Ankle Instability Exercises

Ankle instability can throw a major wrench in your daily activities since it can affect your ability to comfortably bear weight through your feet. Ankle instability is most often a result of an injury, such as a sprain or fracture, but can also be due to underlying health conditions that cause laxity in local connective tissue. Thankfully, there is a simple way to boost your confidence and stability in the ankle: ankle instability exercises. Keep reading to learn more about how to incorporate ankle exercises into your weekly exercise program. 

Mobility Exercises

When it comes to ankle instability, often there are actually specific areas in the ankle that have too much mobility while there are others that are too stiff. If you are experiencing chronic ankle sprains or pain, you may have also developed a lot of stiffness from local muscle guarding. Stretching the ankle in the right direction to restore balance is essential. However, it’s important not to force any motions that feel unstable or off with ankle instability.

Kneeling Ankle Dorsiflexion Range of Motion

Having adequate dorsiflexion (bending) range of motion in the ankle is essential for reducing the risk of injuries. When proper mechanics are promoted in the ankle, this helps the muscles and connective tissues work in optimal coordination.

• Get into a half-kneeling position on the floor with the ankle you are stretching in front
• Make sure your front foot flat on the floor and facing straight forward
• Shift your weight forward while keeping the heel firmly on the ground
• Keep the inner edge of the knee aligned with the big toe to prevent flaring in or outward
• Continue shifting until you feel resistance/stretch in the ankle joint itself
• You might feel a slight stretch in the calf muscles as well, but this is not essential 
• Hold this pain free position for up to 5 seconds at a time 
• Repeat 10 times for 2-3 sets throughout the day 

Seated Calf Stretch

While the stretch reviewed above is directed more at the ankle joint itself, you may have tight muscles that need to be addressed too. Some of the top offenders with ankle stiffness are the achilles tendon and calf muscles, the gastrocnemius and soleus. This simple stretch can help alleviate pain and restore some balance to the ankle.

• Long sit on the floor with both legs straight and flat on the floor 
• Grab a stretch strap, belt, or towel and wrap it around the ball of the foot
• Hold the ends of your strap with your hand as you pull the strap back toward your chest
• Bring the toes closer to to the shin until you feel a strong stretch in the back of the lower leg in the calf muscles
• Hold for 30+ seconds for 2-3 sets on each leg
• You can also try this stretch while sitting on a chair with the leg out straight in front of you, standing on a step, using a calf stretcher (see the tool section below) or even doing a lunge

Other Ankle Mobility Options

Knowing which ankle mobility exercises to choose can be tricky with ankle instability. This is because you don’t want to overstretch any areas of the ankle that are already inherently unstable from your injury or reinforce any areas of hypermobility that may be present (such as the lateral ankle with inversion sprains). Ultimately, this is where having the guidance of a professional like a physical therapist can help. Some commonly recommended movements include:

• Deep squats or lunges (emphasis on increasing ankle dorsiflexion)
• Ankle pumps
• Ankle rotation
• Ankle inversion, eversion, or plantarflexion stretch

Strength Exercises

Once your ankle becomes unstable from an injury or pre-existing condition, strengthening exercises play a primary role in restoring stability. This is because once many of the surrounding connective tissues are stretched, particularly local ligaments, they lose their innate stability and cannot return to their previous level of function. Thus, the strength of local muscles is the best way to gain back some stability. These ankle strengthening exercises will focus on general ankle strength and functional strength to boost proprioception.

Resisted Ankle Dorsiflexion

Strengthening the muscles around the ankle will help promote adequate endurance with daily activities and blood flow for any necessary healing. It’s a great first step in the recovery process before progressing to the more functional moves listed below.

• Grab a loop band and secure it around a stable surface- such as a table leg or shut into a doorway- near the floor
• Long sit on the floor at a distance that provides an appropriate level of resistance
• Get into position with the leg out straight and touching the ground
• With the heel touching the ground and the toes up toward the ceiling, place the band around the top of the toes and foot
• Bring the toes straight back toward the shins and hold for 1-3 seconds
• Repeat 10+ times for 2-3 sets

Plus, you can add other ankle motions with this 3 way band exercise to add ankle plantarflexion inversion, and eversion too. Most importantly, focus on eversion after an inversion ankle sprain.

• Take your loop off of the stable surface and now wrap it around the bottom of your foot
• Then, wrap both sides of the band around the bottom of your other foot and hold the end with your hand at an appropriate level for resistance
• Push the outside edge of your foot against the band so that your toes are moving away from the body (there should be no movement in the knees or hips)
• Hold for 1-3 seconds for 10+ repetitions
• Keep a range of motion in the ankle that is pain free and stable 
• Repeat for 2-3 sets total

Step Calf Raises

Being able to push through your toes with good strength and stability is arguably one of the most important functional moves you can work on. This is because you need this functional move dialed in each time you take a step with walking, going up stairs, or running. Walking/stepping is when we most often sprain our ankles too.

• Grab a step stool or stand at the bottom of the stairs
• Once you’re up on the step, place the midfoot of both feet near the edge of the step
• Use a chair or wall for balance as needed
• The most basic move to complete is to let both heels fall down toward the floor as far as possible
• Move slowly and with control, before switching directions and bringing the heels above the step
• Repeat for 10+ repetitions for 2-3 sets total
• To progress, try dropping one heel down at the time (while both lift up together) or doing a single leg calf raise
• The key is to keep the ankle stable and out of any range that causes it to wobble excessively
• Work on building your strength and range of motion tolerance over time

Single Leg Balance

Being able to balance on one foot with ankle instability can be extremely difficult. This is most often due to sensory changes in the ankle that affects proprioception- the ability of your ankle to sense where it is in space with use. Working on balance exercises can help restore better sensation and make it feel less wobbly and awkward with weight bearing activity.

• Start by standing near a wall, chair, or counter for balance safety- if needed
• Shift your weight into one foot and lift the opposite foot off the ground
• Focus on keeping good posture throughout the body and the core tight- particularly focusing on keeping the foot and ankle as stable as possible
• Attempt to hold for 30+ seconds and build from there
• Repeat for 2-3 sets on each foot
• Progress to standing on more challenging surfaces, such as carpet, a foam pad, or even a wobble board

Tools for Increasing Ankle Mobility

The use of the right tools is always useful when it comes to an ankle exercise program. They can make your exercises easier, more efficient, or provide an extra challenge. Here are some of our favorite tools.

Stretch straps

A stretch strap is a great versatile tool for getting a strong stretch in the ankle without straining the back or neck from reaching (as illustrated in the calf stretch explanation above). It can be used to address other common problem areas in your body as well to keep your connective tissue and muscles as flexible and pain free as possible with your daily routine. Stretching is an essential part of your exercise routine if you experience frequent soreness or stiffness, and a stretching tool can make it that much easier to do it consistently.

Resistance bands

Use of a resistance band is particularly useful when it comes to ankle strengthening. Use of weights with ankle range of motion is practically impossible, while bands can provide a wide range of options for strengthening specific muscles in the toes, feet, and ankles. Plus, the muscles of the foot and ankle are designed for postural endurance based activities, such as standing or walking for longer periods of time, making the lower resistance of bands ideal for building this specific type of strength.

Calf stretchers

If you want to take your calf stretching to the next level, consider a calf stretcher. This simple tool makes stretching the calves, a common problem area, easy and straightforward. Many users report getting a deeper, more satisfying stretch with use of a designated stretcher over other stretching methods such as use of step or standing in a lunge. You can buy options that stretch one ankle at a time or both at once, depending on your needs.

Balance Trainers

Use of balance trainers is the secret ingredient to recovery with ankle instability. Forcing the ankle to stabilize itself in unsteady conditions helps it re-establish the sensory input it needs to function and coordinate optimally with daily activities. Without restoring appropriate ankle sensation, you will continue to be at a higher risk for re-injury and just feel less coordinated on your feet than you did pre-injury.

Choosing the Best Balance Trainer

Tips for Improving Instability

Outside of proper exercise, there are a few other tips to keep in mind that can boost your ankle stability. These include but are not limited to the following:

• Stay consistent with your exercise program (at least a few times per week) and push yourself to new limits as tolerated to make continued progress

• Pair your exercise with proper pain management and other home treatment options- pain can alter the way your ankle coordinates movement. Make sure you are managing it well with modalities such as medication, ice, heat, and electrical stimulation

  More Options for Ankle Instability Treatment

• Boost proprioception of the ankle with regular balance exercises to be able to return safely to higher level activities

• Wear supportive shoes or insole orthotics to support your feet and reduce the risk of ankle reinjury and instability

• Consider use of kinesiology tape or a brace for additional ankle support when completing activities that tend to make your ankle feel unstable

  How to Tape for Ankle Instability

• Get professional guidance with physical therapy as needed for appropriate exercise prescription and other treatment recommendations that boost your ankle health

Building Ankle Stability

Recovering from ankle injuries that cause instability is all about finding exercises that restore as much balance within the joint as possible. This is why the focus with exercise is on regaining adequate ankle mobility, strength, and balance tolerance. With these in mind, you can expect to feel more confident in your ankle- whether it’s for walking safely or getting back to your favorite sport.

If your symptoms are getting worse or you feel unstable on your feet due to ankle rolling, it’s time to get in touch with a trusted medical professional for further medical advice.

Sources:

https://www.physio-pedia.com/Chronic_Ankle_Instability

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