For the Health of It: Ankle and foot reconstruction PT

Tyler Ryan and Hima Dalal discuss considerations after ankle and foot procedures

After foot fracture repair, ankle ligament reconstruction, and tibialis anterior + arch
reconstruction, complications may occur because the area is biomechanically complex and
healing demands are high.
Common Causes of Post-Surgical Complications
1. Incomplete Healing of Tissues
● Tendons, ligaments, and bone heal at different speeds.
● A tendon repair can still be vulnerable months later.
● Too much early load may irritate healing tissues.
2. Swelling & Lymphedema
● Post-operative fluid buildup reduces oxygenation to tissues.
● Persistent edema can delay tendon glide, stiffen ligaments, and weaken muscles.
3. Immobility & Poor Posture During Recovery
● Using crutches, boots, or limping alters posture.
● Compensation patterns can overload hips, back, or the uninjured leg.
● Poor alignment slows recovery of the arch and ankle mechanics.
4. Scar Tissue & Fascial Restrictions
● After reconstruction, the body produces protective scar tissue.
● Excessive adhesions may limit ankle mobility, tendon glide, and arch activation.
5. Weakness of Intrinsic Foot & Core Muscles
● Arch reconstruction requires intrinsic muscle retraining.
● Weak foot core → imbalance in load → pain and slowed healing.
6. Altered Gait Mechanics
● Limping, avoiding weight, or rotating the foot changes alignment.
● These compensations lead to secondary knee, hip, or back issues.

7. Insufficient Proprioception & Balance
● Ligaments contain mechanoreceptors that guide balance.
● After repair, these systems need retraining to prevent reinjury.

�� How Integrative OT (Including Him
Dalal’s Approach) Helps Recovery
Hima Dalal’s integrative OT philosophy combines neuromuscular re-education, somatic
awareness, manual therapy, mind-body techniques, functional training, and lifestyle
modification to support whole-person recovery.
Key Components & Benefits
1. Whole-Body Postural Alignment
● Addresses compensatory patterns from boot use, crutch gait, or pain guarding.
● Corrects pelvic tilt, hip shift, and pronation/supination imbalances.
● Enhances efficiency of movement → reduces strain on repaired structures.
2. Lymphedema & Edema Management
● Manual lymphatic drainage
● Compression strategies
● Breathwork to stimulate lymphatic pump
● Gentle muscle activation to move fluid
Benefits → reduced swelling, improved ROM, decreased pain.
3. CMFR (Crystal Myofascial Release)technique invented by Hima Dalal
● Works on deep fascia, scar tissue, and restrictions around the ankle and arch.
● Improves glide of repaired tendons and ligaments.
● Restores natural foot mechanics and reduces compensatory tightness in calves, tibialis
posterior, peroneals, and plantar fascia.
4. Neuromuscular Re-Education
● Retrains the connection between brain → foot → ankle.
● Essential after ligament reconstruction and tendon repair.
● Helps restore balance, proprioception, and correct gait patterns.

5. Integrative Strengthening for Arch & Ankle
● Intrinsic foot activation
● Short-foot / doming exercises
● Controlled mobility of midfoot
● Progressive TA strengthening
Improves load distribution and long-term stability.
6. Pain Modulation Techniques
● Gentle manual work
● Breath-movement coordination
● Somatic calming methods
● Mindfulness to reduce tension guarding
Supports nervous system regulation and faster recovery.
7. Functional Training & Lifestyle Integration
● Safe return to walking, standing, stairs, and daily activities
● Shoe and orthotic guidance
● Guidance for pacing to avoid overuse

✨ Health Benefits of an Integrative Post-
Surgical Rehab Program
● Faster reduction of swelling & pain
● Improved scar mobility and tissue healing
● Restored balance & proprioception
● Better posture and full-body alignment
● Prevention of chronic compensatory pain
● Enhanced arch stability and ankle strength
● Lower risk of reinjury
● Improved mobility, gait, and long-term function
● Supports mental well-being and reduces stress around recovery
For further questions contact
Himadalalintegrativehealth@gmail.com
Or visit
www.Himadalalintegrativehealth.com