Ankle Exercises and Return to Sport
The exercises shown here are commonly used in ankle injuries and for rehabilitation after surgery. It is, of course, important to tailor the exercises to the condition being treated, and your physiotherapist or treating surgeon will give you advice on that.
Ankle Range of Movement Exercises
Sit down comfortably on a chair, with the affected leg supported, perhaps resting on your other knee. Pretend you are writing or drawing out each letter of the alphabet with your affected foot. This moves the ankle and foot in all directions – it is not intended to be painful. Do it twice through the alphabet, three times each day.
Resistance Band Exercises
Resistance Band Exercise 1: Tie the band so that the feet are bound together, with just a small amount of tension. Use the unaffected leg as an “anchor” – keep your hips and knees still, and use the affected leg to push out, turning the foot out against the resistance of the band. Relax, gently controlling the foot back to the starting position. Keep repeating the out and in movements for about 5 minutes. Do this exercise three times each day.
Resistance Band Exercise 2: Sit on the floor with your injured leg stretched straight out in front of you. Loop the Resistance Band around the ball of your foot, gripping each end of the Band pull it towards your body, keeping your knee as straight as possible. Hold for 30 seconds, relax and repeat twice more.
Resistance Band Exercise 3: Still sitting with your leg outstretched, and the Resistance Band around the ball of your foot, tightly grip each end of the band and stretch by gently pointing your toes down and away from your body. Repeat 10 times, relax the band then repeat twice more (2 times 10 stretches) relaxing briefly between each set of 10.
You will find it more comfortable to do this exercise seated at first. Sit with the feet flat on the floor, then raise your heels so that you are in the tiptoe position.
Lower the heels then repeat so that you do 20 heel raises. As the ankle begins to improve and you are better able to weight-bear you can progress so that you are doing standing heel-raises.
Ankle Proprioceptive (Balance) Exercises
Proprioceptive exercise helps your body to know where your foot is in space (a component of balance) and is essential in preventing further injuries as you return to activity. If you have a physiotherapist you will be advised when you are ready to progress to these.
Single Leg Stand
Do the exercise by standing on the affected leg, with the foot flat on the floor. You may find you need to steady yourself, using your hands on a wall, table or chair, at first.
Stand on one leg for as long as possible, relax, then repeat for about 5 minutes in total. Do this three times each day.
You can progress with this by doing the exercise with eyes closed, or standing on a towel.
Later also try leaning forward, so that you touch the floor with one hand.
Strengthening and Proprioception
As your ankle improves, it is important to strengthen the muscles on the outside of your calf, and to work on your balance (proprioception). This exercise addresses both.
Stand on a folded towel on your affected foot. The two littlest toes should be hanging over the edge, whilst the biggest three and inside border of the foot should be on the rug. Using the muscles on the outside of you calf, pull the little toes and outside border of your foot up off of the floor. Walk around the towel this way for 3-5 minutes.
If you have a physiotherapist you will be advised when you are ready to progress to a wobble board or similar apparatus.
Note: If you experience pain during any exercise you should stop immediately. Continue with RICE 2–3 times a day trying the exercises again after each application to see if they have become more comfortable to do. If your condition does not improve seek professional help from your doctor, physiotherapist or NHS Direct.
Returning to Sport
It is important to have a gradual return to sport, exercise and training after an injury. A physiotherapist or sports trainer/coach is the best person to help you to plan and execute this. The principles are to start slowly, and rebuild the aerobic base (basic fitness). Training sessions should be spaced out, with a rest-only day between sessions. As fitness improves, the rest days can become cross-training sessions.
Cross-Training Can Help!
Athletes, and those who enjoy sports and exercise, want to stay fit despite injury. They want the sense of well-being that they derive from exercise, and loss of the exercise routine, and overall fitness, is one of the most frustrating issues which arises from an injury. There will almost always, however, be some form of exercise that can be continued. Discuss this with the physiotherapist, doctor or sports trainer who is looking after you – if they look blank, seek another opinion!
Swimming is ideal for cross-training with ankle injuries; do lap/lane swimming and pool running.
Swimming is also a great way to maintain cardio-vascular fitness. You could swim lengths or laps, and alternate a lap with running in the pool against the water resistance as the ankle improves. Pool running can just about equal treadmill running in terms of cardiovascular effort and exercise, but with very little load on the feet, ankles and lower limbs. An ideal pool workout should combine 30 minutes of lap or lane swimming with 30 minutes of pool running. You can develop a programme of interval workouts for pool running, just as you would in a running session on land, with intervals, sprints and endurance pace and effort.
In the gym a static bike can often be used early on. As the condition improves, try using the elliptical cross-trainer, the static bike, and the rowing machine for a good cardiovascular work-out.