Assessment Of The Ankle Joint
After an ankle injury, the joint should be assessed for misalignment or structural defects caused by the sprain. A physician will check the joint and test for weakness or deficits in soft tissues .
Your injury may require taping or bracing. If a fracture or dislocation is suspected, an MRI or an X-ray will confirm the diagnosis and determine the most appropriate treatment.
Any ankle injury that does not respond to treatment in one to two weeks may be more serious. Consult a physician for a thorough evaluation and diagnosis.
The Risk Of Nerve Damage
Every time you step on an uneven surface or have to place your foot quickly, tiny nerves in your ankle automatically help it remain steady rather than rolling or twisting. Think of them as the lane-assist feature in some cars, which make tiny steering corrections to avoid drift, Dr. Peterson said, except the nerves bring your ankle back to a neutral position. One major cause of wobbly ankles is when sprains also damage these corrective nerves.
Without that feedback system, you are more likely to roll your ankle again, said Jeff Harvath, a physical therapist at Washington University in St. Louis.
Why Your Ankles Deserve Attention
According to Travers, if you make alterations at your base youll affect the rest of your joints.
One of the greatest worries about a weak base is the effect it has on your knees and how much internal rotation it puts into your hip. If youre deficient at the bottom, the joints and muscles in your knees and hips can weaken as well. This can cause your gait to change, ultimately making it more difficult for you to walk.
That, Travers explains, is why its important to dedicate time in your fitness routine to stretching and strengthening your ankles.
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Balance And Proprioception Exercises
After an ankle fracture, you may notice that your balance is a bit off. Your PT may prescribe single-leg standing exercises to improve your balance.
Once basic single-leg standing exercises are mastered, you may benefit from advanced balance exercises like using a wobble board or a BOSU to challenge your balance and proprioception.
Improving balance means challenging your balance, and this means creating situations where you may be unsteady. This can be a safety hazard. Be sure to prioritize safety while performing balance exercises by having someone else around who can help you if you need help.
Resisted Strengthening Plantar Flexion
Verywell / Ben Goldstein
Resisted ankle plantar flexion helps strengthen your calf muscles and Achilles tendon, the big tendon in the back of your ankle. It also uses a Theraband to provide resistance.
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What Is A Total Ankle Replacement
Your ankle joint is the section of your lower leg where the shinbone meets the talus bone on the top of your foot.
Occasionally, the slippery surface that coats the ends of these bones begins to thin or deteriorate. As this process becomes more advanced, it can lead to significant pain, disability, and difficulty walking.
In these situations, a total ankle replacement may be beneficial. Specifically, there are several conditions that may be helped by this procedure, including:
During an ankle replacement procedure, an orthopedic surgeon removes the damaged ends of the tibia and talus bones and replaces them with an artificial metal covering. A polyethylene component is also secured in between these two structures to help the new joint endings move smoothly on one another.
Following the procedure, you are typically placed in a protective boot or splint and will be advised by your healthcare provider to stay off the surgical leg for 4 to 8 weeks to allow it to heal properly.
Toe Raise Point And Curl
This exercise has three stages and will help strengthen all parts of the feet and toes.
To do this exercise:
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Take Ownership Of Your Ankle Health
What do poor-smelling cologne or perfume and ankle sprains have in common? They both can leave behind a lingering discomfort in the sensory system. The other commonality is that they can both be changed! Building up ankle stability, proprioception, strength, and power will both reduce the likelihood of ankle injuries or get rid of any lingering discomfort that may be present. As for the bad cologne or perfume, you know what to do here.
Craig Lindell, PT, DPT, CSCS
rehab Co-Founder & Chief Content Officer
Craig is a South Jersey native & Penn State Kinesiology Alumni. When the opportunity came, Craig packed his bags and drove to California to pursue his Doctorate in Physical Therapy from the University of Southern California. With rehab, Craig oversees all digital content creation and multi-channel publication that reaches millions of people on a weekly basis. As a PT, Craig has a wide array of experience from working with various neurological conditions to working with collegiate & professional athletes across the Big Five in North American sports. Experiencing physical therapy first-hand as a soccer player in high school, Craig has a passion & special interest in adolescent athletic development working with young athletes to overcome injuries. In his spare time, Craig enjoys exercising, playing golfing, hiking, traveling, watching Philly sports, and spending quality time with his family.
Why Is Ankle Strengthening Important
There are four main reasons why ankle strengthening is so significant.
- First, strong ankles can help to prevent falls and ankle sprains.
- Second, ankle strengthening can help improve your balance and proprioception .
- Third, stronger ankles can improve performance in sports and other physical activities.
- And finally, ankle strengthening can help prevent injuries to other body parts, such as the knees, hips, and back.
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Single Leg Balance With The Ankle Inverted
You didnt get hurt on the table, youre likely not going to get better on the table -IKN
This is one of my go-to lateral ankle sprain advanced exercises & techniques. Training positions of vulnerability is important for a few reasons
- It is important to be able to tolerate and CONTROL these positions
- It is important to regain CONFIDENCE in these positions
- It is important to practice multi-tasking in these positions
Often there is a lot of time spent avoiding and minimizing these vulnerable positions. However, it is imperative that an individual has the ability to decelerate and control positions of vulnerability. This principle can be applied to other injuries such as an ACL decelerating dynamic knee valgus should be a major focus in ACL prehab and rehab!
Range Of Motion Exercises
Jeannot Olivet / Getty Images
Ankle range of motion exercises are one of the first things your PT will prescribe once you get out of your cast or brace after an ankle fracture.
Your physical therapist may passively move your ankle joint through various motions and then have you actively move your ankle to improve the motion around the joint.
Some simple exercises to improve your ankle ROM may include:
- Moving your ankle by pointing your toes up and down as far as possible
- Inversion and eversion
Hold each position for a few seconds, and perform 10 to 15 repetitions.
Another fun exercise to improve ankle ROM after a fracture is the ankle alphabet. Simply pretend that your toes are a pencil, and draw letters with your foot by moving your ankle. Draw each letter slowly and deliberately in both upper and lower case. This can be performed several times per day.
Expect to feel a little pain, but stop the exercises if you feel any lasting or intense pain. If that happens, check in with your PT or healthcare provider.
Once you have perfected ROM exercises, it is time to start to improve ankle flexibility with the next exercise.
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Controlling Pain And Swelling
Post-operative pain and swelling are also normal occurrences after a total ankle replacement. It is not unusual for an ankle to be swollen even six to 12 months after the operation.
While your surgeon will normally prescribe medication to help manage your discomfort early on, physical therapy also plays an important role in addressing these symptoms.
Treatments like electrical stimulation , icing, and vasopneumatic compression are commonly utilized in the early days of physical therapy to reduce your pain or swelling. These modalities are typically used in conjunction with other therapy treatments such as stretching.
Flexibility And Range Of Motion Exercises
As soon as you can tolerate movement in the ankle joint and swelling is controlled, you can begin gentle stretching and range of motion exercises of the ankle joint.
- Towel stretch: The towel stretch is a simple and effective way to improve the flexibility of your calf muscles. While seated on the floor, simply wrap a towel around the ball of the foot and gently pull the towel so the toes and ankle flex up.
- Standing calf stretch: Stretching your calf muscles is important to help loosen the muscles and prevent further injury. While facing a wall, place one leg behind. Lean toward the wall until you feel a slight stretch in the calf of your extended leg.
- Achilles soleus stretch: Slowly stretching your Achilles tendon can help you prevent injury and keep the tendon flexible. To stretch your tendon, stand an arm’s length away from the wall and place one leg back. Keeping the leg slightly bent at the knee, slowly lean forward and press your heel to the floor.
- Toe circles: Move your ankle through its entire range of motionup and down, in and out, and in circles. Move only the ankle and not the leg.
- Alphabet exercise: With your leg extended, try to write the alphabet in the air with your toes.
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Exercises To Improve Ankle Stability
Improving ankle stability is all about balance. Just standing on one leg and practicing balance can build the coordination needed to prevent ankle injuries from happening or at least decrease their severity. Standing on one leg while brushing your teeth, doing dishes or watching TV, for example, may have a positive impact.
The four exercises below will help you be steady on your feet. If youre concerned about falling while doing these exercises, place a sturdy chair next to you that you can use to catch yourself if you get wobbly.
What Are Physical Therapy Exercises
Physical therapy exercises are designed to restore maximum body function with an aim on long-term benefits. This includes recovering from an injury, preventing further damage, relieving pain, or learning to live with a chronic condition. Good for people of any age, they can help to improve blood flow, increase flexibility, develop strength, and enhance endurance.
At-home PT incorporates stretching and strength training, rather than endurance exercise. You dont need access to gym equipment. In fact, most of these exercises dont require any equipment at all. The ones that do require simple items you can find around the house.
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Physical Therapy For Chronic Ankle Instability
Ankle injuries like sprains lead to long-term ankle instability for somewhere around half of patients. As with other types, ankle injury weakens the muscles in the affected area and makes them susceptible to further injury. Strengthening exercises regularly can strengthen the muscles, improving mobility and avoiding future injury.
A physical therapist can assess your ankle condition and overall situation and develop a set of exercises based on how your ankle was injured, how badly, and where it most needs strengthening. Below are some stages of exercises your therapist might recommend.
Physical Therapy Exercises For An Ankle Fracture Repaired With A Plate And Screws
A broken ankle can significantly impact your daily activities â particularly if your bones have to be stabilized with hardware. Broken ankle recovery time after surgery varies based on the severity of your injury, but it’s important to allow your bones to heal properly.
After an immobilization period, physical therapy exercises for ankle fracture concentrate on restoring ankle flexibility and strength. You might even begin broken ankle exercises while in a boot if your ankle is stable. It’s important to perform these exercises regularly, as advised by the American Academy of Orthopaedic Surgeons.
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Balance Exercises For The Ankle
The second type of ankle strengthening exercise is balance exercise. These exercises challenge your balance and help to improve proprioception. These exercises are perfect for improving the strength of the stabilizers of the ankle.
Several different balance exercises can be done to strengthen the ankle. Here are a few examples:
- Single-Leg Balance: Stand on one leg with your knee slightly bent. Hold this position for 30 seconds and then switch legs.
- Heel Walks: Walk on your heels for 20 meters. Repeat this movement multiple times.
- Toe Walks: Walk on your toes for 20 meters. Repeat this movement multiple times.
- Balancing on a soft surface: Stand on a soft surface, such as a balance disc or pillow. Hold this position for 30 seconds and then switch legs.
- Single leg squat on foam pad: Place a foam pad on the ground and stand on it with one leg. Lower your body into a squat position and return to the starting position. Repeat this exercise for 30 seconds and then switch legs.
A foam balance pad is an excellent tool to have at home to challenge your balance and also use as a cushion for kneeling or other activities. To learn more about a home foam balance pad, check out the link below.
These are just a few examples of balance exercises that can be done to strengthen the ankle. Many other activities can be done to challenge your balance, but this is plenty to get you started on improving your balance.
For related topics, check out the blog articles listed below.
Anatomy Review Of The Ankle
The ankle is a hinge joint made up of three bones: the Tibia, Fibula, and Talus. The Tibia and Fibula are the two long bones in your lower leg, while the Talus sits on top of the ankle and acts as a pivot point. These bones are connected by ligaments, which help keep the ankle stable.
There are also two main muscles on the back of the ankle that help with movement and propulsion: the Gastrocnemius and the Soleus.
The Gastrocnemius is a large muscle that covers the back of the calf, while the Soleus is a smaller muscle located underneath it. These muscles help point your foot downwards, otherwise known as Plantarflexion.
On each side of the ankle is a group of muscles and tendons that control the side-to-side stability of the ankle. These muscle groups prevent the ankle from rolling, as many people know with ankle sprains.
These muscles on the sides of the ankle also help with the stability of the foots arch. The most well-known muscles in these groups are Tibialis Posterior and the Peroneals.
Finally, the group of muscles on the front of the leg or shin help pull the toes and the foot up off the ground. These muscles stabilize the front of the ankle and also help with the stability of the foots arch.
Now that weve reviewed the ankle anatomy, lets look at the research on why ankle strengthening is essential for everyone.
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Types Of Rehab Exercises
Specific exercises are prescribed to help restore ankle stability and function. These exercises are progressive and are generally prescribed for range of motion, balance, strength, endurance, and agility.
- Range of motion exercises
- Progressive strength exercises
- Progressive endurance exercises
- Agility exercises
The following exercises can be used to rehab a Grade I ankle sprain. If your sprain is more severe, you should follow the plan prescribed by your physician and physical therapist. Your physical therapist can design the best program for your specific injury and your limitations.
Hip Physical Therapy Exercises
Hip problems become more common as we age. Whether you are sitting or on your feet all day, these muscles are working to keep your body vertical. If you suffer from hip pain, strengthening your hip muscles and joints is the best way to find relief. These stretches can also help with lower back pain. help with lower back pain.
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Work On Gait Training And Balance
After multiple weeks of staying non-weight bearing on the affected ankle, your surgeon will clear you to begin walking on your leg again. When this occurs, your physical therapist will work with you to improve your overall gait pattern and eliminate any limping. They will also help you transition from using crutches or a walker to walking independently once again.
What’s more, after multiple weeks of reduced movement and lack of bearing any weight on the affected ankle, the muscles that surround the ankle have often atrophied or weakened, which can impact your balance.
When you are allowed to begin placing weight through the leg, your PT will typically initiate proprioceptive training aimed at improving your overall ankle stability.
After working on these techniques in physical therapy, balance exercises will be added to your home program and will be progressed as you improve from week to week.