Foot & Ankle Rehabilitation Exercises
Table of Contents:
Foot and ankle rehabilitation and strengthening exercises are an important part of prevention and return to activity. Strong feet and ankles optimize their active use:
- They provide a stable platform for the rest of the body to act on.
- They enhance functional movement and performance.
- They enable efficient movement.
- They reduce injury risk and help with injury prevention.
- They help with return to physical activity when injured.
The exercises on this page are for the foot and ankle, but core exercises are also recommended to help stabilize the whole body. Feet and ankles do not operate in an isolated bubble. The foot is connected to the leg, which is connected to the hip and the back, etc…
FOOT REHAB / STRENGTHENING EXERCISES
• Similar to toe scrunches with a hacky sack, except instead of using a hacky sack use a small hand towel or wash rag. Performed in a seated position.
• Using only your toes move the small towel from the toes down to the heel.
• Using only your toes grab the small towel, lift it off the ground, hold, then release.
• Pass the small towel back and forth between your feet using only your feet and toes.
• Repeat with 15-20 reps per foot. Reps should be controlled and intentional.
Similar to toe scrunches with a hacky sack, except instead of using a hacky sack use a small hand towel or wash rag.
- Start in a seated position with your knee and ankle both bent to 90° angles.
- Place a small hand towel or wash rag on the floor.
- With your sole of the foot parallel to the floor, place your toes on the towel.
- Using only your toes move the small towel from the toes down towards the heel.
- Using only your toes grab the small towel, lift it off the ground, hold, then release.
- Reps should be controlled and intentional.
- Repeat with 15-20 reps per foot.
For an extra challenge, pass the small towel back and forth between your feet using only the bottoms of your feet and toes.
Similar to toe scrunches with a hand towel, except instead of using a towel use a hacky sack.
- Start in a seated position with your knee and ankle both bent to 90° angles.
- Place a hacky sack on the floor.
- With your sole of the foot parallel to the floor, place your toes on the hacky sack.
- Using only your toes move the hacky sack forward and backwards beneath your forefoot.
- Using only your toes grab the hacky sack, lift it off the ground, hold, then release.
- Reps should be controlled and intentional.
- Repeat with 15-20 reps per foot.
- For an extra challenge, pass the hacky sack back and forth between your feet using only the bottoms of your feet and toes.
This will help with toe and foot control. It will also help activate the intrinsic foot muscles, the foot core.
- Drive your big toe down to the ground while simultaneously lifting the other four skywards.
- Keep the toes straight and bend only at the joint where the toe attaches to the foot, the metatarsophalangeal joint.
- You should be able to see the medial arch rising slightly as you drive the big toe downward.
- Next, do the opposite. Lift your big toe skywards and drive your other four toes down to the ground.
- Reps should be controlled and intentional.
- Repeat with 20-30 reps per foot.
Don’ts:
- Your ankle should not move from side to side while performing this exercise.
- Your toes should not curling / flex at the smaller toe joints. The only the joint which should be moving is the one where the toe attaches to the foot.
- These practices help isolate and strengthen the intrinsic muscles of the foot, rather than the longer foot muscles starting above the ankle.
- Raise all the toes upwards.
- Spread the toes apart from side to side as much as possible and lower them down.
- Lower the great toe (hallux) last. This helps with activation of the abductor hallucis muscle.
With this exercise you create a dome in your midfoot by elevating your arch. This has the appearance of shortening the length of your foot. The goal is to lift one’s arch by pulling ball of the foot towards the heel without curling the toes.
This builds on the strengthening and activation which develops with Toe Yoga. When doing Toe Yoga correctly you will notice the medial arch rising slightly as you drive the big toe downward.
- Start in a seated position with your knee and ankle both bent to 90° angles and your foot placed flat on the floor.
- Without curling, flexing, or scrunching the toes, pull the ball of your foot toward your heel.
- Keep the toes straight and relaxed. Do not move them downwards. Plantarflexing the toes downward will give a false appearance of arch elevation.
- Do not invert or evert the foot in the process. Inversion will give a false appearance of arch elevation.
- Relax the foot and lower the arch.
- Reps should be controlled and intentional.
- Repeat with 20-30 reps per foot.
Tips:
- Master Toe Yoga, Toe Splay, and Toe Scrunch exercises first.
- 4-Way Resistance band exercises are also a good precursor.
- Pressing /pushing the great toe joint (NOT the toe itself) down into the ground may be helpful in learning to do this exercise.
- For advanced practitioners and increased difficulty, this may be done while standing, balanced on one foot, or while doing squats.
There are many conditions where this is not advised. If you have peripheral neuropathy and / or diabetes, do not ever place your feet on the ground without a good fitting shoe or slipper. Other conditions and the effect of barefoot walking on them should be discussed with your foot and ankle doctor. Walking barefoot will make some conditions and injuries worse.
If appropriate for your feet, barefoot activity is best approached as an exercise with limitations on time and effort, rather than as a lifestyle. People who embraced the barefoot fad several years ago promoted in the popular and entertaining book “Born to Run” by Christopher McDougall traded one set of injuries for another. Shoes and their effect on feet are a large topic and discussed elsewhere on this site. Each pair of feet is unique, and what works well for one set will not work for another.
Barefoot walking or running, under the right circumstances, and when done in moderation, can be helpful with some conditions. It can increase foot mobility and strength. This should be approached with caution and care to avoid overuse.
ANKLE REHAB / STRENGTHENING EXERCISES
- Using your toes / forefoot, trace the letters of the alphabet in the air.
- This mobilizes the ankle and is done without resistance.
- For variety trace the letters of the alphabet in upper- and lower-case letters, as well as cursive and block scripts.
- Sit in a chair or on the floor with your leg in front of you.
- Wrap or loop the TheraBand or similar resistance band around the ball of the foot.
- Hold the opposite end securely with your hands.
- Reps should be controlled and intentional.
- The difficulty of these exercises is controlled by the strength of the resistance band used, and how hard one pulls on the resistance band in the opposing direction.
- These exercises should NOT be painful.
1. Ankle Dorsiflexion (upward motion)
- Against resistance slowly move the foot upwards, pulling the toes upward toward your shin. This movement is primarily in the ankle joint.
- Pause for 1-2 seconds. Slowly return to neutral position, then repeat.
- Perform 15-20 reps.
2. Ankle Plantarflexion (downward motion)
- Against resistance slowly move the foot downwards, as if you are pressing down on the gas pedal of a car plantarflexing the ankle. This movement is primarily in the ankle joint.
- Pause for 1-2 seconds. Slowly return to neutral position, then repeat.
- Perform 15-20 reps.
3. Ankle Inversion (turning inward)
- Place the center of the TheraBand around the outside edge of the opposite foot. This redirects the TheraBand and creates a fulcrum to provide resistance against ankle inversion.
- Against resistance slowly rotate the foot inwards, towards the center or midline of your body. This movement is primarily in the ankle and hindfoot joints.
- Pause for 1-2 seconds. Slowly return to neutral position, then repeat.
- Perform 15-20 reps.
4. Ankle Eversion (turning outward)
- Place the center of the TheraBand around the outside edge of the opposite foot. This redirects the TheraBand and creates a fulcrum to provide resistance against ankle eversion.
- Against resistance slowly rotate the foot outwards, away from the center or midline of your body. This movement is primarily in the ankle and hindfoot joints.
- Pause for 1-2 seconds. Slowly return to neutral position, then repeat.
- Perform 15-20 reps.
- Stand on a flat surface with both feet flat on the ground. A nearby wall or railing may be used for balance purposes if necessary.
- Rise up onto your toes with both feet.
- Lift the non-working foot off the ground.
- On the working side gradually and slowly lower the heel down to the ground.
- Hold the raised position for 45 seconds. This may be done on either one foot or two.
- Perform 5-20+ reps.
- The goal is to minimize the upward workload by doing this on both sides and maximizing the isometric contraction by only using one side on descent.
- This exercise should NOT be painful.
- If this exercise is painful to do, place your hands on a countertop directly in front of you and lean forward. This will reduce difficulty of the exercise, and can be done only when rising upwards, or for downward assistance also.
- While a light backpack could be loaded with up to 10-15 lbs. for extra resistance during this exercise, increasing the number of reps is recommended rather than increasing weight when performing this exercise.
- Stand on a flat surface with both feet flat on the ground. A nearby wall or railing may be used for balance purposes only (not to support weight) if necessary.
- Rise up onto your toes with both feet.
- Hold the raised position for 45 seconds. This hold position may be done on either one foot or two.
- Slowly lower the heel(s) down to the ground.
- Perform 5-10 reps.
- This should NOT be painful.
FOOT AND ANKLE STRETCHING EXERCISES
- Stretching should NOT be painful.
- The goal with stretching is a long steady hold rather than short fast effort.
- If you cannot comfortably hold the stretch for 90-120 seconds you are being too aggressive. Back off.
- The amount of time put into this is more important than the effort in doing so.
This isolates the plantar fascia so it can be stretched and manually manipulated directly.
- Start in a seated position.
- Cross your affected foot over the knee of your other leg.
- Grasp the toes of your painful foot with hand on the same side as the foot, then slowly maximally dorsiflex upwards the big toe and ankle in a controlled fashion.
- If it is difficult to reach your foot, wrap a belt or towel around your big toe to help pull your toe and ankle toward you.
- Place your other hand along the prominent plantar fascia.
- The fascia should feel like a tight band along the bottom of your medial arch and foot when stretched.
- Perform firm deep tissue massage with the thumb of the hand on the contralateral side from the affected foot. Firmly press and knead longitudinally along the tight plantar fascia and stretch the fascia.
- This may be uncomfortable. It should NOT be painful, and it should NOT flare up the fascia.
- Do this for 90 seconds, then relax.
- Repeat 10-15+ times throughout the course of the day.
- Start by facing and standing at arm’s length away from a wall.
- Place the elbows or palms of both hands against the wall at eye level.
- Place both feet back, away from the wall hip width apart.
- Keep the bottom of the heels flat on the floor.
- Rotate your toes inward (as if you were pigeon-toed).
- Keep your knees straight.
- Slowly lean into the wall until you feel a stretching sensation in the back of your calf muscles. This should NOT be painful or uncomfortable.
- If there is any discomfort, bring both feet closer to the wall until the discomfort goes away.
- Hold this position for 90 seconds, then relax.
- Repeat 15 times throughout the course of the day.
- This stretches both the gastrocnemius and soleus muscle bellies together when the knee is straight.
- Keeping both feet equidistant from the wall, rather than forward and one back, allows both calves to be stretched simultaneously. This cuts the time required to do this exercise in half.
- Both knees may be flexed to stretch the soleus muscle only. The stretching sensation when doing so will be lower on the calf.
This is less aggressive than the standing wall calf stretch.
The seated calf stretch is generally performed in the morning prior to rising.
- Start in a seated position on the bed and place the leg to be stretched out in from of you. Loop a towel or belt around the ball of the foot and pull the ends of the towel / belt toward your torso.
- Keep your knee straight.
- This should NOT be painful.
- If there is any discomfort, lessen the pull on the towel until the discomfort goes away.
- Hold this position for 90 seconds, then relax.
- Repeat 3 times each morning.
This is more aggressive than the standing wall calf stretch.
It is easier to be too aggressive with this stretch than the other calf stretches.
This stretch is more comfortable when done while wearing shoes, rather than barefoot.
- Start standing with the ball of the foot on the edge of a step / stair. The heel should be floating in the air.
- Hold the rail for balance.
- Keep the knee straight.
- Slowly and gently lower the heel downwards a stretch is felt in the calf muscles.
- This should NOT be painful or uncomfortable.
- If there is any discomfort, put less weight and force on the leg being stretched and transfer weight to the hand railing until the discomfort goes away.
- Hold for 90 seconds then relax.
- Repeat 10 times throughout the course of the day.
- This stretches both the gastrocnemius and soleus muscle bellies together when the knee is straight.
- The knee may be flexed to stretch the soleus muscle only. The stretching sensation when doing so will be lower on the calf.
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