Fitness - FITNESS GUIDANCE : Ankle exercices
We explain ankle exercises for rehabilitation of specific injuries as well as mobility, strengthening, prioprioception (balance) and functional or sports specific exercises.
Injury specific exercises
If you are looking for exercises for a specific ankle injury:
- Ankle sprain
- Achilles tendonitis
- Tibialis posterior tendinopathy
- Calf strain
- Foot strengthening exercises
The aim of mobility exercises is to restore range of motion without putting any damaged tissues under stress. The exact exercises and how quickly you progress through will depend on the type and severity of injury. If you have had an ankle sprain then avoiding lateral or sideways movements may be important in the early stages.
Active ankle mobility
Active mobility exercises where the athlete physically moves the joint through a range of motion are often done early on. They will help to increase movement at the joint and also pumping the ankle up and down will help reduce swelling. Exercises can be performed seated or standing. If an ankle sprain has occurred then only up and down movements should be done initially, protecting the lateral ligaments at the side. As it heals, sideways mobility and writing the alphabet with the toes may also be performed.
Active ankle eversion
Ankle eversion is the movement of turning the sole of the foot outwards and is controlled by the peroneal muscles on the outer calf. The athlete starts in a side lying position with the ankle to be worked on top. Start in inversion (with the ankle turned in) and move the foot upwards, turning the sole of the foot out. Slowly return to the starting position under control.
Balance board & proprioception exercises
Proprioception is our sense and awareness of the position of our body parts and is closely linked to balance. Having good proprioception helps to reduce the risk of injury. The following exercises improve the co-ordination of the joint which is usually damaged with a lower leg injury, especially ankle sprains, helping to prevent recurring injuries.
Wobble balance board exercises
Wobble boards are excellent for ankle proprioception and strength training post injury as well part of your normal training routine to help prevent ankle sprains. A range of different exercises can be performed from simple mobility circles up to eyes closed one legged squats. See our top 10 wobble board exercises...
Heel toe balance
The heel toe balance exercise, sometimes called a tandem stance is designed to start to work on proprioception and balance. This is a good build-up to wobble board work. The patient stands with the involved foot immediately behind the other foot, with the toes touching the front heel as shown. This position should be held for 30 seconds without losing balance.
Once this is accomplished the athlete closes their eyes to increase the difficulty. The next step is to balance on an unstable surface such as a trampette, wobble cushion or half foam roller.
Medicine ball catch
The medicine ball catch exercise is designed to challenge the single leg balance with an unknown. This develops proprioception after lower limb injuries. Start off standing on a single leg. Get a partner or therapist to throw a ball towards you so you can catch it. Maintain your balance throughout. Start with gentle throws directly towards your body. As you improve try slightly harder throws or throws slightly off to the side or overhead. A further challenge is to do the same exercise whilst balancing on a wobble board.
Early strengthening exercises
Strengthening exercises can begin as soon as pain allows. The aim is to gradually increase the load through the tissues. We have categorized strengthening exercises into early stage, mid stage and later stage.
Isometric inversion and eversion
This exercise is used to begin to strengthen the ankle invertors (tibialis posterior) and evertors (peroneals) in the early stages of treatment. To strengthen the invertors, the athlete pushes the inside of the foot against a table or chair leg, trying to turn the foot inwards against resistance. To strengthen the evertors, the athlete pushes the outside of the foot against a table or chair leg, trying to turn the foot outwards. This exercise can also be performed with a therapist providing
Plantar flexion with band
Plantar flexion is the ankle movement of moving the foot down, pointing the toes away from the body. Using a resistance band is an early stage exercise for calf strengthening. The band is wrapped around the forefoot with the ends held in both hands. Starting with the toes pointing up, the athlete pushes the foot down against the resistance of the band. This can be done with a bent knee to target the Soleus muscle more than Gastrocnemius.
Dorsi flexion with band
Dorsiflexion is the movement of pulling the foot upwards. Using a resistance band to perform this movement will strengthen the shin muscles. The band is wrapped around the forefoot and anchored to a fixed point in front of the foot. The athlete starts with the foot pointed away and dorsiflexes or pulls the foot up so the toes point to the ceiling. Return to the starting position slowly and under complete control.
Or foot raise exercises work the shin muscles at the front of the lower leg. This is an early stage exercise which can be progressed using a resistance band. To strengthen the shin muscles the athlete raises the toes and forefoot up off the floor. Initially this should be seated, before performing in a standing position and then on an incline with the toes lower than the heels. When standing, ensure you have something to hold onto for balance purposes.
Posterior tibialis exercise
The posterior tibialis exercise targets this muscle specifically by combining the two movements which it performs. This muscle may need strengthening to help reduce overpronation. The band is looped around the forefoot of the exercising leg with the other leg crossed over the top. The athlete simultaneously pushes the foot down and turns the sole of the foot in against the resistance. The combination of plantarflexion and inversion works the Tibialis Posterior.
Mid stage ankle exercises
These ankle exercises are usually done when the athlete can walk pain free although this will depend on the type of injury and how bad it is. Follow the advice of your specialist practitioner.
Seated calf raise
The seated calf raise exercise is used to strengthen the calf muscles, especially Soleus. It is an early stage exercise which can be progressed to standing once this is pain free. To strengthen the Soleus muscle, the athlete performs a heel raise in a seated position. Bending the knee relaxes the overlying Gastrocnemius. A bar weight can be added to the thighs to increase difficulty. Ensure the downward phase is performed slowly and under complete control.
Calf raise on a step
The calf raise is a widely used exercise to strengthen the calf muscles. There are many variations and resistance machines are also available. Start on a step with only the forefoot on the step, the heels off the back. Rise up onto the toes and then slowly back down. To make this harder it can be performed with a weight in each hand, barbell over the shoulders or on a single leg.
Eccentric heel drop
The eccentric heel drop places the emphasis of the movement on the downward phase so that the calf muscles must contract as they lengthen to control dorsiflexion. Start on a step with the heels off the back so only the forefoot is on the step. Stand on one leg on tip toes with the knee straight and slowly lower the heel down below the level of the step. Place the other forefoot on the step and use both legs evenly to lift back up to the toes. Go back onto one leg and repeat.
Resistance band inversion
Also known as pronation is the movement of turning the foot so that the sole faces inwards. A resistance band is great for this exercise and other ankle exercises. A resistance band is wrapped around the forefoot and anchored to a table leg or held by a partner. This exercises works the ankle inverter muscles as the athlete turns the foot in against the resistance of the band. Start with the foot fully everted (sole turned outwards) and the band just taught so that resistance is felt throughout the whole movement.
Resisted eccentric inversion
Is a great exercise for using after ankle sprains to help reduce the chance of future injuries. A therapist or partner is required to move the ankle. The patient is seated with the legs out straight. The therapist starts to move the ankle into inversion (so the sole faces inwards). The patient then tries to control and slow this motion.
Heel toe walking
Is a great exercise for the ankle and calf muscles. It will strengthen all muscles of the lower leg, as well as help improve proprioception or balance. Walk slowly across the floor. Start with a heel strike and once you get to the forefoot push-off, come up onto the toes. Swing the other leg forward and heel strike with the next foot to continue.
Ankle eversion with band
Ankle eversion is also sometimes known as supination and is the movement of turning the foot so the sole faces outwards (away from the other foot). A resistance band is very useful for ankle exercises. The athlete sits on the floor as shown with the band wrapped around the foot to be worked. The other end of the band is attached to something sturdy on the other side of the body. The starting position is with the foot in inversion (sole turned in to face the other foot). At this point the band should just be taught to ensure resistance throughout the whole movement. Turn the foot outwards as far as is comfortable before slowly returning to the starting position.
Late stage / Sports specific & functional
These are more advanced exercises related more to day to day activities (functional exercises) or sports specific exercises designed to bridge the gap between rehabilitation and returning to full training or competition. Agility drills involving acceleration and change of direction may be developed depending on your sport.
Box jumps are a form of advanced exercises called plyometrics. They strengthen the entire leg ready for powerful, explosive movements and also aid proprioception development. Numerous exercises can be created using a box or step to jump over. To start the athlete may jump sideways over the box, moving rapidly from one foot on one side, to the other foot on the other side. This may also be performed front to back. A further progression is high jumps over the box, firstly landing on two feet and progressing to one.
Are important in late stage rehabilitation in lots of sports. They help to improve balance, proprioception and explosive strength. Many variations on hopping exercises are available. Start with a small hop on the spot and gradually increase the height jumped. Try hopping to the front, to the side and backwards. Try hopping from one leg and landing on the other. Equipment such as hoops, agility ladders and minim hurdles can all be used to add further challenge.
Resistance band jumps
The resistance band jump exercise is a great late stage proprioception test! Hops and jumps can be used in the early stages but using the band adds an extra challenge. A resistance band is wrapped around the waist and anchored or held behind the athlete. They then perform side to side or forwards and backward jumps. The resistance from the band provides a challenge to the balance.
Step back exercises can be used as late stage ankle exercises to increase push-off strength, but will also work the hip and bum muscles. Take one leg backwards, touch the foot on the floor and push off with the forefoot to move it back onto the step. Alternate legs. This can be increased indifficulty by performing on a higher step or at a faster speed.
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