From the Ground Up: Keeping your Ankles Strong and Stable

In my past few blogs I covered the shoulder, hip and knee joints. Moving on down the body – we now turn to the ankle joint. Your ankles have a tall task:  they must support the weight of your entire body with only the help of small ligaments and tendons.  Furthermore, whenever you walk, run or jump, your ankles have to transmit the force of impact from your feet to your legs.  No wonder the ankle is the most frequently injured joint in the human body.

Your ankle is a hinge joint formed by the articulation of your tibia and fibula (lower leg bones) and your talus (ankle bone).  Because your ankle is designed to move like a hinge around one axis, it is resistant to lateral movements. Typically an ankle sprain occurs when the foot is forced to invert, resulting in a sprain on the outside of the ankle.  Participating in activities that involve fast-paced lateral movements such as tennis, basketball or dance can leave your ankles vulnerable to injury, particularly if the muscles, tendons and ligaments surrounding your ankle are weak and/or inflexible.

Tight calf muscles can also lead to ankle injuries by making it difficult to flex your ankle. This isn’t a problem if you’re moving on even ground, but if you step in a gofer hole, your foot may come up short and twist laterally, resulting in a potential sprain or even fracture. When this happens, the ligaments surrounding the ankle often get overstretched. Because they aren’t very elastic, ligaments often don’t bounce back to their original supportiveness. Protect your ankles by shortening your stride when traversing uneven terrain. This will allow you to react more quickly to potential pitfalls in the trail. Also, practice walking heel-ball-toe.

Case Study

If you do injure your ankle, the pool is a great place to both rehab it and strengthen it to prevent future injuries. Deep water cycling, running and other ankle-specific exercises can help reduce swelling, restore range of motion (ROM), and gradually allow the return to normal activity.  “Bob” came to me after severely breaking his ankle while hiking in Telluride. The break was so bad that surgical pins were placed in his ankle to hold it together. After several months of aquatic therapy and aquatic workouts, the ROM and strength of Bob’s ankle were largely restored to his pre-accident level. Furthermore, he’s now back to running trails pain-free. For more information on aquatic rehab and training, please visit my website at

The key to preventing ankle injuries is to strengthen and stretch the muscles supporting the joint. Try the following three exercises and be sure to stretch your calf muscles after each exercise.

1. Heel Raises

Standing with your feet shoulder-width apart, rise up on the balls of your feet as far as possible and hold for five seconds, then lower your heels. Work up to 20 repetitions and then try the exercise on the edge of a step, lowering your heels below your toes and then raising them as high as possible. Next try walking on your heels around a room. Stretch your calves afterward by letting your heels hand off the edge of the step and holding for 20-30 seconds.

2. Toe Raises

Standing on your heels, lift your toes off the ground and hold for five seconds. Work up to 20 repetitions and then progress to walking around the room while keeping the toes elevated.

3. Edge of Foot Walking

Alternate walking on the inside edges of your feet and then on the outside. This strengthens and stretches the peroneal muscles above your ankles on the sides of your lower legs.

Be Well,




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