The main thing that you deal with when a body part gets out of a cast is muscle atrophy. This is when the muscle decreases in size and strength due to inactivity. There is also usually increased stiffness of the ankle due to the prolonged time in the cast. Initially, activities should attempt to increase range of motion and decrease pain. Activities that can assist in increasing range of motion are performing ankle pumps, moving the forefoot upward and downward in a pain-free range, performing circles in both the clockwise and counterclockwise directions with the forefoot, and using the forefoot to draw all the letters of the alphabet in upper and lower case.
Once range of motion has increased, exercises can be used to increase strength. Movements of the foot in multiple directions can be used to strengthen by wrapping resistance bands around the forefoot and pulling in the opposite direction. Performing calf raises by standing and pushing up onto the toes is also a good strengthening exercise. It is also important to increase balance. This can be accomplished by standing on the injured leg. To make the exercise more difficult, an unstable surface such as foam padding can be used or you can shut your eyes while balancing.
It is always a good idea to see a physician for proper follow-up evaluation. The physician may refer you to an appropriate healthcare provider, such as an athletic trainer, to assist you with a progressive rehabilitation program.
(This answer provided for NATA by the King College Athletic Training Education Program.)