Regaining ROM after ORIF

I’m about six months out from ORIF for a fibula fracture and dislocated ankle. I’ve been very dedicated to PT and my recovery has overall been going well. Climbing feels nearly normal, hiking feels ok and I’ve just begun to run short distances again, however my dorsiflexion is still rather poor.  I made good improvement in the first few months after getting out of the boot but I seem to have plateaued in the last 4-6 weeks. I’ve been doing ankle stretches every morning/evening and try to push the ROM during PT exercises. My surgeon said he expected I would regain full ROM but I feel very limited in certain motions like squats or uphill running.

Has anyone with a similar injury had success gaining much back after six months? Did hardware removal help? My ankle is still fairly swollen and I’m hoping when this eventually decreases some mobility may return too.  I’d really appreciate any insights or experience anyone is able to share!

Jared

I broke my fibula and had what looks like similar hardware put in about 13 or 14 years ago. I fully tore the tibiofibular ligament... Not sure exactly how that compares to what you have going on, I know ankle dislocations often come with complex injuries.

I would say my recovery didn't go horribly, but it doesn't sound like it was as as good as yours has been. I didn't run for probably about 10 months. Biggest issue for me long term was muscle atrophy in the calf (never really came all the way back), and asymmetry in my gait causing weird issues like knee pain and shin splints when I tried to increase running volume. I used to run quite a bit, I still can go for runs but something usually starts hurting if I run every day so I kind of quit anything more than a jog once or twice a week.

I generally was back to normal after a year or so, but had random pain pop up every now and then for a few years following. Honestly it was a real bummer for the first year+ but nowadays I rarely think about it. Only thing is I can't really ski anymore because the boots apply a weird pressure which is pretty painful. I thought about getting the hardware removed but it doesn't seem worth it. Snowboard boots are totally fine but I just suck at snowboarding.

Sounds like you're on a good recovery path 

Hey Jared,

it sounds like you are doing great! Keep up the good work.  I broke my fibula and tore my deltoid ligament (inside of ankle) Oct 2024.  I had to have the plate and screw for the fibula as well as the deltoid ligament reattached and a tight rope applies.  Even tho they are similar injuries I’m sure there are differences.  Prior to the injury, I could do 3x8 pistol squats on each leg.  I just did 3x7, so I’m almost back!

I bring up pistol squats because they require a lot of Dorsi flexion.  My dorsiflexion ROM was pretty poor for what felt like 6-8 months.  I had a lot of swelling and it felt like I was limited more from that then from tightness in the Achilles.  I was worried about it and ultimately went in to see my dr.  They gave me a cortisol shot that eased things up.  Not sure if it was really that needed because things felt like they really started to heal naturally around that time too.  I incorporated more rest and actually stopped icing   I think allowing the swelling to occur, and being able to use it as a measure of when to rest was very helpful  

Sorry I’m kind of rambling.  What I’m trying to get across is that I still saw significant improvements after 6 months.  

As far as what to try, I really liked doing knees over toes split squats.  Elevate the front foot on a weight plate or box, and decrease the elevation over time.  Something about loading the muscle through the range of motion just felt like it worked well. 

Anyways, best of luck and let me know if you have any more specific questions.  I’m happy to go into detail!