Ankles act as the body’s primary shock absorbers, playing a vital role in maintaining balance, standing, walking and running. However, most people rarely pay attention to their ankles until they suffer an injury.
Such injuries are common, according to Genevieve Tawiah, a performance physiotherapist who has worked on television shows such as Strictly Come Dancing, reports BBC.
Data from the National Institute for Health and Care Excellence (NICE) shows that ankle injuries account for five per cent of all visits to Accident and Emergency (A&E) departments in the UK.
Speaking on the podcast What’s Up Docs?, Tawiah said these injuries could be prevented “if you are strong and aware of your foot and ankle and the chain that affects it”.
She outlined three key ways to strengthen the ankles and reduce the risk of injury.
Building a mind-body connection
Tawiah said developing strong ankles and reducing the risk of injury starts with becoming “brain to body aware”.
This means being able to recognise the specific movements of the ankles without having to look down at them.
“It’s about sending information from the brain down to our foot and ankle to ground us and build a good foundation for any exercise training that follows,” she explained.
To develop this awareness, Tawiah recommended exercises that involve observing foot movements, starting with small toe movements that influence how weight is distributed through the ankles.
She highlighted two exercises:
Big toe press: Press the tip of the big toe into the floor, hold it and observe how the arch of the foot engages. This should feel like “something pulling through the arch of your foot”.
Toe abduction: Place a pen on the floor parallel to and next to the big toe, then try to move the big toe towards it.
Developing strength, control and balance
Tawiah explained that the ankle’s main functions are to help maintain balance, bear weight and transmit force.
To improve these functions, she recommended several exercises and routines.
Heel raises: Stand next to a sturdy surface, lift the heels off the floor and roll onto the toes. Ensure the ankles remain stable and do not wobble or turn outwards.
Balance walks: Walk with one foot directly in front of the other, similar to a gymnast walking on a balance beam, while maintaining control of the feet.
Movement control: Practise moving from sitting to standing on one or both legs, as well as walking up and down stairs. Those who habitually lead with one leg when climbing stairs should practise using the opposite leg.
For people recovering from ankle sprains, Tawiah suggested balancing on one leg while throwing and catching a ball. She also recommended practising controlled landings by stepping to either side and stabilising on the landing leg.
For those with tendinopathy, a condition involving chronic tendon pain, she stressed the importance of applying a slow, heavy load. Weighted calf raises, including those performed on a leg press machine, are one option.
Wearing appropriate footwear
Choosing the right footwear is also essential for ankle support.
Tawiah warned that many people “fall into the trap of wearing flat ballet pumps, pointy shoes or trainers that are narrower at the front”.
She suggested imagining the foot with the top of the shoe removed to check whether the toes have enough room or whether the big toe is being pushed sideways.
Although barefoot shoes are becoming increasingly popular and can be useful, Tawiah stressed that people should first establish a good level of foot and ankle strength and gradually adjust to wearing them.
She also recommended footwear with some arch support, as this influences how weight is distributed through the foot during physical activity.
Different activities also require different types of footwear.
Squats: Flatter shoes are preferable because spongy soles make it harder to maintain balance and distribute weight properly.
Running: Trainers with greater cushioning are more suitable for absorbing impact and shock.
All-terrain walking: Hiking boots can help reduce the risk of serious ankle sprains. However, wearing them for long periods every day may increase ankle stiffness by limiting ankle mobility to some extent.
