When can I start physical therapy after a fracture?

As soon as your physician or surgeon clears you. Some patients begin once the boot comes off; others start gentle work earlier within protected limits. We follow your medical team’s protocol and weight-bearing instructions.

Do I need a referral?

In most cases, no — Oregon is a direct-access state. After a fracture, your physician will often refer you, but you can typically begin without one. Some plans require a referral; our front desk verifies before your visit.

Can physical therapy help foot or ankle arthritis?

Yes. While we can’t regrow cartilage, the right combination of motion work, strengthening, and load and footwear strategies can substantially reduce pain and keep you active — often delaying or avoiding the need for more invasive treatment.

What is blood flow restriction training and why use it after a fracture?

BFR uses a calibrated cuff to build real strength with very light loads. It is ideal early after a fracture, when the bone can’t yet handle heavy weight but the muscle is rapidly losing strength — letting us rebuild strength safely and sooner.

Is physical therapy covered by insurance?

Yes. We are in-network with most major plans including Regence/BCBS, Moda, PacificSource, Aetna, Cigna, United Healthcare, Medicare Part B, and Triwest/Tricare. Call 503-245-5710 to verify your plan.

Book online or call 503-245-5710 to schedule at our Cedar Mill, Tigard, or Milwaukie clinic.

Foot & Ankle Fracture and Arthritis Rehab in Portland

Key takeaways

After a fracture, the time in a cast or boot leaves the foot and ankle stiff, weak, and swollen — and rehab is what restores normal function.
Foot and ankle arthritis causes stiffness and pain as joint surfaces wear, and the right exercise and movement strategy can reduce pain and keep you active.
Physical therapy rebuilds motion, strength, balance, and a normal walking pattern, often using blood flow restriction (BFR) early when heavy load is not yet allowed.
For fractures, we follow your physician’s or surgeon’s timeline and start as soon as you are cleared to bear weight.
We see patients at Cedar Mill, Tigard, and Milwaukie, and coordinate directly with your medical team.

Overview

What are foot and ankle fractures?

A foot or ankle fracture is a break in one of the bones that bear your weight with every step. Whether it is treated in a cast, a boot, or surgically, the bone needs time protected from load to heal — and that protected time, while necessary, leaves the foot and ankle stiff, weak, swollen, and hesitant to bear weight. The fracture heals the bone; rehabilitation restores the function.

Foot and ankle arthritis is a different but related problem: the smooth cartilage on the joint surfaces wears down, leaving stiffness, pain, and reduced motion. It can follow an old injury (post-traumatic arthritis) or develop with age. While the cartilage itself does not regrow, the right movement, strengthening, and load strategies can substantially reduce pain and keep you moving.

At Creekside Physical Therapy, we rebuild what immobilization and joint wear take away. After a fracture, we follow your physician’s protocol and progress you safely from protected weight-bearing to confident walking and full activity — often using blood flow restriction training early to rebuild strength before the bone can handle heavy load. For arthritis, we build a program that improves motion and strength and reduces pain. You work one-on-one with the same therapist throughout, and we communicate directly with your medical team.

Anatomy

The foot and ankle contain 26 bones and dozens of joints that share your body weight with every step. The ankle joint provides up-and-down motion; the joints below it allow the foot to adapt to the ground; and the many small joints of the midfoot and forefoot let the foot absorb shock and push off. A fracture or arthritis in any of these disrupts the chain — and because the foot is the foundation, the knee, hip, and back above it often compensate, which is why restoring normal foot and ankle mechanics matters for the whole body.

Symptoms

What it feels like

After a fracture or with foot and ankle arthritis, common issues we rehabilitate include:

Stiffness and loss of motion in the ankle or foot after time in a cast or boot
Weakness in the calf, foot, and ankle from disuse
Lingering swelling around the foot and ankle
A limp or guarded, hesitant walking pattern
Pain and stiffness with the first steps or after sitting (common in arthritis)
Difficulty with stairs, uneven ground, or standing for long periods
Reduced balance and confidence on the affected foot

Causes & risk factors

Why it develops

The challenges we treat in this area arise from a few sources:

Healing time in a cast or boot, which unavoidably causes stiffness and muscle loss
Swelling and protective guarding after the injury or surgery
Worn joint cartilage from an old injury (post-traumatic arthritis) or age
Altered walking mechanics adopted to avoid pain
Loss of balance and proprioception during immobilization
Deconditioning of the whole leg during a period of reduced activity
Returning to activity before strength and motion are restored

Diagnosis

How we evaluate a foot or ankle fracture

Your first visit is a one-on-one physical therapy evaluation. For a fracture, your therapist reviews your physician’s or surgeon’s protocol and your weight-bearing status, then assesses motion, strength, swelling, balance, and your walking pattern within the allowed limits. For arthritis, we assess joint mobility, strength, and how the foot loads and walks. We do not perform imaging — your fracture diagnosis and clearance come from your medical team, and we build the rehab plan from there. You leave with a clear roadmap of what each phase of recovery looks like.

Treatment

How physical therapy treats it

Rehabilitation after a fracture, and for foot and ankle arthritis, is built around restoring motion, strength, and confident movement. Your one-on-one plan typically includes:

Protocol-guided progression that follows your physician’s or surgeon’s timeline after a fracture
Manual therapy and range-of-motion work to recover the stiffness lost to immobilization or arthritis
Swelling management to help the foot and ankle settle
Progressive strengthening of the calf, foot, and ankle, advanced as healing allows
Blood flow restriction (BFR) training to rebuild strength early when heavy loading is not yet permitted
Balance and gait retraining to restore a normal, confident walking pattern
Activity- and footwear guidance, plus pain-relief strategies for arthritic joints
A structured home exercise program to keep progress moving between visits and maintain gains

When to act

When to seek care

You have been cleared by your physician to begin weight-bearing or rehab after a fracture
Persistent stiffness, weakness, or a limp weeks after coming out of a cast or boot
Foot or ankle arthritis pain that is limiting your walking, work, or activity
Loss of balance or confidence on the affected foot
New or worsening pain, redness, or swelling during recovery — check in with your physician first

Your care team

Fracture rehabilitation and foot and ankle arthritis are treated by Creekside’s physical therapists at all three clinics, and we coordinate directly with your physician or surgeon throughout your recovery. For post-surgical fracture cases, we follow your surgeon’s protocol and communicate progress with their office so your rehab and surgical plan stay aligned.

FAQ

Frequently asked questions

Related conditions

Ready when you are

A healed fracture isn't the finish line — getting your motion, strength, and confident walking back is. Book online or call 503-245-5710, and we'll guide you from the boot all the way back to full activity.

503-245-5710