Important
If a peroneal tendon repair or debridement was also performed, follow the Peroneal Tendon Repair/Debridement protocol instead — that pathway is different and less aggressive.
Precautions
- Protect the lateral ligament repair: avoid forced inversion and end-range plantarflexion for ~6 weeks.
- Progression is criterion-based (motion, swelling, strength), guided by symptoms.
- If the repair was augmented (internal brace / suture tape), weight bearing and motion may be advanced sooner per surgeon.
Phase 1 · Weeks 0–2 (Protect)
- Post-op splint or CAM walker boot in neutral; elevation for swelling.
- Weight bearing as tolerated in the boot.
Phase 2 · Weeks 2–6 (Motion & Early Strength)
- Transition to a functional (lace-up or stirrup) brace.
- Begin physical therapy: range of motion to tolerance limiting inversion and end-range plantarflexion.
- Evertor/peroneal and ankle strengthening; proprioception and balance training.
Phase 3 · Weeks 6–12 (Function & Sport Prep)
- Progress to sport-specific activity in a functional brace.
- Advance strengthening, single-leg balance, and a running progression as tolerated.
Return to Sport (~12 Weeks, Criterion-Based)
- Symptom-free with full functional range of motion.
- Ankle/evertor strength and single-leg balance and hop testing symmetric to the other side.
- Tolerates sport-specific demands; wean out of the brace as symptoms allow.
References
- Early Mobility and Rehabilitation Protocol after Internal Brace Ankle Stabilization. Int J Sports Phys Ther.
- Functional Results of Open Bröstrom Ankle Ligament Repair Augmented With Suture Tape. Foot Ankle Int, 2018.
Modernized to current practice: added standard early precautions (limit inversion and end-range plantarflexion ~6 weeks; evertor emphasis) and made return to sport criterion-based rather than time-only.