Ankle strengthening exercises using resistance bands represent one of the most common ways to restore and improve ankle strength following an injury. Most of these exercises can be performed in a non-weight bearing position, and while they are helpful at any stage in the rehab process, they are especially good in the sub-acute phase when you’re ready to be doing something to get better, but not quite ready for more functional weight bearing activities that may load the ankle beyond its capacity.
This article will review some of the best ankle band exercises to perform after an ankle injury or surgery, for example an ankle sprain, fracture, or open-reduction internal fixation (ORIF). In addition to describing and showing the exercises, we will discuss some of the related anatomy and things to keep in mind for various ankle injuries.
With that said, it is important to keep in mind that there is a wide array of ankle injuries and associated surgeries, and as such, the clinical treatment plan may be different depending on the individual and extent of injury.
Therefore, in order to determine the appropriateness of these ankle band exercise for your particular case, especially if a fracture or surgery is involved, it is highly recommended to consult with a physiotherapist in person to ensure you know exactly what to look out for when trying these exercises for your own recovery.
Non-Weight Bearing Ankle Band Exercises
Ankle Eversion
This ankle strengthening exercise can be considered a go-to ankle strengthening exercise, especially after ankle sprains. Eversion is the motion whereby you bring the outside of your foot up towards the outside of your shin. You can do this exercise in many different positions, for example, standing, sitting, or lying on your side. I personally prefer the long-sit position, as this allows you to monitor your own form quite well, and I just find it easier to isolate the eversion motion this way.
Banded ankle eversion is really important when trying to improve strength and overall ankle stability. It will target the peroneal muscle group, which are located on the lateral aspect (outside) of the leg. While the main action of the peroneal muscles is ankle eversion, their contraction will help prevent inversion when the foot is planted on the ground, which is the classic mechanism of injury for a lateral ankle sprain. They represent the first line of defence against rolling the ankle, and as such, it can be an important exercise when attempting to improve ankle stability.
Caution should be taken with this exercise when rehabbing a medial ankle sprain, as excessive eversion too early in the recovery process may stress the deltoid ligament while it’s healing. When in doubt, performing this exercise in an isometric fashion, that is, working against the resistance band without actually moving the ankle, can be an alternative approach.
Instructions:
– Tie a resistance band around your forefoot.
– Stretch the resistance band towards the opposite foot, loop around it, and hold the band in your hand.
– Without rotating the whole leg, bring the outside of the foot towards the outside of the shin. This is a small and sometimes tricky movement to perform. One indication of a proper movement pattern is seeing or feeling the peroneal muscles contract on the outside of the leg.
– Tip: Placing a rolled towel, or something similar, under the Achilles tendon can help left the heel off the ground, which can reduce any sort of grip that may be interfering with the motion.
– Dose: A good starting point is 3 sets x 8-12 repetitions. If this can be comfortably performed, one can further refine from there. Higher resistance and lower reps will facilitate strength gains, while lower resistance with higher reps will facilitate endurance.
Ankle Inversion
Banded ankle inversion is another exercise that is crucial for ankle stability, especially after a medial ankle sprain. Inversion is the motion of rolling your ankle and will target a variety of different muscles, including tibialis posterior and tibialis anterior.
These muscles also have other functional actions, such as supporting the medial arch of the foot. Just like banded ankle eversion, this inversion exercise can be performed in many different positions. I personally prefer the long-sit position, as it allows you to easily monitor and isolate the movement pattern.
Ankle inversion strength is often ignored in lateral ankle sprain rehab, as moving through this full range of motion can stretch the ligaments on the outside of the ankle, such as the ATFL and the CF ligament, and these structures need to be as taut as possible once healed.
Therefore, moving through full range inversion is often avoided in early stages of recovery from a lateral ankle sprain, and can instead be performed in an isometric fashion (i.e. working against the resistance of the band without actually moving the ankle).
While it may be recommended to avoid this full range of motion in the acute and sometimes sub-acute phases of lateral ankle sprain rehab, it is still a functional movement pattern and the muscles involved are important for general ankle and foot stability, so it should not be ignored altogether, especially once in the remodelling phase of tissue healing.
Instructions:
– Tie a resistance band around your forefoot.
– Cross your legs and stretch the resistance band towards the opposite foot, loop around it, and hold the band in your hand (e.g. when doing this exercise for the left ankle, you will be holding the band in your right hand)
– Without rotating the whole leg, bring the inside of the foot towards the inside of the shin, like you’re rolling your ankle. This is a small and sometimes tricky movement to perform. One indication of a proper movement pattern is seeing or feeling the tibialis posterior muscle contract on the inside of the ankle. Its tendon wraps around the medial malleolus and can be palpated in this area.
– Tip: Placing a rolled towel, or something similar, under the Achilles tendon can help left the heel off the ground, which can reduce any sort of grip that may be interfering with the motion.
– Dose: A good starting point is 3 sets x 8-12 repetitions. If this can be comfortably performed, one can further refine from there. Higher resistance and lower reps will facilitate strength gains, while lower resistance with higher reps will facilitate endurance.
Ankle Plantarflexion
Ankle plantarflexion is the motion of pointing your foot/ankle down, for example, pressing the gas pedal. This is an extremely functional movement pattern, as it’s one of the main propulsion mechanisms for walking and running, and as such, is one of the crucial ankle strengthening exercises.
The most classic exercise for ankle plantarflexion is a calf raise, but this exercise may be too dangerous to perform in the early stages of recovery from an ankle injury, especially if weight bearing is contraindicated. By performing ankle plantarflexion with a resistance band, you can still strengthen the calf muscles that perform this movement while avoiding the load of weight bearing.
For the sake of simplicity, we will discuss the two primary ankle muscles involved in plantarflexion: the gastrocnemius muscle and the soleus muscle. Both of these muscles form the Achilles tendon which crosses the back of the ankle and attaches to the heel.
More proximally, the muscles actually originate from different spots on the leg. The gastrocnemius forms two heads, a lateral and a medial head, which cross the knee. This is the bigger and more superficial calf muscle you can see on the back of your leg close to the back of your knee. Given it crosses the knee, contraction of this muscle will also assist in knee flexion in addition to ankle plantarflexion.
The soleus, which is located a little further down the back of the shin and sits deep to the gastrocnemius, is often ignored by gym-goers, as you can’t see its definition quite as well as the gastrocnemius. That said, the soleus is actually considered the powerhouse for walking and running. Given it only cross the ankle, its action is purely focused on ankle plantarflexion, but then the foot is planted flat on the ground, it can also serve to control ankle dorsiflexion and knee flexion during a squat-like maneuver. Therefore, there is absolutely merit in targeting this muscle specifically when strengthening the calf.
Both of these muscles can be strengthened using a resistance band. In this case, the preferred position is sitting in a chair, or in long-sit like the eversion and inversion exercises. In order to target the gastrocnemius muscle, the exercise should be performed with a fully straightened knee. Conversely, to target the soleus muscle, the exercise should be performed with the knee bent, which will reduce the contribution of the gastrocnemius, thus shifting the focus to the soleus muscle.
Instructions:
– Tie or loop a resistance band around your forefoot and hold the band in your hands.
– Gastrocnemius: While keeping the knee fully straight, point the foot downwards like you are pressing the gas pedal. You should feel a squeeze in the back of your leg in the calf muscle.
– Soleus: Keep your knee bent, or place something under the knee to keep it bent, and perform the same pointing motion with your ankle like you are pressing the gas pedal. You should feel a squeeze in the back of the leg in the calf muscle, just a little lower down relative to the straight knee version.
– Tip: Placing a rolled towel, or something similar, under the Achilles tendon can help left the heel off the ground, which can reduce any sort of grip that may be interfering with the motion.
– Dose: A good starting point is 3 sets x 8-12 repetitions. If this can be comfortably performed, one can further refine from there. Higher resistance and lower reps will facilitate strength gains, while lower resistance with higher reps will facilitate endurance.
Ankle Dorsiflexion
Ankle dorsiflexion, which is the motion of bringing your foot up towards your face, is essentially the opposite of ankle plantarflexion. The motion itself is also extremely important from a daily function perspective, as it allows people to do things like clear their foot from the ground when walking, descend stairs in a normal fashion, and perform a squat motion. As such, it’s an equally important ankle strengthening exercise as the ones listed above, but is often overlooked.
The main muscle involved in ankle dorsiflexion, among others, is the tibialis anterior muscle. This is the muscle you can feel on the front of the shin just to the outside of tibia, which is the bigger shin bone you can feel. You should be able to feel this muscle contract by bringing your foot upwards while leaving your heel on the ground.
One of the easiest ways to strengthen this muscle is by tying a resistance band around a table leg and around the top of your forefoot. Starting in a pointed foot position, you can then bring your foot upwards against the resistance of the exercise band. This exercise is usually easiest to do in a long-sit position, or sitting in a chair.
Extreme caution should be taken with this motion/exercise if the Achilles tendon or calf muscles have been injured, and as such, if injury to these structures is involved, it’s highly recommended to check with a physiotherapist in-person first to determine suitability of this exercise.
Instructions:
– Tie a band around a sturdy object like a table leg and then around your forefoot.
– Pull against the band’s resistance by bringing your forefoot up towards you.
– You should feel a squeeze on the front of the shin, perhaps even bserving the contraction of the tibialis anterior muscle.
– Dose: A good starting point is 3 sets x 8-12 repetitions. If this can be comfortably performed, one can further refine from there. Higher resistance and lower reps will facilitate strength gains, while lower resistance with higher reps will facilitate endurance.
Ankle Band Exercises – Beginning of Weight Bearing
Squat with Focus on Peroneus Longus and Flexor Digitorum Longus
This is a rather unique ankle strengthening exercise that usually doesn’t come to most peoples’ minds when they hear the term ankle band exercises. While it may not look like one of the more conventional ankle resistance band exercises, this exercise is a great way to shift towards more functional strengthening when getting back into weight bearing, as it requires a good level of focus and control, but doesn’t require single leg weight bearing and can be performed within a range of motion that is comfortable for the individual.
The purpose of this exercise is to recruit peroneus longus and flexor digitorum longus, two important ankle muscles, in a functional weight bearing movement pattern. We mentioned before that peroneus longus is one of the main muscle responsible for ankle eversion, but by way of its origin and insertion points, it also helps to pull the inside of the foot and big toe down to the ground during the first half of stance phase in walking and running.
The same goes for flexor digitorum longus, which attaches to the bottom of the big toe. This is a very important function to prevent rolling of the ankle, or an inversion ankle sprain, when walking or running, so it’s a great ankle strengthening exercise for those who anticipate returning to these activities after an ankle injury.
Instructions:
– Tie a band around a table leg very close to the ground.
– Stretch the band out so there is a good amount of tension on it.
– Pin the band to the floor under the ball of your big toe (1st MTP joint), but NOT your heel.
– Keep the band pinned to the floor with the ball of your big toe while you perform a partial or full squat. You may feel a bit of a squeeze in the medial arch of the foot or bottom of the foot, or it may also feel like you are more constrained/restricted while performing the squat.
– Tip: If you don’t feel any additional work created due to the band relative to a normal squat, check to make sure the band isn’t also pinned under your heel, as this will defeat the purpose of targeting the peroneus longus and flexor digitorum longus muscles. You may also require more resistance/stretch on the band regardless.
– Dose: A good starting point is 3 sets x 8-12 repetitions. If this can be comfortably performed, one can further refine from there. Higher resistance and lower reps will facilitate strength gains, while lower resistance with higher reps will facilitate endurance. That said, this exercise isn’t about pure strength and endurance, but more so about motor control and practicing incorporating these muscles into functional movement patterns. Therefore, some people like to do less sets/reps to focus purely on the technique, and then as they become more familiar, incorporate this into more repetitions to really build it in.
Ankle Band Exercises – Summary
Ankle band exercises are a great way to build strength, stability, and even range of motion around the ankle joint without exposing the ankle the load involved in weight bearing, making them especially good for rehabbing ankle sprains. Even in the later stages of injury rehab, or without an injury altogether, these exercises are a great way to build and maintain foundational ankle strength.
While generally safe to perform, there are certain situations in which particular injuries may not respond well to a particular exercise, especially in the acute stages of recovery, so if you’re concerned about suitability of these ankle exercises, it’s highly recommended to consult with a doctor or physiotherapist prior to commencing any exercise you are not confident in performing safely.
Disclaimer:
The content here is designed for information & education purposes only and is not intended for medical advice.
