Ankle sprains are one of the most common injuries that an athlete or physically active individual can experience. It occurs when the ligaments surrounding the ankle joint are torn or stretched as the foot and ankle joint is twisted, turned, or forced beyond its normal range of motion. Ankle sprains sometimes occur due to deficiency of lower limb strength, flexibility, or endurance, but more often occur as a result of insufficient balance - proprioception. Poor balance is the most common symptom of decreased proprioception.
Every injury has the potential to subsequently reduce your proprioception and balance. However, you can quickly improve both your proprioception and balance with proprioception and balance exercises.
Proprioception refers to awareness or perception of your joint’s position and movement in space. When a joint is sprained, it loses proprioception, feels unstable, and can give out. Ankle strengthening exercises involving proprioceptive and balance exercises help the body to relearn ways to control the position of the joint and prevent injury in physically active individuals and athletes.
Ankle Strengthening Exercises Including Balance and Proprioception Exercises
Exercising may perhaps be the last thing on your mind to do when your joints are stiff and painful. Nevertheless, exercise is a significant part of treatment for ankle strains to help ease pain and keep you active. Ankle strengthening exercises play a crucial role to restore normal ankle function and improve flexibility, strength, and proprioception by specifically targeting ankle joints and muscles for better management of ankle strains. Here are some exercises that are designed to stretch, strengthen, and stabilise your ankle.
Strengthening and Endurance Exercises
- Step-ups : Start on a short step and gently step up in a controlled manner while concentrating on contracting the muscles of the leg, ankle, and foot. Turn around and step down slowly in the same manner. Do 20 repetitions every day several times.
- Isometric exercises : Slowly push against an immovable object in 4 directions of ankle movement, such as inward, outward, up, and down. Hold for 5 seconds. Do 10 repetitions every day several times.
- Heel and toe walking : This exercise involves walking on your heels for 30 seconds and then switching on to your toes and walking on it for another 30 seconds. Gradually increase to 60 seconds on heels and toes alternating for 5 to 10 minutes and perform this several times a day.
- Toe raises : Stand firmly on the floor. Hold the back of a chair or place your hands on the wall for support. Slowly lift your heels a few inches off the ground and rise up on the toes of your both feet. Hold this position for a couple of seconds and gently lower both the heels to the floor. Do 2 sets of 10 repetitions.
- Elastic band pulls : Tie a resistance band around a heavy object such as a table leg or desk. Now, sit on the ground and hook your upper foot and toes into the band. Gently, pull your foot and toes back towards you and return it to its starting vertical position. Do 10 repetitions of several sets every day and slowly progress to a higher level.
Range of Motion and Flexibility Exercises
- Towel stretch : This is a very effective exercise to improve your calf muscle flexibility. Sit on the floor with your leg stretched out in front of you. Wrap a towel around the ball of your foot and gently pull the towel towards you so that the ankle and toes flex up and you feel a mild to moderate stretch on your calf muscle.
- Ankle alphabet : Sit on a comfortable chair or couch. Extend your leg out and write the letters of the alphabet in the air with your big toe. This exercise assists in moving your ankle in all directions. Do this 2 to 3 times a day.
- Towel/tissue scrunches : Sit on a chair with your bare feet firmly on the floor. Put down a small towel in front of your feet on the floor. Now gently try to grab the towel with your toes, scrunch it up to a count of 5 seconds, slowly release the towel, and repeat for 8 to 10 times.
- Standing calf stretch : Stand in front of a wall and place your hands on it for support. Now put your injured ankle about one step backwards and your uninjured foot forward. While maintaining your back heel flat on the floor, gently bend the knee of your uninjured leg until you feel a mild to moderate stretch in the calf of your injured leg. Hold this position for 30 seconds and repeat 3 times.
- Toe circles : This is a simple exercise in which your ankle is moved through its full range of motion – in and out, up and down, and in circles. Ensure that you do not move your leg and only the ankle is moved.
Proprioception and Balance Exercises
- One-leg squat : Stand with your feet placed firmly on the floor. Add pressure on the injured leg and slowly lift the uninjured, non-supporting foot slightly off the floor and lower to a squat position. Hold this position and perform up and down one-leg squat motion of 10 to 15 repetitions for 2 to 3 sets. Extend your arms for balance if necessary.
- One-leg balance : With your hands on a chair back, countertop, or wall, slowly lift your uninjured leg upward behind you so that your weight lies on the leg with the injured ankle. Hold this position for 20 to 30 seconds and gradually progress to more seconds as you get stronger.
- Step up and step down onto balance board : Put down a balance board (or foam pad or soft pillow) to a level that is six to eight inches higher than your starting point. Now, step up and step down 10 times.
- Balance board with half-squats : Place a wobble board on the floor and carefully place both of your feet on the board. Now while balancing on the wobble board, try to perform slow and controlled half-squats of 8 to 10 repetitions. Gradually increase as you feel comfortable.
- Balance board ball toss : While balancing on a balance board or wobble board, ask your partner or therapist to throw a small medicine ball weighing 5 pounds towards you so that you can catch it while maintaining your balance on the board.
Gentle stretches and strengthening exercises of the ankle including proprioception and balance exercises can offer significant pain relief, stronger muscles, and improved mobility, strength, and flexibility to your ankles. There are several ankle exercises that your physician or physiotherapist can recommend to choose from to achieve this objective and help you get back to your favourite sports and recreational activities. People with ankle sprains can experiment with different exercises under their physician’s guidance and choose the ones that work best for them and incorporate them into their daily exercise routine for better management of ankle sprains.
Learn more about how you can manage ankle pain from the following resources: