Out of all the injuries and impairments reported by individuals, ankle injuries and pain are one of the most common – for those who exercise and for those who don’t! The ankle is most susceptible to injury due to its location as the support for our legs but also due to how easily it can be incorrectly positioned due to postural or form issues while exercising. When ankle injuries do occur, people generally keep off of the ankle in order to avoid the pain of using that area. However, beyond the inflammation phase of these injuries, it has been shown to be more beneficial to resume exercise slowly. Individuals who do not resume exercise following these sprains of the ankle have been shown to have an increased chance of developing chronic ankle instability – a condition that may require surgery to alleviate its painful symptoms and lack of support (4). Therefore, we really want to push the information presented in this article. There are many people who have been scared to continue exercising when presented with an injury, especially of the ankle. Yet, it is that hesitation to exercise again that increases the risk of more weakness and more pain down the road.

If you are suffering from chronic ankle weakness, pain, or injury, check out the following exercise and fitness tips to improve strength and mobility.

Functional Support (1)

When it comes to ankles that are freshly injured or perhaps more unstable with daily activity, studies have shown that functional support, rather than immobilization, is the best option. Functional support can include elastic bandages or a hinged brace, which allows the ankle to have more mobility, giving it the chance to gain strength. Wearing a functional support device during the first week or as medically instructed following an injury or the beginning of a new exercise program can help prevent immediate injury and provide more stability to the ankle. You can also wear these functional supports in and outside of exercise, in order to help with movement during daily activities. Make sure to only use these functional supports for about a week for minor issues, as a functional support used long term can inhibit the development of mobility and range of motion in the ankle.

Balance Training

One of the most beneficial activities to partake in following ankle injury or instability is performing regular balance training exercises. Balance training can overall reduce the risk of more sprains in the area (1). Balance training also normalizes neuromuscular control, helping the ankle resume a normal movement pattern unconsciously (2).

One example of a balance exercise is a single back leg lift (3). Hold a chair with both hands in front of you and lift a leg back behind you one at a time and then back to the ground. It is important to perform some of these balance exercises with eyes open AND eyes closed, in order to help train the brain to unconsciously memorize these movements and reeducate the joint receptors (5).

Strength, Flexibility, and Range of Motion Training

Regardless of how you may feel following an ankle injury, individuals can actually begin working out within 3 days of a minor injury (5). Physical therapy can be a major help to accelerate healing and develop strength and flexibility in the area again. Manual therapeutic practices provide physiological benefits to those with injured or weak ankles (1). There are several studies that show the benefit of exercise therapy in treating ailments of the ankles (2). Exercise in general will not only strengthen the ankle and leg, but also work to prevent subsequent injuries and weakness from occurring.

The following are some simple exercises used to get you started with improving range of motion, flexibility, and light strength to injured and weak ankles:

Ankle circles: Sit on a chair and cross the exercise leg to rest on top of the knee of the other. Your foot should be hanging off the opposite knee sideways. Slowly and gently perform circles in the air with the ankle. Repeat on the opposite leg.

Drawing/Writing with Ankle: With your ankle/foot in the air, work on drawing or writing the alphabet with your foot. Use your big toe as a “cursor” for guidance (3). You can perform this first seated and then advance to standing balancing on one leg while performing this exercise with the other.

Towel toe curls: Sit in a chair and have your feet flat on the ground. Put a towel flat on the ground under one or both of your feet. Grip the towel with your toes, squeezing/curling your toes under your feet in the process, and then release the towel.

Band ankle pushes: Sit on the ground and have your leg extended outward in front of you. Put an exercise band looped around the ball of your foot while upright. Hold the band with your hands. Push your foot into the band in a forward direction (as if you are pointing your toes away from you), then use your ankle to gently return your foot backwards in a bend toward yourself. Repeat this many times until you feel a comfortable fatigue.

Heel raises: While standing, lift your heels off of the ground and then back down. It is recommended to use a chair or other solid object nearby for stability (3). Perform this standing on both legs when first getting acclimated to this exercise. You can advance to performing standing on one leg after successfully completing multiple sessions with ease on both feet.

Calf stretches: Sit on the ground with both legs straight and outward in front of you. Take a towel or a no stretch strap and wrap around the ball of your feet. Pull the strap toward yourself, until feeling the stretch in your calf muscles. Release after holding for 30 seconds. If you are able to, you can also simply use your hands around the ball of your feet and hold the stretch. This should be performed at the end of your exercise routine or on a rest day.

Cardio

The last thing anyone wants to do with a weak or injured ankle is cardio. I know, the idea of running on your bad leg is giving you the shivers! However, there are perfectly safe cardio workouts to do that do not add any pressure or pain to your ankle. Here are a few options:

Swimming: The water has a ton of buoyancy, helping you become weightless in a body of it. Due to the weightlessness, you are putting no pressure or weight onto your weak/injured ankle. You can easily swim and perform aquatic exercises without any pain to the region. Additionally, water has a wonderful degree of resistance – providing a mild strength training effect to any workout performed in a pool.

Biking: A regular stroll around the park on a bicycle may be a bit too much at first following a major weakness or injury to the ankle. However, a recumbent bike is a great alternative for this. The way a recumbent bike sits, which is much lower and leaned back than a regular bicycle, works to alleviate a lot of strain on the legs and ankles, and more pressure onto your glutes and core. Consider purchasing a recumbent bike or using a recumbent bike at the gym in order to get in a great cardio workout without any of the pain.

Conclusion

The ankle is a complex joint in our body – as it connects to so many other important structures needed for daily functioning and activities. If you experience ankle weakness, instability, injury, or pain, it is important to treat the ankle as the complex unit that it is. Functional support, balance, strength, flexibility, and range of motion are all key factors in helping the ankle resume normal mobility free of pain and weakness.

By Ashley Gresko

Blog Editing Consultant for Health Industry Designs

References

1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103112/

2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164373/

3) https://www.medicalnewstoday.com/articles/sprained-ankle-exercises#range-of-motion

4) https://online.boneandjoint.org.uk/doi/full/10.1302/2058-5241.1.000010

5)https://www.healthline.com/health/sprained-ankle-exercises#overview