After ankle ligament reconstruction, often called a Brostrom procedure, most people spend about 2 to 3 weeks off the foot, then a few weeks in a walking boot. By 8 to 10 weeks you are usually walking normally in a shoe with a brace.
Sport takes LONGER.
Straight-line jogging usually starts around 3 to 4 months, and a full return to cutting, jumping and pivoting sports often lands somewhere between 3 and 6 months.
Your surgeon decides when you can put weight on the foot and when the boot comes off. Some now allow walking in the boot within days. Others keep you off the foot for 2 to 3 weeks. Follow their protocol over any timeline here.
What the surgery does
Chronic ankle instability means the ankle keeps rolling or giving way long after a sprain. The ligaments on the outside of the ankle healed, but healed stretched and loose. Most people try a few months of balance and strength work first. Surgery comes in when the ankle still gives way despite that. See ankle sprain recovery.
- The Brostrom procedure tightens the stretched ligaments on the outside of the ankle and stitches them back to the bone, often reinforced with nearby tissue
- It uses your own tissue. If the ligament is too poor to repair, the surgeon may use a graft instead, and recovery tends to run a little slower
- It is often combined with an arthroscopy, a camera look inside the joint, to clean up cartilage damage or scar tissue
Week by week
- Weeks 0 to 2: splint, cast or boot, crutches, and the leg raised as much as possible. Most surgeons want little or no weight on the foot. Your team will talk to you about preventing blood clots. See blood clots after surgery
- Weeks 2 to 6: walking boot, with weight on the foot building up as your surgeon allows. Gentle up and down ankle movement usually starts here. Turning the sole of the foot INWARD is off limits, because that is the exact movement that stretches the repair. See weight bearing after surgery
- Weeks 6 to 10: out of the boot into a supportive shoe and an ankle brace. Physio ramps up: strength, balance and walking without a limp
- Months 3 to 4: jogging in straight lines once you can do a set of single-leg heel raises, hop without pain, and balance well on the operated leg
- Months 3 to 6: running drills, cutting, jumping and then full sport. Many surgeons want a brace or tape for sport for several months after you return
The surgery tightens the ligament. Balance training teaches the ankle to use it.
Why balance retraining matters so much
A sprain damages more than the ligament.
It also damages the tiny sensors in the ligament that tell your brain where the ankle is. That is a big part of why the ankle kept giving way in the first place, and surgery alone does not fix it.
- Start simple: standing on the operated leg on a firm floor, holding a counter if you need it, once your physio clears you
- Make it harder slowly: eyes closed, then a cushion or folded towel underfoot, then catching a ball or turning your head while you balance
- Add sport-like work last: hopping, landing and changing direction, first in straight lines and then side to side
- Keep going after you are back: a few minutes of balance work a few times a week is cheap insurance against another sprain
The American Academy of Orthopaedic Surgeons has a clear guide to ankle sprains and chronic instability, including when surgery is considered.
What’s normal
- Swelling at the end of the day for several months, even once you are walking normally
- Numbness or tingling on the outer side of the foot near the scar. A small skin nerve runs through this area. It often settles over months, though a small patch can stay numb
- A stiff ankle when the boot comes off, especially bending the foot up toward your shin
- Feeling nervous on uneven ground or stairs for the first few months. Confidence comes back as balance does
Will it give way again?
- Most repairs hold. Results are generally good, and in long-term follow-up only about 1 in 100 repairs needed another operation within about 8 years
- A new bad sprain can still tear it. The repair is strong, not bulletproof, which is why the brace and balance work matter in the first year of sport
- Not everyone gets back to their old level. Some people stop for reasons unrelated to the ankle. Others are held back by pain or stiffness, which is more likely when there was cartilage damage inside the joint as well
- Some things raise the risk: very loose joints throughout the body and higher body weight both make a repair more likely to stretch out. Ask your surgeon whether either applies to you
When can I…
- Drive: after a left ankle repair in an automatic car, sometimes within a couple of weeks. After a right ankle repair, not until you are out of the boot and can stamp on the brake without pain. Check with your insurer
- Go back to a desk job: often within the first few weeks, if you can keep the foot up and get there safely
- Go back to standing or manual work: usually not until you are out of the boot, and later for heavy or on-your-feet work
- Run: usually around 3 to 4 months, once your physio is happy with strength and balance
- Play sport: often between 3 and 6 months. Pivoting sports such as soccer, basketball and netball sit at the later end
Go to the emergency department if
- You have sudden pain or swelling in your calf or thigh
- You have chest pain or sudden shortness of breath
- Your toes look blue or white, or feel cold and numb
Call your surgeon today if
- The wound is red, swollen, hot or leaking
- You have a fever or feel unwell
- Pain keeps getting worse, or the cast feels too tight and raising the leg does not help
- You felt a pop or the ankle rolled badly and it now feels loose again
Mention it at your next review if
- The ankle still feels unstable when you walk on uneven ground after 3 months
- Numbness on the outer foot is spreading or burning
- Stiffness is stopping you walking normally several weeks after the boot comes off
The surgeon tightens the ligament. The balance work you do over the next six months decides whether it stays tight.