Q: I broke my ankle six weeks ago, and when they removed the cast, I could barely move my foot and ankle. Is this normal?
A: Yes, your experience is quite common. In fact, it’s more likely to happen than not. When joints are immobilized in a cast, the muscle fibers tend to shorten. Additionally, the injury to the bone and surrounding tissues can alter how the soft tissues function, further delaying the return to normal movement.
A common issue is the loss of dorsiflexion, where moving the toes up towards the face becomes difficult. This is known as a plantar flexion contracture. About three out of four people experience this type of contracture after the cast is removed. Surprisingly, 22% of those affected may still have a contracture even two years later.
Physiotherapists are actively researching the best treatment methods for this issue. Current findings suggest that exercise alone is sufficient, while adding stretching exercises doesn’t seem to offer additional benefits.
Reference: Anne M. Moseley, PhD, et al. Passive Stretching Does Not Enhance Outcomes in Patients with Plantarflexion Contracture after Cast Immobilization for Ankle Fracture: A Randomized Controlled Trial. In Archives of Physical Medicine and Rehabilitation, June 2005, Vol. 86, No. 6, Pp. 1118-1126.