Physiotherapy after surgery · Singapore
Ankle Fracture Surgery Recovery Program
Written by Zita Sham, Fairuuz Saleh and Shiv Mohan Banka, Principal Physiotherapists at Phoenix Rehab.Clinically reviewed by Louise Yow, Principal Physiotherapist and Director, AHPC A1300363H.Last reviewed 28 September 2026.
Six weeks not weight bearing costs you about a third of your calf. Nobody warns you about that part.
An ankle fracture fixed with a plate and screws heals on the bone timeline. The stiffness, the wasted calf and the limp are on a different timeline entirely, and they are what the program is for. This program is run by our physiotherapy team.
No referral needed. Every first visit is one 45-minute Assessment & Treatment, $230, nett, no GST. Bring your operation note or scan report.
Where are you right now?
Four situations we see
- You are non weight bearing in a boot or cast. Hip, knee and the other leg are the work now, and so is keeping the foot from stiffening into a pointed position.
- You have just been allowed to walk on it. The first fortnight of weight bearing is where the limp gets learned or unlearned.
- The limp has stayed. Almost always ankle range and calf strength rather than the fracture, and both are measurable.
- Months on and you cannot go down stairs normally. That is a calf strength and ankle range test, and it is a specific number.
What the immobilization costs
Calf muscle disappears faster than any other muscle in the leg
The calf loses size and strength rapidly when it stops taking load, and it is the muscle that makes a normal step possible. Walking pushes off through the calf. Stairs, particularly going down, need it to control the descent. A single heel raise on one leg needs it to lift your entire body weight.
After several weeks not weight bearing, most people cannot do one single leg heel raise at all, when the normal figure is somewhere upwards of twenty. That gap is the actual reason for the limp, the reason stairs feel unsafe, and the reason the ankle aches at the end of the day. It is not the plate and it is not the bone.
The other predictable loss is ankle dorsiflexion, which is the ability to bring the shin forward over the foot. Without it a normal stride is impossible and the body finds a way around it, usually by turning the foot out. Both dorsiflexion and heel raise count are measured in a couple of minutes, and both respond to loading rather than to time.
Usually expected, and what is not
Is this normal after ankle fixation?
Ankles are among the slowest joints to settle and swelling persists long past healing.
Usually expected
- Swelling at the end of the day for six months or more.
- A stiff ankle and a visibly thinner calf when the boot comes off.
- Aching in cold weather or before rain.
- Being able to feel the plate under the skin, particularly on the inner ankle.
Contact your surgeon or doctor
- Calf pain, swelling or tenderness, or breathlessness. Clot question, same day medical review.
- Wound discharge, spreading redness or fever.
- A new inability to weight bear after you had been managing.
- Numbness or a foot that drags.
If you have sudden severe pain with a hand or arm that is cold, white or losing sensation, or you are unwell with fever and a hot swollen wound, that is an emergency department today, not a therapy appointment.
If it is not going to plan
You are walking fine on the flat and still cannot manage a kerb
Flat ground hides almost everything. A kerb, a stair and a slope all demand dorsiflexion range and calf control that walking does not, which is why people are discharged walking normally and then find out what is missing at a bus stop.
Count your single leg heel raises on each side. If the injured side is well short of the other, that is the finding, and it changes with loading rather than with more walking.
The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what tissue does under graded work cannot be read in one visit. $690, nett, no GST.
The program
The four stages, and what moves you up
- Stage 1, Calm and Protect. Weight bearing exactly as your surgeon allowed, swelling controlled with elevation and compression, and hip and knee kept strong.
- Stage 2, Move and Mobilize. Ankle range in all directions, particularly dorsiflexion, and walking without aids. Criteria to move up are range in degrees and a symmetrical step.
- Stage 3, Rebuild and Strengthen. Calf loaded properly, single leg work, and balance. Heel raise count is the headline measurement here.
- Stage 4, Return and Perform. Stairs, slopes, uneven ground, and running or sport where that applies. Tested side to side.
Logistics
When can I…
Your surgeon decides, based on healing and what your job demands. These are typical points, not permissions.
What our patients say
Google reviews from our clinics in Singapore.
| Activity | Typical point | What has to be true first |
|---|---|---|
| Desk work | 2 weeks | Swelling controlled, leg up when you can, and a safe way to get to work. |
| Driving | 6 to 10 weeks | Left ankle in an automatic is often sooner. Right ankle usually waits until you are out of the boot and can brake hard. Check your insurer. |
| Walking without the boot | 6 to 10 weeks | Your surgeon clears full weight, and you walk without a limp. |
| Jogging | 3 to 4 months | Stage 3 criteria met, including calf strength against the other leg. |
| Running sport | 4 to 6 months or later | Stage 4 criteria met, and your surgeon’s clearance. |
| Medical certificate | Your doctor issues it | Physiotherapists do not issue MCs. We can write a report on your functional limits for your doctor or employer. |
What it costs
$230 per 45 minute appointment
One to one with your therapist for the whole 45 minutes. Nett, no GST. Same price for your first appointment and your last. Most of the appointments sit in Stages 2 and 3, from the point the boot comes off onwards. The Ankle Fracture Surgery Recovery Program is 12 appointments, $2,760 in all. You pay for each appointment as you attend it. If you need more, your therapist shows you which stage criteria are still open, and each extra appointment is $230.
This program runs Stages 1 to 4 of the Phoenix Recovery Protocol, and sits under physiotherapy after surgery alongside the rest of our recovery programs.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Timeframes on this page are typical ranges, not promises. Where your surgeon has given you a protocol, that protocol takes precedence over anything written here.
Where we are
Clinics across Singapore
SERANGOON
265 Serangoon Central Drive #04-269
S550265 · Lift C only
NE12CC13 Serangoon MRT
WhatsApp 8892 4121TANJONG PAGAR
10 Anson Road #02-77A
International Plaza, S079903
EW15 Tanjong Pagar MRT
WhatsApp 8227 7074JURONG EAST
2 Venture Drive #02-02
Vision Exchange, S608526
NS1EW24 Jurong East MRT
Opening 20 October 2026
WhatsApp 8242 7340