Healthy Life: Ankle Exercises (703)
Healthy Life: Ankle Exercises
蘇鎮邦 (Christopher So)：
舒整物理治療師 (Manipulative Physiotherapist) 人類工程師 (Ergonomist)
Ankle sprain is one of the commonest sports injuries. Almost everyone would have sprained their ankles during their life even they do not play any sport. If the sprain is bad enough to affect walking or require the use of crutches, then physiotherapy is a must for full rehabilitation and recovery.
Inversion injury (diagram 1) is by far more common than eversion injury because the range of movement of inversion is much greater than eversion especially when it is in the toes up or plantaflexion position. Ankle plantaflexion is greater than dorsiflexion.
Diagram 1: Inversion injury – lateral collateral ligaments, tibia and fibula
There may be various types and degrees of ankle sprain but the rehabilitation exercises are basically the same. However, the speed of progression will be instructed by the physiotherapist. The following exercises are for reference. If in doubt, you should consult your physiotherapist.
The first stage is for active exercises then it should progress to passive stretching exercises. The second stage is strengthening exercises in the form of active resistive exercises which should progress to weight-bearing exercises. The final stage is for balance exercises.
(1) Plantaflexion and dorsiflexion
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(2) Inversion and eversion
(3) Resisted exercises
Use of elastic band or thera-band to resist (a) upward movement of the foot or dorsiflexion, without resistance is a passive stretching exercise
(b) downward movement of the foot or plantaflexion, without resistance is a passive stretching exercise
(c) inward movement or inversion, without resistance is a passive stretching exercise
(d) outward movement or eversion, without resistance is a passive stretching exercise
(4) Weight-bearing exercises
Dorsiflexion is a very important functional movement. You need to be able to lift your ankle up to walk and bend it passively as you walk downstairs. If this is not fully rehabilitated, it can affect your knees and hips and even your back due to limping or uneven weight bearing on each foot.
The exercise looks simple but it needs to be done correctly. Your heels must be on the ground all the time. You need to put your hands on the wall to avoid putting too much pressure on your knees. The good point about this exercise is that you can measure your improvement by measuring the distance between the wall and the big toe of your affected foot.
(5) Balance exercises and Calf strengthening exercises
The exercise looks simple but it needs to be done correctly. You need to put your fingers on the wall especially for the balancing exercises. If you lose balance you can save yourself. There is no point in hurting yourself doing the exercises. Exercises need to be effective and safe.
There are two stages for calf strengthening exercises:
(i) With both feet on the ground, push your toes up together.
(ii) With the unaffected foot up, push up only on the affected foot.
All the above exercises should be done 20 repetitions for 4 times a day. Older patients should half the number of repetititon but still for 4 times a day.
There are two stages for balance exercises:
(i) With your foot flat, lift the unaffected foot up and balance on the affected foot. If you can balance for a count of ten or 10 seconds then it should be adequate for most activities.
(ii) Next, you have to upgrade it to standing on your toes.
10 repetitions 4 times a day should be adequate for most people. Athletes may need to do more. You should consult your physiotherapist.
