Once you have completed the early phase of rehabilitation it’s time to start challenging and progressing the strength and stability of the ankle. The key exercises to be able to do prior to starting this phase of rehabilitation include:
- A normal walking pattern without the need for braces or crutches.
- Isometric seated heel raise with 1.5x body weight or as much weight as you have available. Thirty repetitions is the aim.
- Double leg heel raises up to 20 repetitions.
- A knee to wall distance of greater than 2cm.
Single leg heel raise
- Start position: stand on the injured side foot. A light hand touch on a wall is helpful for balance.
- Movement: raise up onto your toes of the standing foot.
- Hold: for 1 second before lowering back down slowly.
- Repetitions: aim to complete 2 sets of 15 reps.
- Progression: aim to increase the height of the heel lift as high as is comfortable.
Knee to wall ankle stretch
- Start position: stand nearing a wall facing it.
- Movement: with the injured foot flat on the ground and placed in front of you, bend your knee and try to get your knee to touch the wall. Keep the foot flat on the ground. If you can touch the wall with your knee, move your foot backwards. Aim for a stretch at the back of the ankle.
- Hold: hold the stretch for 20-30secs,
- Repetition: repeat 4 times, multiple times a day.
Single leg balance
- Start position: stand on the injured side foot. If needed, use an object to steady yourself initially and then take this support away. Keep your eyes open.
- Movement: attempt to maintain your balance on one leg for at least 30seconds. Try not to fixate your eyes on a single point as this can help your balance but does not help challenge your ankle rehabilitation.
- Repetition: attempt to complete 3 repetitions of 30second holds.
- Progression: you can try balancing with your eyes closed, aiming for 3x10secs holds. You can also try balancing with your eyes open or closed while standing on a soft surface such as a foam mat or a rolled up thick towel.
Balance taps / Y-Balance test
- Start position: stand on the injured side foot with your eyes open.
- Movement: attempt to tap the non-standing foot as far away as possible in any direction. Keep the majority of the weight on the balancing leg. You can bend the knee of the standing leg in the attempt to tap as far as possible.
- Repetition: attempt to complete 4 times 15 taps in any direction. Complete 2 times a day.
- Progression: complete the same exercise while standing on a foam mat or a rolled up thick towel.
Goals before progressing
As a guide, the following should be able to be achieved before progressing to the next phase of rehabilitation:
- Single leg heel raises up to 20 repetitions or at least 80% of the repetitions of the uninjured side.
- A knee to wall distance that is greater than 8cm or within 3cm of the uninjured side.
- Balancing on one leg with eyes open for at least 30seconds and at least 10second with eyes closed.
- A taping distance in the Y-balance test that is less than 4cm different to the uninjured side.