Posted on September 24, 2015 by Jenny Cromack

Exercise Rehabilitation for Ankle Injuries

At some point in our lives we will all have or will “twist” or roll our ankles. In some cases this will be more severe than others. Whether we experience a higher or lower grade sprain, or even a fracture, many people will continue to suffer for months, years, or indefinitely with pain, stiffness, or instability. This is often due to incomplete or poorly designed rehabilitation. Rehabilitation should restore all aspects of health and fitness, but also make sure that daily stresses, and activities are replicated and retrained. We need to work through range of motion, strength, and power exercises to regain these elements of fitness. An important part of rehabilitation that is sometimes underplayed is stability, proprioception, balance and co-ordination. This replicates the stability needed when we carry out daily activities to ensure our ankle doesn’t roll or twist again.

Here are some exercises for ankle rehabilitation.

Range of Motion

These exercise simply involve us moving our foot through its full range in various different planes of movement. By progressing these movements we can regain our full range of movement. These exercises help stretch any tightened ligaments, muscles and tendons to prevent the foot stiffening up. If we keep up with moving our foot through range it prevents the soft tissues from remaining in a shortened state, allowing full pain free movement. This will help optimise the strength and subsequent exercises.

Exercise to include are:

  1. Pointing the toes and foot downwards,
  2. Lifting the foot and toes backwards,
  3. Turning the foot on its outside, turn the sole inwards,
  4. Roll the foot onto its inside, turning the sole outwards,
  5. Make circles with the foot

Strength

It is important to regain the strength in the whole of the lower body not just around the ankle. If our legs are strong and working optimally it reduces our risk of re-injury. When approaching this we need to start lighter with more repetitions (15-20) progressing to heavier weights and lower repetitions (8-12). By doing this we build up a resistance to fatigue, if our muscles can become more resistant to fatigue we are less likely to lose stability or control as a result of our muscles tiring and re-injuring our ankle. Stronger muscles around the leg will produce more forceful and controlled movements. It also provides the strength to hold the joint in position as we move through forceful movements and activities again preventing any injury reoccurrence.

Exercises to include are:

  1. Resisted Versions of the Range of Motion Exercises Using a Band
  2. Squats
  3. Lunges
  4. Calf Raises
  5. Glute Bridges

Power

As well as building strength and the ability to create forceful movements we need to retrain the ability to produce forces quickly but safely. By training the power element our muscles develop the ability to create and absorb force over very short burst of time. The faster twitch fibres will develop creating more force within these short bursts. This is good news when it comes to needing to make quick movements throughout our day, if we can cope with these we are less likely to put any unnecessary stress through our ankle. This element is also important for these who participate in power based sports or activities.

Exercises to include in this section are:

  1. Squat Jumps
  2. Box/Step Jumps
  3. Drop Jumps
  4. Double Foot Bounding for Distance
  5. Single Foot Leaps for Distance

Proprioception, Balance, & Co-ordination

These elements are a key component of exercise rehabilitation of the transition back into normal activity. Training these elements create adaptations within the neuromuscular system and the connection between the brain and the muscles. The muscles ability to detect slight movements and transmit these to the brain is improved. The muscular response is then also improved which is to contract and adjust joint position to correct any movements (such as rolling the ankle). If there is good communication between the muscles and the central nervous system and vice versa then we can minimise the risk of the ankle rolling again. As soon as the foot is suddenly put into a bad position the communication system kicks in and rectifies this.

In this phase we also want to include whole body movements and co-ordinate muscles to work optimally together. If we can ensure that all the muscles can do their job and control their joints, when it comes to carrying out daily activities and exercises there is a reduced risk of there being any dysfunction in joints when we perform multi-joint movements. By training with multi-joint and limb movements the co-ordination between body parts and muscles becomes more automatic.

Exercises to include are:

  1. BOSU Squats
  2. BOSU Lunges
  3. Single Leg Hops
  4. Lunges with Opposite Hand Overhead Press
  5. Single Leg Step Up with Cable Row

Summary

Rehabilitation is a process that needs to tick a lot of boxes to ensure a full recovery is made and re-injury doesn’t occur. Every aspect of fitness needs retraining and making sure these needs are in an optimal state before returning to full and normal daily activities or exercises. Combining all the above elements in a way that replicate daily movements and exercises will ensure that when we return to these activities our bodies have been trained and adapted to cope with any stresses experienced during these movements.