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.

Non-weight bearing

The first exercises you’ll probably do will be the lightest, to build strength slowly. For these, you will probably sit on a bed or the floor with your feet out in front of you.

• Dorsiflexion – Starting with your toes pointed straight upward, flex your ankle upward toward your knee as far as you can without causing pain. Hold it for 15 seconds, then slowly release to resting position.
• Plantar flexion – The same thing in reverse. From the initial position, turn your foot down, away from the rest of your body like a ballerina’s toe-point. Stretch as far as you can, hold it, and slowly release.
• Inversion – With the toes pointing vertical, turn your injured ankle in towards your good foot. Count 15 seconds and release.
• Eversion – From the starting position, point your toes outward until either your ankle hurts or it won’t move any further. Count and release.
• Drawing the alphabet – With your ankle hanging loose (like from a stool of the side of a bed), gently draw the alphabet with your foot, pretending that your big toe is your “pen.” This gets your ankle moving in many different combinations of range and direction.

Isometrics

These are exercises where you contract the muscles but the joint they control does not move. Sometimes you do that by tensing muscles on opposite sides of a joint or limb. In this case, you prop your foot against something like a door, wall, or piece of furniture.

• Eversion – Put the outside of your injured foot against the stationary object and contract the muscles as if to turn your toes outward, but use the object to prevent that. Hold for a set time and release
• Inversion – Put the inside of your foot against the object and do the same thing, as if trying to move the object with your toes but not succeeding. Hold and release.

In both these exercises, the solid object is to ensure that while your muscles contract, your ankle does not move.

Resistance

When you’re ready to add resistance, your physical therapist will probably recommend using an exercise band or very small weights (bands are popular even with the uninjured). It will depend on the situation, which is one reason you want a therapist’s advice.

These exercises are essentially the same as the weightless ones above, except for the addition of resistance: dorsiflexion, plantar flexion, eversion, inversion.

Partial weight-bearing

After a little artificial resistance, your physical therapist may start you on limited-weight strengthening exercises.

• Seated calf raises – Sitting in a chair, with both feet on the floor, raise the leg of the injured ankle by basically doing one of those plantar flexions from earlier. You’ll be lifting some of the weight of one leg, but no more.
• Standing weight shift – Stand with your weight on your good foot and hold on to a stable object. For about 15 seconds at a time, shift some of your weight to your injured ankle, stopping before it starts to hurt.

Full weight-bearing

Almost done! When your physical therapist thinks your ready, he or she can give you the green light to put your whole body weight on your now mostly-recovered ankle.

• Single leg stance – Stand up and hold on to something for balance. Put all your weight on your injured ankle for 15 seconds.
• Standing calf raises – Again with a balancing aid, put all your weight on your injured ankle and raise yourself up on it by extending it. Hold for 15 seconds.
• Lateral stepping – Put something like a rolled-up towel on the floor as a divider, and step sideways over it with both feet.
• Lateral jumping – This is the same thing, except you jump sideways back and forth across the towel, landing always on your outer foot.
• Balancing towel stand – Fold a towel up till it’s fairly thick, and stand on it with your injured foot. The thickness of the folded towel should force you to balance with your injured ankle, rebuilding strength and mobility.

These exercises vary by direction and intensity, and a physical therapist can guide you through when you need to keep working on one stage and when you can move to the next.

Haymarket Physical Therapy are the premiere physical therapists in the Prince William or Fauquier County area. If you’re recovering from an ankle injury and want to be sure to heal as safely and quickly as you can, give us a call at one of our Northern Virginia locations.

Haymarket, Va.: 703-753-0261

Bristow, Va.: 571-719-3563

Bealeton, Va.: 540-905-7111