke the malleolus which resulted the foot to externally rotate about 45 degrees from the ankle - not a pretty sight. After a surgery, seven screws, steel plate and plenty of rehab it got 100% pain free pretty quickly. It hasn´t bothered me at all after the initial recovery.

However I´m still havinh some problems with mobility, especially with dorsiflexion. I can squat all pretty good, especially with weightlifting shoes. Exercices that require significant amount of mobility are still out of the question though, such as pistol squats etc. For example I can do a bodyweight pistol on my left leg somewhat good, but I tend to fall on my back every time I try to do it on the rigth leg. There´s a a clear feeling that is resulting from restricted dorsiflexion. All in all the right ankle feels stiffer in general. Usually it´s a slight pinching feeling in front of the ankle.

Any suggestions how to go on improving ankle mobility in a case like this? I´ve done standing ankle mob drills and stretching just about daily for the past 6 months or so and the progress has stalled long time ago.

Has anyone done any "loaded stretching"? By this I mean going in the half kneeling position and putting a kettlebell or any kind of weight on top of the leading knee and pushing the knee past the toes as far as possible and keeping the foot flat on the ground. This seems promising since I can feel a way better strecth compared to more conventional methods.

Here´s an x-ray, if anyone wants to see.

X-ray

Thank you.
 

 

The first thing you need to do is to contact your surgeon and ask them if there is anything that they did that would mechanically interfere with dorsiflexion. You NEED to know this, because if there IS something in the way you could be setting yourself uo for catastrophic failure.

 

IF everything is ok, and you are given the green light for ankle dorsiflexion stretching, be careful with the loading and degree of stretch. Slow and steady is the way to go.

 

Perhaps Kit Laughlin can give you more specific advice on the stretching.

Thanks for the reply.

 

I´ve talked with a PT about the rehab and had several sessions during the initial rehab.. Basically I can do anything with the limits of pain. There hasn´t been any for a long time (4-5 months). Only a slight pinching feel in the front of the ankle when going to the end ROM in dorsiflexion.

 

On top of that there shouldn´t be any mechanical restrictions since the screws do not cross the two bones in the ankle. If that wasn´t the case there would definitely be some limitations.

If you have medical clearance, I would proceed carefully, just like all other stretching. That pinching feeling could be something out of place, or a lax ligament that is falling into the joint space and getting impinged. If that is the case, you can sever that ligament with extra dorsiflexion, so be careful.

Yes, for sure the slow and steady usually wins the race in a situation like this. I´ll proceed with caution and see what happens.