Whether you’re dealing with a posterior or anterior ankle impingement, quickly addressing your ankle injury with proper treatment will result in quicker recovery. Rebuilding ankle function is crucial and a well-rounded treatment plan should include appropriate ankle impingement exercises that focus on both flexibility and strength. Keep reading to learn more about the best ankle impingement exercise recommended by physical therapists.
Swelling, pain, and abnormal ankle mechanics from ankle impingement commonly result in limited range of motion and poor flexibility. Gently stretching the ankle joint and lower leg muscles can give pain relief, improve blood flow, allow better joint mechanics, and improve your ability to return to daily activities. Regardless of whether you’re suffering from anterior ankle impingement or posterior ankle impingement work on adding these exercises to your daily routine.
There are many different ways to stretch the calf muscle; including this staggered lunge. This area is often stiff and sore with any ankle issue.
A standing calf stretch can also be done in sitting with a stretch strap or standing on a step.
Additionally, you can try stretching the ankle in the opposite direction; such as a plantarflexion stretch like this one.
When your ankle is feeling stiff, some simple guided stretches with your hand can feel pretty great. The key is to stay as relaxed as possible and let your hands guide your ankle passively. These stretches will address local ankle muscles, tendons, the joint capsule, and ligaments.
This explanation is specifically for addressing stiff ankle dorsiflexion, the most common deficit with ankle impingement. You may choose to add other stretching options such as plantarflexion (most sensitive for posterior impingement), inversion and eversion. Simply use your hands to guide your foot into the area of restriction- pointing the toes or shifting the entire food inward or outward.
This mobilization exercise keeps the tibia in an optimal position as you bend the ankle. This helps improve normal joint mechanics, range of motion and flexibility with dorsiflexion. When done correctly, you should notice immediate results with more pain free ankle range of motion.
When dealing with ankle pain and weakness, a simple 4-way ankle strengthening routine can be great for mobility and function. This routine is based off of the four primary movements of the ankle joint: inversion, eversion, plantarflexion, and dorsiflexion. Start with low resistance and build the intensity and number of repetitions with time as your ankle can tolerate it.
Grab a resistance band and sit on the floor with the legs out straight for this exercise. These moves strengthen and mobilize the medial (inside) and lateral (outside) ankle joint muscles and connective soft tissue.
Grab your resistance band again for this one. This is a gentle way to strengthen the calf muscle and promote better joint mobility without the pain that often occurs with weight bearing exercises.
Weakness with dorsiflexion is common with anterior ankle impingement. To strengthen the shin muscles that dorsiflex the ankle, you will need to create your own pulley system or ask someone for help!
Proprioception, or the ability to sense where our joints are space, is crucial for good balance and safety with daily activities. When the ankle joint is injured, this messes with this delicate sensory system. Additionally, it can lead to weakness or poor coordination with the intrinsic muscles of the food and ankle. Balance exercises are always a great way to restore your confidence in your feet and ankles.
Standing on one leg is one of the easiest ways to challenge your balance. Depending on your current level of fitness and comfort, you can stand on the floor or a softer more challenging surface like a foam pad or balance disc.
To progress, add dynamic moves while standing on one leg. These might include head turns, closing the eyes, arm movements, or movement of the opposite leg.
Completing step ups on a foam balance pad adds an extra dimension of balance. You should feel muscles working and coordinating all the way from your core to your toes. You can simply place the foam pad on the floor or on top of a step to add a height challenge as well. To prevent slipping, ensure that the pad is placed in a non-skid area.
To progress, you can add further height or try a side step as well.
This balance exercise has so many great benefits for ankle impingement, particularly ballet dancers. You are strengthening intrinsic foot muscles while addressing balance and building tolerance for plantarflexion (pointing the toes). Always make sure that you can properly do a toe raise on a sturdy surface first before progressing to a foam pad. There should be minimal shaking or ankle instability and no pain when completing this exercise.
To progress, try returning on only one leg at a time (alternating) or doing a full single leg toe raise.
If you want to take your exercises to the next level to build your strength for daily activities and sport- then the following exercises are a great option for you. These are advanced exercises that are meant to be used in the last stage of the recovery process when you are ready to return to your sport or other activities.
This is a great functional exercise since it promotes optimal balance and muscle control in the leg while standing on one leg. Since we stand on one leg each time we take a step to walk or run, having this control will improve your quality of life.
To progress, try holding weights in your hand. Start with 3-5 pounds and build up to 10+ from there.
A lunge is a great functional exercise for coordination, full body movement, strength, and range of motion (particularly ankle dorsiflexion). Lunging is a common daily move that we use to pick small items up off the floor or during sport activities.
A squat is another very functional move that we do every single day. Whether it’s getting up from a chair or a dance move, being able to comfortably squat with good form is essential. It can be particularly difficult with ankle impingement since it requires pain free dorsiflexion.
To progress, you can try adding more dynamic ankle motion with a calf raise (heel off the ground) at the top of each repetition.
Exercise is a crucial part of an ankle recovery program. A well-balanced program will restore strength, flexibility, and coordination that are necessary for pain free use. The hope is to be able to manage your symptoms conservatively to avoid surgery, like an arthroscopy. The benefits of regular exercise for the ankle are endless, including:
In general, to promote optimal recovery, simply avoid any move that increases your pain, aggravates symptoms, and causes ankle instability. This most often means that you will avoid end-range of motion and high impact moves like jumping or running until your symptoms are better managed.
If you are having trouble tolerating any exercise, consider other treatment modalities for chronic ankle pain relief before and after your exercise program.
If you’re not sure where to start or how to progress, scheduling a round of physical therapy is a great option for a personalized program and treatment plan that you can feel confident in. Additionally, if your symptoms aren’t improving or getting worse, make sure to get a hold of your doctor as soon as possible for appropriate medical advice. They may need to do additional testing, such as an x-ray, to rule out issues like fracture or bone spurs.
With the right understanding and exercise program, you can feel in control of the recovery process for ankle impingement. Try out the exercises, stay in touch with your doctor or physical therapist, and you will notice a gradual change in your symptoms in no time.
Sources:Ankle Impingement Products