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      Post Procedure Foot and Ankle Protocol


      • No NSAIDS such as Advil, Motrin, ibuprofen, Naprosyn, and Aleve x 2 weeks

      • Pain: Tylenol for mild pain and if needed use mild narcotic provided

      • Driving restrictions: No driving until out of boot and can safely move from gas to brake.  If left foot/ankle, must be able to safely use clutch.

      • Work restrictions: Depends on duration of weight bearing restrictions

      • Exercise restrictions: 2 weeks relative rest followed by 4 weeks progressive PT.  No running, cutting, jumping, lunges or deep squats until 8 weeks.

      • Use crutches for __________ days, non-weight bearing for _______ days

      • May begin partial weight bearing WITH crutches from days ____________

      • Use boot, with / without heel lift for ____________ weeks

      • Use stirrup ankle brace for 3-4 days continuously then 4-6 weeks when on feet

      • Come out of the boot for simple non-weight bearing range of motion 1-2 times daily after the first 2 days of continuous boot wear

      • f/u for PT in 5-7 days

      Activities: In general, with strength and activities, keep pain level below 4/10

      First 2 Weeks:

      • Use crutches as directed above.

      • Strengthening/Motion: Isometrics are always good.  Non-weight bearing and passive range of motion is good too. Try to get full range of motion by 2 weeks.

      • Walking: No hiking. Once allowed to bear weight, may walk on flat ground initially for 10-15 minutes. If this goes well, may walk 5 minutes longer the next day.

      • Cycling: May do gentle riding on a stationary bike for 10-15 minutes after week 1. Exertion level 1-3/10.

      • Swimming: May use pull buoy after week 1 alternating with GENTLE kicking.

      Weeks 2-4:

      • Strengthening/Motion: Start low load closed chain concentric/eccentrics with PT.

      • Walking: May begin gentle hiking on even surfaces (no more than 30 minutes).

      • Cycling: May ride up to 30 minutes. No getting out of the saddle til after week 4. Exertion level 4-6/10.

      • Swimming: Increase kicking intensity alternating with pull buoy. Swim ½-1 mile.

       Weeks 4-6:

      • Strengthening/Motion: Progress to moderate load, progressive strengthening.

      • Walking: May progress to longer hikes up to 60 minutes, still no jumping.  Can add mildly uneven surfaces now.

      • Cycling: May ride up to 60 minutes.  May get out of saddle. Exertion level 7-9/10 during intervals.

      • Swimming: May swim up to 1-2 miles now.  Still encourage breaks with buoy.

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