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. 

So if you like this video  press the thumbs up button,  

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may find a summary of the positions  and exercises that you can download  

and print to do at home, also there is a link  

to all products that I mentioned in  this video if you want to purchase them, 

And watch my next video here Goodbye