Table 1.

Postoperative rehabilitation protocol

Postoperative	Crutches; no weight bearing; elevate leg
	Walking boot and cold therapy
	Start home exercise program for stretching
1 week	Home exercises (stretches and range-of-motion exercises)
	Protected weight bearing as tolerated
	Wean to one crutch
2 weeks	Assess range-of-motion
	Start home exercise with resistance bands
	Start weaning out of boot over next 2–4 weeks to stirrup brace, depending on comfort
3 weeks	Normal gait in walking boot or brace
1 month	Increase in weight-bearing exercises
	Proprioception (eg, BAPS board) and gait training with brace and athletic shoe
	Resistance band exercises and stationary bike program
4–6 weeks	Progress from bike to elliptical trainer to stair climber
8–10 weeks	Running with brace
2 months	Strengthen entire lower extremity
	Sport-specific agility drills
3–6 months	Return to sport

Note: Reproduced with permission from Porter DA: Evaluation and Treatment of Ankle Syndesmosis Injuries, in Azar FM, O’Connor MI (eds): Instructional Course Lectures, volume 58. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2009.

Abbreviation: BAPS, biomechanical ankle platform system.