Paediatric Orthopaedic Specialist
After ankle cast
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
For whom: After cast removal and confirmation of healing: start only authorised movements. Loading, resistance and sport need fracture-specific instructions; avoid forced passive manoeuvres. Gradual daily activities are sufficient in many uncomplicated cases.
Dose and frequency: Perform only the exercises selected during the visit. The listed dosages are examples to adapt: follow the dose, frequency, rest and progression prescribed for age, symptoms and phase. Do not automatically perform the whole list.
Equipment and supervision: A stable, clear surface, comfortable clothing and a secure support. Check resistance-band anchors. Adult supervision; avoid marbles and small objects if the child may put them in their mouth, using a towel instead.
Avoid: Forcing a painful or unauthorised movement; Increasing load, resistance or frequency without the agreed rest periods; Doing balance exercises without stable support or supervision.
1.Ankle mobility recovery
Ankle will be stiff after immobilization
Seated, move the ankle in permitted directions, for example tracing small letters with the tip of the foot by moving the ankle, not just the toes. Resume walking gradually; running, jumping and sport require fracture-specific advice.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.
2.Pressing the foot down against a band (plantarflexion)
The illustration shows only pressing the foot down
Example of the plantarflexion anchor. Other directions must be demonstrated separately. After a fracture, begin only when the treating clinician has confirmed healing and authorised resistance.
Only after fracture healing is confirmed and resistance and range of motion are authorised: seated, place a light band around the forefoot as shown and slowly press the foot away from the body within the prescribed range. Do not use this illustration for other ankle directions, which need different instructions and anchors. Stop if pain, swelling or limping develops.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.
3.Progressive balance
Balance and awareness of foot position (proprioception), only after full weight bearing is authorised
Only after the treating team confirms fracture healing and permits this movement, loading and any resistance. Cast removal alone is not clearance for every exercise. After full weight bearing is authorised, begin on both feet near a stable support, then try single-leg stance on firm ground with eyes open. Put the other foot down before losing balance. Unstable surfaces or eyes-closed work require direct professional supervision.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- A red or hot joint, or inability to bear weight: seek prompt assessment; use emergency care if severe.
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Paediatric Orthopaedics - ASST Gaetano Pini-CTO
Content version: 24 September 2026
ortopediaevolutiva.com • Printed: 18/10/2026
Full exercise sheethttps://ortopediaevolutiva.com/en/parents-kids/exercises/post-cast/after-ankle-cast
Prepare the visit handout
Use the condition and phase indicated by your clinician. You can leave out individual exercises; instructions, illustrations and safety advice remain together.
Exclude exercises if needed
3 of 3 exercise cards included
The full web page remains available. Your selection is not saved or shared.
Before You Start
Who is this guide for?
After cast removal and confirmation of healing: start only authorised movements. Loading, resistance and sport need fracture-specific instructions; avoid forced passive manoeuvres. Gradual daily activities are sufficient in many uncomplicated cases.
What you need
A stable, clear surface, comfortable clothing and a secure support. Check resistance-band anchors. Adult supervision; avoid marbles and small objects if the child may put them in their mouth, using a towel instead.
Suggested frequency
Perform only the exercises selected during the visit. The listed dosages are examples to adapt: follow the dose, frequency, rest and progression prescribed for age, symptoms and phase. Do not automatically perform the whole list.
Common mistakes to avoid
- •Forcing a painful or unauthorised movement
- •Increasing load, resistance or frequency without the agreed rest periods
- •Doing balance exercises without stable support or supervision
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- A red or hot joint, or inability to bear weight: seek prompt assessment; use emergency care if severe.
Detailed Exercises
- 1
Ankle mobility recovery
Ankle will be stiff after immobilization
Seated, move the ankle in permitted directions, for example tracing small letters with the tip of the foot by moving the ankle, not just the toes. Resume walking gradually; running, jumping and sport require fracture-specific advice.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme. - 2
Pressing the foot down against a band (plantarflexion)
The illustration shows only pressing the foot down
Example of the plantarflexion anchor. Other directions must be demonstrated separately. After a fracture, begin only when the treating clinician has confirmed healing and authorised resistance.
Only after fracture healing is confirmed and resistance and range of motion are authorised: seated, place a light band around the forefoot as shown and slowly press the foot away from the body within the prescribed range. Do not use this illustration for other ankle directions, which need different instructions and anchors. Stop if pain, swelling or limping develops.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme. - 3
Progressive balance
Balance and awareness of foot position (proprioception), only after full weight bearing is authorised
Only after the treating team confirms fracture healing and permits this movement, loading and any resistance. Cast removal alone is not clearance for every exercise. After full weight bearing is authorised, begin on both feet near a stable support, then try single-leg stance on firm ground with eyes open. Put the other foot down before losing balance. Unstable surfaces or eyes-closed work require direct professional supervision.
Individual dose to complete with the clinician: repetitions or duration ___; sets ___; rest ___; times per day/week ___. Complete before using this sheet as an exercise programme.