Anklepump is the English name of this exercise, which sounds a bit strange because it is directly translated from the English name, Ankle is the ankle, ankle joint, commonly known as the ankle; pump means pump. Simply put, it means that through the movement of the ankle joint, it acts like a pump to promote blood circulation and lymphatic flow in the lower limbs. This is essential for recovery after surgery! This article focuses on ankle pump exercises for patients to understand, learn and refer to in order to help them recover well after surgery. The circulation in the distal part of the limb is worse after swelling, fresh blood containing nutrients does not flow through, and blood with local inflammatory substances and metabolites does not flow back, so the inflammation subsides slowly and the tissue growth and repair does not get sufficient nutrition; it also aggravates the pain because of the pressure on the tissues from swelling; at the same time, because of the braking after surgery, the blood flow slows down and platelets stay and collect in the periphery of the blood vessels. It is easy to form thrombus, and early thrombus is movable, in case the thrombus is unfortunately dislodged and blocked in the lungs, heart, or brain …… Well, I won’t continue to talk about these horrible to add to the psychological burden, but let’s get back to the topic of ankle pump. Since the swelling of the lower limbs is so harmful, it is natural to find ways to combat it. There is an apparatus that generates pressure by inflating to promote circulation in the lower extremities outside the body. It is like a pair of thick cotton pants, and after it is placed on the leg, the apparatus will automatically inflate in sequence, first the foot, then the calf, then the knee, then the thigh, then deflate, and then inflate again to apply pressure from the beginning. This is equivalent to gentle compression from the bottom to the top outside the body to help blood and lymphatic return to the distal end. But this method has many limitations. First, it is a passive exercise, the muscles of the lower extremities are not active, and the effect of promoting circulation is much less. And because the muscles are only squeezed, it will not enhance muscle strength. It is well known that muscle activity can squeeze blood flow back, and there are more than 500 capillaries in every square millimeter of cross-sectional area of muscle. Also, if the pain is very intense, it should not be used, because the inflatable compression is gentle again is constantly stimulating and will increase the pain. In addition, if the leg is immobilized in a cast or splint, or if it is not easy to move, it is completely unusable. In order to better promote circulation and help reduce the swelling of the lower limbs, but also to be able to move the muscles of the calf and try to avoid muscle atrophy, it is necessary to carry out the aforementioned “ankle pump” exercises. This exercise looks very simple, that is, active flexion and extension of the ankle joint. That is, lying or sitting on the bed without moving, thighs relaxed, and then slowly, but forcefully, within the limits of no pain or only a slight pain, as much as possible angle hook the toe (hook the foot upward, so that the toe towards themselves) and then step down (so that the toe down), pay attention to the maximum position to maintain about 10 seconds, the purpose is to allow the muscle to continue to contract. Just repeatedly flex and extend the ankle joint, preferably for 5 minutes every hour. Note: The cushion under the calf is to show the ankle movement better when taking pictures, and the actual exercise can be done directly on the ankle, no need to pad anything. When we flex and extend the ankle joint, the muscles of the calf will contract and relax. Plantar flexion (toe down) when the calf triceps contraction becomes shorter, the tibialis anterior muscle relaxed and elongated; back extension (upward hook toe) when the tibialis anterior muscle contraction becomes shorter, the calf triceps relaxed and elongated (the relevant content is written in the “movement of the muscles needed for each joint” inside). These two groups of corresponding muscles are like pumps that squeeze blood and lymphatic fluid back in when they contract, and fresh blood flows in again when they relax. In this way, the whole leg does not have to move, just flex and extend the ankle to promote the circulation of the entire lower limb. It has also been suggested that the ankle joint can be not only flexed and extended, but also looped, as this moves more muscles. This means that a combination of plantarflexion, pronation, dorsiflexion, and valgus exercises is better than ankle pump exercises alone in terms of increasing the peak velocity of blood flow in the femoral vein. However, the actual exercise may affect the amplitude of the flexion and extension movements due to the wrap-around motion or may cause significant pain. So if you want, you can increase the circumferential movements, but if you are not strong or feel increased pain, you can achieve the result by only doing the flexion and extension movements. These are the principles, functions, and methods of the “ankle pump” exercise. This exercise may seem simple, but it can be very useful in preventing and helping to reduce swelling in the lower extremities after injury or surgery. The best part is that it is very safe because the amount of movement is minimal and the body and legs do not have to move, only the ankle. With the exception of surgery on the ankle itself, you can safely and boldly start practicing once the anesthesia for the surgery subsides, whether it is a fracture of the lower extremity, joint replacement (including hip and knee), or surgery on a muscle or ligament tendon, as long as the foot is not immobilized in a cast or the like. Of course, if the pain is obvious, you can first reduce the time and frequency of exercises, or use a small amount of force to adapt, and then gradually increase the intensity.