Ankle Health


Ankle Health: Preventing Injuries Before They Kick You to the Ground

Strength & Conditioning Exercises to Keep Your Ankles in Top Condition and On Your Feet

By Jerry Shreck, Head Strength & Conditioning Coach, Bucknell University

Talk to any group of athletes and ask them if any of them have ever sprained an ankle. About 90% would say they have at least “rolled” their ankle at one point during their athletic career. Of this 90%, I would bet 50% of them lost some playing time, and 20% might have lost significant time.

Thank goodness, most athletes today have Athletic Trainers to turn to for injury evaluation, rehab, and taping, which will shorten potentially lengthy missed sport participation time.

But how about the rest of us who don’t have access to a good trainer?

As in most cases, it turns out that prevention is the best cure. There are a number of strength & conditioning exercises we can perform to keep the Ankle Complex as healthy as possible. And, of course, we also know that a strong kinetic chain begins from the ground up. So keeping the ankles in top condition decreases the potential for knee and hip injuries.

What Is the Ankle Complex

The ankle complex is made up of many muscle tendons and ligaments. The muscles are responsible for dorsi-flexion (pulling the foot upward), plantar flexion (pushing the foot downward), eversion (turning the foot outward), inversion (turning the foot inward), and combined angle movements.

For those of you who are anatomy buffs, here are the primary muscles responsible for these movements:

Dorsi-Flexion: Tibialis Anterior, Extensor Diditorum Longus, Peroneus Tertius, and Extensor Hallucis Longus.

Plantar Flexion: Peroneus Longus, Peroneous Brevis, Tibialis Posterior, Plantaris, Flexor Digitorum Longus, Flexor Hallucis Longus, Soleus, and Gastrocnemius.

Eversion: Extensor Digitorum Longus, Peroneus Tertius, Peroneus Longus, and Peroneus Brevis.

Inversion: Tibialis Anterior, Extensor Hallucis Longus, Tibialis Posterior, Flexor Digitorum Longus, and Flexor Hallucis Longus.

When an athlete “rolls” his or her ankle, it is typically classified as an inversion or eversion sprain. They will have a strain to one or more muscle tendons and sprain one or more ligaments. The ligaments (Anterior Talofibular, Calcaneofibular, and Deltiod) attach bone to bone and help stabilize the ankle joint.

Now let’s get to the preventative exercises I have my athletes perform to help prevent or reduce the severity of an ankle sprain:

The Exercises

Banded Eversion:

Sit on the floor with your legs straight. Take a circular fitness band and loop it around your foot and your torso. Then reach down with both hands and grasp with each hand the band at approximately half the distance down your shin and sit back. This will put tension on the band. Keep your ankle locked in a perpendicular position or at 90 degrees. Keeping tension in the outer side hand, pull with the inner side hand and stretch the ankle into an internally rotated position as pictured. It is important to keep the ankle perpendicular to the floor. You will then turn the ankle and foot outward against the resistance of the band. This should be a smooth movement and allow for full range of motion in the ankle. Return back to the internally stretched position again in this smooth fashion. You do not want the motion to be “jerky.” Repeat this for the desired number of reps (typically 12 reps).

Banded Eversion: Turn the ankle and foot outward against the resistance of the band

Banded Inversion:

This is just the opposite of the banded eversion. Band position is identical, but you will keep tension in the inner hand/band and pull the outer hand/band tight, which will externally rotate the ankle and foot. Again keep the ankle perpendicular to the floor.

You will then rotate the ankle internally against the resistance of the band and return in a smooth motion to the stretched externally rotated starting position. Repeat for the desired number of reps (typically 12).

It is important to remember that whether you are internally or externally rotating the ankle/foot, the ankle stays perpendicular to the floor through the entire movement. (Most athletes will make the mistake of pushing the foot down toward plantar flexion as they are rotating the ankle/foot.)

If done correctly, you will feel a quick muscle burn in the outer and inner lower foreleg, specifically in the peroneus muscles.

Banded Inversion: Rotate the ankle internally against the resistance of the band

Resisted Dorsi-Flexion:

There are various ways to train this anterior shin area (the front of your lower leg). I use two 2 x 4’s to raise the heels up from the floor. For a smaller athlete, a single 2 x 4 may be adequate.

Sit at the end of a bench with your knees bent at 90 degrees and your heels placed on the board(s). Then place a plate on the front part of your distal foot at the base of the toes. You’ll then dorsi-flex the ankle/foot (i.e., pull your toes up) for the desired number of reps prescribed (typically 10-12).

Resisted Dorsi-Flexion: Place a plate on the front part of your foot at the base of the toes. Then pull your toes up for the desired number of reps.

Another great way to apply work to the dorsi-flexors is by using manual resistance (not pictured). Sit on a bench with your legs straight and your heels off the end of the bench. Then have your workout partner apply resistance to the distal portion of the foot (same position as the plates) and pull your feet toward your shins against this resistance. You’ll then try to hold this position as your workout partner pulls your feet back to the original starting position. Repeat until fatigue starts to set in. Manual resistance can also be used in a similar fashion for inversion and eversion exercises.

Plantar flexion type of exercises, when you raise your heels (not pictured), commonly known as calf raises, can and should be done standing and seated. When done seated off a bench, place the 2 x 4 under the toes with the feet at shoulder width and the knees at 90 degrees. Placed weight (plates, dumbbells, kettlebells) on the front portion of your quads above your knees and then raise your calves up through the full range of motion for the desired number of reps.

When doing standing calf raises, hold weight in your hands or place a barbell across your upper back in a “high bar” back squat position. Place your toes and front part of your foot on the 2 x 4 with the feet spaced at shoulder width, heels on the floor. Raise your heels off the floor through the full range of motion and squeeze your calves at the top position, lower back to the floor, and repeat for desired reps.

Some coaches will instruct athletes to turn their toes in and then out to “emphasize” different portions of the calf muscles. I do not do this. I opt to have them stand in a wider than shoulder width and then with their feet together in a narrow stance when performing reps.

I have funky rep sets with different names that my athletes laugh about. For example, Satan Calves 6/6/6 would be 6 reps at shoulder width, then 6 reps at a wide stance, followed by 6 reps at a narrow stance done consecutively. This is our heaviest calf workout.

Another example would be Dirty Dozen Calves 12/12/12, this would be done just as Satan Calves but with 12 reps in each position. This is a higher rep, lighter weight, calf workout.

Of course there are always other ways to train plantar flexors. I am not a real fan of machines, but some people find them very convenient.

No matter what your game, keeping your ankles in top condition can save you a great deal of pain and suffering. And keep you “on your feet,” quite literally. In addition, you’ll also likely enjoy the improved shape your calf muscles will start to take after even just a month or two of these exercises.