Exercises for Ankle & Foot Injuries
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Causes - Common Injuries - Exercises & Stretches
Injuries to the ankle and foot can be particularly debilitating as they are essential to everyday movement from place to place.
In addition, as the foot represents the body’s first point of contact with the ground, an inability to buffer forces going through the foot can have a negative knock-on effect upwards towards the knee, hip, and lower back.
Pain in the lower back and knees can often be attributed to previous (or chronic) ankle injuries due to faulty biomechanics of the ankle.
Most ankle injuries in sport are caused by direct trauma to the area, often causing the ankle to twist or turn while bearing weight on top. There are also common injuries to the ankle and foot that are caused by repetitive stress to the joints, muscles, ligaments, and tendons.
Ankle Inversion Sprain (Anterior Talo-Fibular Ligament Sprain)
The most common ankle injury is the inversion sprain, in which the foot goes in a direction where the toes are pointed away and towards the midline of the body, while the body moves laterally.
This puts a lot of stress and tension on the outside of the foot and ankle, which can rupture or tear the anterior talo-fibular ligament (ATFL) that normally functions to resist forces in this direction.
In the worst case scenario, there could be a fracture of the base of the 5th toe bone, which would warrant a trip to the hospital and immobilization of the ankle. If there is no fracture and weight bearing is not extremely painful, it is recommended to utilize the PRICE protocol:
P - Protect the area from further injury
R - Relative rest from painful activities/sports
I - Ice for 24-48 hours post injury
C - Compress the area
E - Elevate the foot and ankle.
Tibialis Posterior Tendonitis
The tibialis posterior is a muscle that lays on the inside (medial) part of your lower leg and ankle.
Its tendon wraps around the inner ankle and is one of the muscles that creates and reinforces the arch of the foot. With people that have fallen collapsed arches (flat feet), or repetitive chronic ankle sprains, it is quite common to develop tendonitis of the tibialis posterior with weakness to the muscle and activities that are overloading.
Typically people with this condition feel pain and tenderness along the inner ankle bone and/or soreness on the bottom of the medial arch of the foot. Strengthening of the tibialis posterior, the arch muscles, and correcting faulty biomechanics can help this condition over time.
Plantar Fasciitis
Plantar fasciitis is an overuse injury that is created by swelling and inflammation of the fascia typically after a sudden increase in activity, frequency, and or duration.
The plantar fascia is extremely dense connective tissue (fascia) at the base of the foot - that part that connects the heel to the ball of the foot.
As an example, consider a runner that normally goes for 5km runs twice a week. However, the runner has an upcoming race and suddenly increases their running to 10km five times a week. In this scenario, the plantar fascia on the bottom of the foot does not have time to adapt to the new demands and load that is placed on it, and therefore becomes inflamed and painful.
One of the most common symptoms (and a tell-tale sign) of plantar fasciitis is feeling pain first thing in the morning when walking, which usually gets better after 10-15 minutes.
The most important factor in getting rid of this condition is to remove the aggravating activity and strengthen the muscles of the foot, ankle and calf that support it.
The isometric bent-knee calf raise specifically strengthens the soleus muscle, which is the deepest of the calf muscle (sitting right on top of the bone). It is the most powerful plantar flexor muscle, which is important for any sport where hopping, running, or jumping is involved. It also acts as a stabilizer of the foot and ankle, especially in the push-off position of the foot and landing positions.
Exercise instructions: (template)
On one leg, bend the affected leg slightly at the knee.
Lift the heel straight up by pushing through the big toe.
Try and raise the heel as high as possible and hold.
Hold for 10s-30s and slowly lower back to the ground.
Tips on technique:
Try to bend the knee at about 10-30 degrees.
Suggested workout:
3 sets x 10s-30s or until fatigued.
After an ankle sprain, balance is affected as the receptors of the ankle joint decrease in activity.
Ankle kettlebell passes are an excellent way to improve balance/proprioception and lower body stability. This exercise works on improving balance in the front plane (side-to-side), which is often neglected in ankle rehab programs.
Standing on one leg and leaning forwards also activates the gluteus medius muscle which helps to stabilize the hip joint. To make this exercise more difficult, you can increase the weight you are holding or widen the distance that the weight moves side-to-side.
Exercise instructions: (template)
Stand on one foot, leaning forwards at the hip.
Pass the kettlebell between the left and right hands in a slow and controlled manner.
Tips on technique:
Try to stay in one position, without your body swaying from side to side.
For more difficulty, increase the length of pass or increase the kettlebell weight.
For less difficulty, stand up straight instead of leaning forward.
Suggested workout:
3 sets of 10 passes.
For most people with ankle sprains, standing straight up is difficult enough in the initial stages.
This exercise is slightly more difficult than others because it challenges all directions of movement.
By introducing a single leg squat or increased knee bend, we can further challenge the joint receptors, stabilizing muscles, and the prime movers (quads and hamstring), and these actions can help accelerate our recovery.
Exercise instructions:
Stand on the injured leg, while bending slightly at the knee.
With the other foot, lightly touch as far as you can in all four directions (without squatting).
Tips on technique:
Try to balance your weight equally over the big toe, baby toe and heel.
Suggested workout:
2 rounds clockwise and 2 rounds counter clockwise.
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