When Can I Drive After Foot or Ankle Surgery?

“When can I drive?” is one of the first practical questions after foot or ankle surgery, and it has a safety answer, not just a convenience one. The ankle is the main mover in braking, so an operation on the right foot or ankle can slow your reaction to an emergency in a way you may not notice until you need it.^[2] This article summarizes what research on brake response time has found and how to decide with your surgeon. For the wider picture of getting back to normal life, see recovery after foot and ankle surgery.

What the research shows

Researchers usually measure brake response time: how quickly a person can move from the accelerator to the brake and press it, on a device or in a simulator. A person passes when the time is comparable to that of healthy volunteers.

• A systematic review of 34 studies of return to driving after lower-limb surgery found average recommendations of 6.7 weeks for foot surgery, 6.7 weeks for Achilles surgery and 4 weeks for ankle surgery, compared with 4.1 weeks after hip surgery and 5.4 after knee surgery. The authors intended the numbers to help clinicians give informed advice, not to set a rule.^[3]
• After right Achilles repair, 91.5% of 59 patients had a passing brake response time at six weeks, all of them still walking in a boot with removable heel wedges. The five who did not pass had a slower average time, and the three who were retested at about seven weeks all passed. Braking normalized at about six to seven weeks.^[1]
• After right total ankle replacement, 92% of 59 patients passed at six weeks and everyone who completed the study passed by nine weeks. Those who had not passed at six weeks had more pain and less ankle motion.^[2]

Averages hide a lot. They come from particular operations, particular patients and particular tests. Your own timing depends on your operation, your pain, your motion and your strength.

“I feel ready” is not the same as “I’m safe”

A systematic review of return to driving after orthopedic surgery found that objective measures of braking response often returned to normal weeks after the operation. It also found that patients frequently start driving before those measures have normalized, and that factors such as strength, range of motion and opioid use also matter.^[4] In the Achilles study, a short driver-readiness questionnaire predicted a passing brake time 80% of the time it said someone was ready, which is useful but not proof.^[1]

Which foot was operated on?

The right foot is the one most cars use for braking, so surgery on it is the situation most of the research covers. If the operated foot is your left, and your car is an automatic, ask your surgeon whether that changes the answer; it can, but it is an individual call.

Driving with the left foot after right-sided surgery is common. In a survey of 96 patients after right foot surgery, 37% reported driving with the left foot. In a driving simulator, left-footed driving took longer to reach a full brake and to release the throttle, and the authors concluded that driving with either foot in this situation carries a safety risk.^[5] It is not a workaround to try without your surgeon’s advice.

Practical rules

• Do not drive while taking opioid pain medicine. Opioid use is one of the factors that affect driving safety after surgery.^[4]
• Do not drive in a boot or cast on the foot you use to brake.
• Be able to brake firmly and quickly in an emergency, without pain or hesitation, before you drive at all.
• Ask first. Your surgeon knows your operation, your bone healing and your protocol, and can tell you when to start.
• Tell us if you drive for work. It can change the plan.
• Plan for the gap. Arrange rides for the first weeks, including to appointments; see how to prepare for foot and ankle surgery.

Questions to ask your surgeon

• Which foot will be affected, and does my car change the answer?
• How long until I can drive, and what will you look at to decide?
• Does my pain medicine matter, and when can I stop it?
• Can I drive in a boot, a shoe or a brace on the operated foot, and if not, when?
• How will I know that I am ready?

Common questions

How soon can I drive after Achilles repair?

In one study of right Achilles repair, braking normalized at about six to seven weeks, and 54 of 59 people passed at six weeks. Ask your surgeon before driving.^[1] See Achilles rupture: surgery or no surgery?

How soon can I drive after total ankle replacement?

In one study, 92% of 59 people passed at six weeks and everyone who completed the study passed by nine weeks, and those who did not pass at six weeks had more pain and less motion.^[2] See ankle fusion vs. ankle replacement.

How soon can I drive after bunion surgery?

There is little bunion-specific data. Across studies of foot surgery, average recommendations were about 6.7 weeks, with wide variation.^[3] Your surgeon will decide based on the foot, the boot and your pain medicine. See the bunion surgery recovery timeline.

Can I drive with my left foot after right foot surgery?

It is common, but a simulator study found it slowed braking and throttle release, and the authors judged it a safety risk. Do not rely on it without your surgeon’s advice.^[5]

Does pain medicine matter?

Yes. Opioid use is one of the factors that affects driving safety after surgery.^[4]

The bottom line

Driving after foot or ankle surgery depends on the foot, the boot, the medicine and your brake response, and it usually starts weeks after surgery, not days. Use the research as a guide to what is typical, but ask your surgeon for the answer that fits you.