Deep Dive Into the Ankle Joint

by: Alicia Oberholzer PT, DPT, OCS – Warm Springs Holistic Health

The ankle joint is the connection between the lower leg and foot. It is composed of three bones known as the tibia, fibula, and talus.

The ankle joint allows the foot to move through the contraction of muscles, which are connected to the bones via tendons. The foot can move in four directions, further explained below.

  • Dorsiflexion: The muscles on the front of the lower leg move the foot up towards the shin.

  • Plantarflexion: The muscles on the back of the lower leg point the toes downwards, like when pushing down on a gas pedal.

  • Eversion: The muscles on the outside of the lower leg move the foot out and away from the body’s midline.

  • Inversion: The inner muscles on the lower leg point the foot in closer to the body’s midline.

The ankle bones are further connected by ligaments, which help to stabilize and support the joint. While there are ligaments on both the inside and outside of the ankle, the outer ones are most commonly injured. These injuries, known as lateral or inversion ankle sprains, account for 85% of all ankle injuries.

While unfortunately it is impossible to prevent 100% of ankle sprains, research has shown that the risk of repetitive injuries can be reduced through consistent and progressive exercise.

Simple progression of ankle stabilization exercises:

  1. Tandem Stance: Place one foot directly in front of the other so that the heel of your front leg is in contact with the toe of your back leg. Perform 3 sets of 30 second holds daily.

  2. Single Leg Stance: Perform 3 sets of 30 second holds daily.

  3. Y balance: Draw or imagine an upside down “Y” on the ground. The stem at the base of the “Y” should be pointing out ahead of you with the fork behind. Stand on one leg at the center point where the 3 lines connect. Practice reaching your opposite foot out as far as you can along the 3 lines consecutively (forward, backwards/left diagonal, backwards/right diagonal) making sure to not put your reaching foot down in between reaches. Work up to performing 5 sets on each leg without errors.

Other ways to progress the above balance exercises include standing on a foam pad, rotating your head side to side, or closing your eyes. Safety is the number one priority, so make sure that you are in a safe environment with friends and family present if necessary. If you have balance issues that put you at risk for falling, it is best to first consult your doctor about initiating your program within a medical setting like Physical Therapy.

If you have further questions about the ankle joint, please reach out to the Physical Therapy team at Warm Springs Holistic Health for more information. We are accepting new patients for in person and telehealth visits on a referral basis.

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