PHASE 1: 0 TO 2 WEEKS POST INJURY

Below you will find important information to follow 0 to 2 weeks post injury.

Pain relief: Paracetamol can be used by following the instructions on the packaging. For stronger pain relief or if you have any allergies please contact your General Practitioner or a pharmacy.

Toe strapping (if provided): Please use the strapping for 2 weeks, avoiding getting it wet. You may change the strapping if you feel comfortable to do so.

Walker boot or Shoe (if provided): Do not sleep in the boot or shoe. It is important to place as much weight as possible through the boot or shoe when walking to help the healing process. The boot should be worn when walking but can be taken off when you are:

• resting
• applying ice
• elevating the ankle
• doing simple exercises

Ice: A cold pack or frozen peas wrapped in a towel can be applied to the ankle for 15 minutes, 3 to 4 times a day. The ice must not come into direct contact with the skin. Ice is most effective within 72 hours of injury.

Elevation: The ankle should be rested and elevated above the level of your hip regularly throughout the day for 20 to 30 minutes. Phase 1 exercises can be undertaken whilst the ankle is elevated to help reduce swelling.

Exercises: 

Undertake exercises little and often as pain allows.

1. Sit down straight and trace circles with your foot by turning your ankle in one direction without moving the knee. Return to the middle and repeat in the other direction.

2. Lie on your back. Point your toes up and down as far as you can. Relax your feet.

Sick Note: You will not require a sick note for the first 7 days that you're absent from work. Please contact the fracture clinic if you require a further period of time off work.

You may move onto Phase 2 when you are 2 weeks post injury.

Below you will find important information to follow 2 - 4 weeks post injury.

Pain relief: Continue to use appropriate painkillers as necessary.

Walker boot or shoe: The boot or shoe should be weaned down and discarded now. Comfy and spacious footwear such as trainers will provide support and reduce irritation. You may increase you walking distance as pain allows.

Toe strapping: If your toe was strapped, please now remove the strapping. Strapping must not be worn for more than 2 weeks.

Elevation: Continue to elevate the foot if it looks swollen in comparison to your opposite side.

Exercises: 

Undertake exercises little and often as pain allows.

1. Sit on a chair with the affected foot resting on a flat towel. Slowly bunch up the towel by curling the toes. Replace the towel and repeat.

2. Sit straight on a chair with your feet flat on the floor. Flex the ankle to go on the tip of your toes, raising the heel off the ground. Lower and repeat.

You may move onto Phase 3 once you are 4 week post injury.

Below you will find important information to follow 4 weeks after injury.

IMPORTANT

• Phase 3 exercises should only be done if you were able to do them prior to injury.
• If you were unable to do these exercises before you were injured, only perform phase 2 exercises .

Exercises: 

Undertake exercises little and often as pain allows.

1. Stand in front of a counter and hold onto the countertop. While maintaining your back straight and your hips above the level of your knees, slowly lower your body into a semi-squat position without leaning forward and keeping your heels in contact with the ground at all times.

2. Stand on both feet with your hands on a chair or table for balance. Raise on your tiptoes without bending the knees. Lower under control to come back to the starting position and repeat.

3. Stand and lift one leg. Hold that position for up to 20 seconds.

You may progress to Phase 4 when you are 6 week post injury.

Below you will find further information to support your recovery.

• By the sixth week post-injury you should have moved into phase three of your rehabilitation package the exercises. 
• You should have improved your movement and overall function.  
• The injury you have sustained takes six weeks to heal but it is not uncommon to experience pain and or swelling for three months post injury. 
• Continue to use pain relief as appropriate. 
• If you are happy with your recovery and outcome, you can discontinue your exercises.  
• You may return to sport after six weeks post-injury if you feel able to do so. 
• We do not routinely follow up this type of injury.  
• If you continue to experience pain after three months post injury, please contact us for further consultation. If we do not hear from you within three months, you will be discharged back to the care of your general practitioner.