After an injury, it is important to regain range of motion (ROM) in the ankle. Any stiffness or swelling in the ankle can affect your gait (the way you walk), and will affect you in your sport. Your entire kinetic chain can be affected, leading to knee, hip and back problems. Yet it is also important to maintain ankle range of motion to prevent injury. If the muscles of your ankle are too tight or too weak, that will lead to injury as well. The strength, or lack thereof, in the muscles of the lower leg and foot, which all cross the ankle joint, plays a role in ankle range of motion.
Use your toes to "write" the letters of the alphabet in the air. This exercise works the ankle in all ranges of motion and exercises the muscles that are affected by ankle sprains or fractures, shin splints and Achilles tendon injury or tightness. The alphabet exercise is easy to do and doesn't require any equipment. It's best to do this exercise with your foot and ankle hanging off the bed or table with your lower leg still supported. Keep your lower leg still and do not roll your hip in or out. In a physical therapy clinic, you may be instructed to do this exercise on an isokinetic machine or in a pool as part of aquatic physical therapy.
Ankle Inversion and Eversion
The most common ankle injury is the ankle sprain. It can happen while running or walking on an uneven surface, landing awkwardly or even just stepping off the curb or wearing heels that are too high. There are three major ligaments on the outside (lateral) of the ankle and the most commonly sprained is the ATF (anteriortalofibular ligament). By using resistance tubing or Theraband, wrap it around the involved foot. Pull the band around the edge of the table at the desired resistance. You can also cross the uninvolved foot over and wrap the resistance band around the outside of the uninvolved foot for resistance. With your foot and ankle hanging off the surface, with your leg straight, roll your ankle in (inversion) against the resistance of the band. This exercise targets the posterior tibialis muscle. Wrap the band around the opposite side of the table and roll your foot out (eversion). This strengthens the peroneal muscles on the outside of the lower leg. Both inversion and eversion should be performed for three sets of 10 reps.
This exercise strengthens the calf muscle (gastrocnemius). There are muscles in the foot that cross the ankle joint that are also active during a heel raise. Hold on to a chair or a wall for balance, if necessary. Tip your toe slowly for four counts and lower slowly until your heels touch the ground again. Do two sets of 10 repetitions, working your way up to three sets. This exercise can be done while seated. By bending the knee a separate calf muscle, the soleus, is targeted.
A tight Achilles tendon can be painful and will limit ankle ROM. A sudden increase in activity can also cause an Achilles tendon rupture. Step back with the involved leg and keep the heel on the ground. Bend the front knee and lean forward until a stretch is felt in the calf and Achilles. You can also use a towel, belt or stretch cord and stretch your calf and Achilles while seated. Hold the stretch for 30 seconds and repeat three times.
- "Rehabilitation Techniques in Sports Medicine"; Third Edition; William E. Prentice; 1999
- "Therapeutic Exercise for Musculoskeletal Injuries"; Second Edition; Peggy Houglum; 2005