If you had an ankle or foot fracture, then you have a higher chance of developing foot or ankle
arthritis. Ankle arthritis is usually a problem secondary to a foot fracture, ankle sprains, or
inflammatory arthritis like rheumatoid arthritis. It is a condition caused by loss of cartilage that
protects the bones, reduced joint space and loss of lubricant fluid between the bones.
Pain occurs when you put weight on your ankle, so it hurts when you walk, go up
and downstairs, or other movements of the ankle. Your doctor suggested you take painkillers or
get a cortisone injection, and maybe one day you will need an ankle replacement surgery.
But now, is there any kind of exercise you can do to improve your pain and function?
Today, let’s talk about exercises for ankle arthritis.
These exercises are also very helpful if you just had a recent ankle trauma, like a sprain or
fracture, and you were immobilized for a few weeks. After your doctor removed the cast or boot,
they told you to do some exercises. Well, these exercises are excellent for that situation.
Make sure you have a non-slip shoe, like a sneaker
or running shoes, so you don’t slip or lose your balance.
Do not do these exercises if you get dizzy. If you have a tendency to lose your balance,
ask someone to stay with you while you do the balance exercises.
There are 8 exercises in this routine These are the equipment you will need:
You will need some elastic bands for the strengthening exercises, and a staircase
to practice going up and down. If you don’t have a staircase, you may practice with a step.
So, exercises are always the first choice treatment for osteoarthritis. You need to
remember the LAWS exercises that I demonstrated in the video of hip and knee osteoartrtitis.
L is for lubrication exercises, remember motion is lotion. They help to warm up the joints,
improve range of motion and break down any thick fluid. You may do lubrication exercises
in the morning before you get up from bed. A is for aerobics, they are important to maintain
a good cardiovascular system. They also help to maintain a healthy weight. They include walking,
going up and downstairs, and many other activities that make your heart beat faster. Make sure
to talk to your doctor and ask if you don’t have any restrictions to do cardio exercises.
W is for weight-bearing exercises. The main advantages are that they reduce pain
and maintain calcium in the bones. This is important to avoid osteoporosis. Another condition
that is very common in people with osteoarthritis. S is for stretching. This is important to maintain
flexibility of the joints, to improve range of motion and to reduce muscle tension.
S is also for strengthening. It is important to maintain the muscles strong to improve
the stability of the ankle joint, so you don’t have another sprain or fracture.
Before I continue, please remember that these videos are for educational purposes
only. You should consult a physician or your physiotherapist to ask about these exercises.
If there is an emergency, go to the nearest emergency department or call an ambulance.
So, the first exercise that you can do when you get out of bed is the lubrication exercises for
the ankle. So, our ankle does plantar flexion, dorsiflexion, inversion, eversion. It is important
to do these exercises in the morning because when you sleep you don't move your ankle, your foot
and then there's not a lot of production of synovial fluid, and then when you wake
up in the morning, there might be stiffness of the joint, and doing this lubrication exercise is very
easy to do in the bed. What you do is: you draw numbers, one to zero, one to ten, with your ankle,
so only using the join,t the ankle joint ,we are going to draw number one, number two, three,
four, five, six, seven, eight, nine, and zero. You see? That's easy, you can do a couple of times,
and when you do this, you do all movements of the ankle before you even get out of bed.
So during the day, the exercise that you can do is just walking,
and i want you to walk on the tippy toes, and on your heels. So make sure that you have a non-slip
shoe,s like running shoe,s or sneakers. So you don't lose your balance, and you don't slip.
But if you feel that you're going to lose your balance, make sure that there is a counter top,
or chair, or some place that you can hold. But this is important. So, first,
if you go on your tippy toes, try to give a few steps, and walk a little bit. what happens is,
you are strengthening the muscles on the back of your leg, here right? So, your calf muscles,
so if you do this they, especially if they had been immobilized after a fracture or after a ankle
sprain, they are very weak, the cuff muscles, so doing this, you are strengthening them,
okay? And there's a couple of times during the day, and you can do this many times during the
day, like if you're in the kitchen, or if you are, you know, watching tv, you can be doing this
exercise, make sure that you don't lose your balance, and you wear some non-slip shoes.
So, the other exercise is walking on the heels, because when you do this,
now you are strengthening the muscles here in the front of your leg,
and this is also important because if they had been immobilized, they're weak,
and I noticed this sometimes. you know. with these weak muscles. the patients complain that they have
cramps in those muscles. So this is a very common source of cramps,
weak muscles here. if you're not using them, so walking on your heels, you see when you do this,
you have to maintain the muscles here, they are called tibialis anterioris, so they keep, them you
know contracted, and this is also good for your balance, because your ankle controls the balance,
the ankle has a lot of receptors for joint position. they are called proprioceptors.
Proprioception means your brain is receiving information about the position of your joints,
and when you are immobilized for a long time, or if you have arthritis of your ankles, you're not
receiving that information, so, well, so by doing this a couple of times, walking on your heels,
you will be exercising that joint, training the proprioception, but also
strengthening those muscles in front of your leg. So, the other exercise is, imagine that there is a
straight line here, on the floor, and you're going to walk in tendem, with one foot in front of the
other one, this is good for your balance, again as i explained, we have proprioception coming from
the joints, the bones, the cartilage, they send information to our brain about the position of our
joints, for example if i don't look at my ankle, I know exactly the position, this is going down,
this is up. How do I know the position of my joints without looking at them? It is because
of the proprioception! So, when we do this, we are training a lot of things, we are training
balance ,and again make sure that you don't fall, you can touch you know the wall, if
you think you're going to fall, but if you don't touch anything, and you don't look at your foot,
okay, so ,you don't look down, try to walk putting one foot in front of the other, one, so the heel
touch the tiptoes the other heel, touch you will see? this is not easy, looks easy, but it's not,
because especially if you had been mobilized in a cast, or in a boot for a couple of weeks,
you lost this ability to sense your joints, and if your proprioception is not good, then you're
more predisposed to have another ankle sprain, ankle fracture, or any other problem with your
feet, because you're losing the ability to control the movements of your ankle, and
the bones in the your foot. so these are exercises that you can do during the day, many times.
So, the other exercise that we're going to do is strengthening exercise with some elastic bands.
Here, to do some resistance to the movements. So, the ankle does this movement: plantar flexion,
and dorsiflexion, so here, you see? and you can always compare the left and right.
if you had the left one for example immobilized because you had a sprain or fracture,
and now your doctor told you that you can remove the boot or the cast, and start doing exercise,
you may compare, you know, the two because you may notice the normal one can dorsiflex up to here,
you see? it's 90 degrees, a little bit more than 90 degrees, and maybe the one the affected side,
is like here, you can't do more than this. And the same thing for plantar flexion,
you see? plantar flexion normal, is almost like a straight line here, and when you had immobilized
for a long time, maybe you cannot do this, maybe your movements are just from here to here.
like here to here, and then, you need to gain that range of motion, and how you're going to do this?
with exercise! and exercise like plantar flexion, dorsiflexion, and if you have a resistance band
like this, so then you can apply some resistance, and you do this exercise against resistance,
so you're also not only gaining range of motion, but you're also gaining some coordination,
because you see? you have to coordinate to the movements, and also strengthening the muscles,
especially here, you're strengthening the muscles of your calf muscles,
okay? and you can use different resistance bands, there are some that are harder than other ones.
So. the other exercise that the ankle does is inversion, eversion. Inversion is inside,
eversion is to the outside. So, we also need to do exercises to strengthen the muscles. The muscles
that do eversion they are here on the side of the leg, and the muscles that do inversion they
are here on the back inside of the leg. And I like to use loop resistance bands, and I have
these ones, like this is extra light ,this is light, a little bit stronger,
this one is heavy, so and this is very extra heavy. extra heavy so you need more, so you
can progress, you know? from the light to the heavy ones. So let's try with this one, if we're
going to do eversion exercise, what you do is you just put them here, and you use your good foot to
do resistance, with the the foot that you're treating, so here, just do this, and you can
do this a couple of times, and you can hold here, hold, hold, hold, you can hold up to 8 10 seconds,
and come back and hold and you do this like eight repetitions, the more you do the better,
and the more stronger the elastic bands, the more strength you're putting there,
more power you're putting in the muscles, right? So this is for eversion, for the muscles outside,
and if you put your hands here, you're going to notice, like relax muscle, put your hands here,
now you're going to feel that they are contracting, these are the peroneal muscles,
or fibular muscles, okay? Now how we're going to do for the inversion, you do the same thing
but now you do it with the legs crossed, okay? So now with the legs crossed like this, you put here,
so now let's say that, let's say that this is the affected foot, the other one would just
stay quiet there, and this one you're going to pull inside, and the same thing you hold for a
couple of seconds, hold, hold, hold. and you can put your hand here, and you're going to notice
that the muscles are contracting, and you're strengthening the inversion muscles.
So, this exercise for the ankle you need to do in a stair, so find a staircase,
if you live in an apartment maybe go to the staircase of your apartment, make sure that you
have handrails, so you don't lose your balance and fall, and if you think you're going to lose your
balance, make sure that there's someone with you, and you're safe, and you're not going to fall.
So, this is an exercise that we're going to go up and down stairs,
but this is more like a brain training of exercise, like it's retraining your brain
how to use the ankle, because if you just go up and down stairs normally, that's so automatic,
that you're not even paying attention, to what you're doing, but if you pay attention,
we're going to go only on the right foot up, and when you do this you see it's not automatic,
so you have to think about, and when you're thinking about the exercise, you're doing
you're sending messages to your brain that your ankle is moving normal, and your ankle has healed,
and when you send information to your brain, that that body part that was injured now it's healed,
the pain goes away, because your brain doesn't need to be alerting you with the pain signals
anymore, okay? So, we're going to do it simple, just go up on the right leg,
and when you're doing this pay attention on the movements of your ankle, your knee,s your hips,
okay, you go up, on the right, and now you go down on the right, just using the right down, right
down, right down, right, right, right, right, so you do this a couple of times up and down,
and now we're going to do with the left leg, so leg, left leg up, left, left, left.
and you can do this many times and again left down, now left, left, left, left, left,
left, left, left, and left, okay? So this exercise is to stretch the
calf muscles here, and we're going to use the first step, to do this exercise so you just
if you don't have staircase, just find a box, or a step that you can do this exercise,
you just go on the edge here, and you do this for both at the same time, and you just let your
ankle you see? so when you do this, the ankle the heels go down, the tip of your foot go up, and you
are stretching the muscles, the calf muscles, so you can go a little bit forward with your body,
forward you'll be doing this more, and just relax here and feel the cuff muscles, stretching.
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may find a summary of the positions and exercises that you can download
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And watch my next video here Goodbye