Do you feel like you have weak ankles or feel like you sprain your ankles often?
One of the things you have to work on besides regaining mobility and proprioception, is the strength of the muscles specifically in your ankle.
In this article, we will explain the main muscle groups you need to target, as well as, why they are important to get your ankle stronger. We will break up the muscles by their main muscle action. In other words, muscles generally have one primary, or main, movement, and that is how we will classify them. The picture below shows all the muscles that surround the foot and ankle, but we will go over the main ones: calf (soleus/gastroc); peroneals (brevis/longus); tibialis anterior; and posterior tibialis.
Furthermore, these muscles can be divided by their muscle actions: plantar flexion (calf); dorsiflexion (tibialis anterior); eversion (peroneals); and inversion (posterior tibialis).
Plantar Flexors (Gastrocnemius/Soleus)
The muscle group that tends to get the most attention during training and rehab are the calf muscles. We mentioned muscles, because there are two main muscles that make up the calf: the gastrocnemius and the soleus. They both converge and insert into the achilles tendon. The main difference between the two is that the soleus does NOT cross the knee, while the gastrocnemius does. Therefore, to train them, you have to either bend or straighten the knee when performing a calf raise.
The first exercise is the soleus heel raise, which is a single leg calf raise with your knee bent. Our coaching cues of this exercise are to keep the knee bent and aligned with the 2nd/3rd toe, keep weight between the 1st-3rd toes, go as high as you can, and control the movement.
The next exercise is a gastrocnemius heel raise with assistance to really make sure we keep our knee straight during the exercise. Try for 2-3 sets of 12-15 good/proper repetitions.
Dorsiflexors (Tibialis Anterior)
The next muscle group is the dorsiflexors, which are the muscles located in the front of the shin. These muscles are responsible for bringing your feet up (dorsiflexion). One of the ways we like to strengthen these muscles is via wall assisted toe raises. Our coaching cues include keeping the knee straight, bringing your ankle as high as possible, limiting your toes from doing too much extension, and focusing on the shin muscles when doing the exercise. We recommend performing this for 12-20 reps for 2-3 sets.
Inverters (Posterior Tibialis) & Everters (Peroneals)
The next two muscle groups are the evertors and invertors muscle. They are responsible for moving the foot side-to-side. The main invertor muscle is the posterior tibialis muscle and the main evertors are the peroneals.
These muscles are huge when it comes to protecting the ankle from sprains. They help create a stable foot/base, which is needed when doing exercises and activities. In the video, we demonstrate how to activate these muscles with only a theraband. We recommend performing this 12-15 reps for 3 sets.
Conclusion
In conclusion, in order to get our ankle stronger we have to strengthen the 4 main muscle actions of the ankle which are dorsiflexion, plantar flexion, inversion and eversion. Those actions are done by these muscles: gastoc/soleus, posterior tibialis, anterior tibiabils, and peroneals. Strengthening these muscles will help decrease your risk for further ankle sprains and keep your ankle strong. If you are dealing with an ankle sprain, check out our 12 week ankle sprain rehab program.
5-Phase Online Program to Return to Sport & Optimize Your Foot & Ankle
- 12-Week Program; 5 Training Days per Week
- 150+ Exercises with Step-By-Step Video Guided Instructions
- "Virtual Doctor Check-In's" with Fellow-Trained Podiatric Foot & Ankle Surgeon
- PDF Resources to Stay on Track
- Flowsheet to Determine Which Phase of The Program You Should Start At
- Developed by Doctors of Physical Therapy and Backed by a Foot/Ankle Specialist
Sources
Plisky, Phillip et al. Star excursion balance test as a predictor of lower extremity injury in high school basketball players. 2006.
O’Donnell, Michael. Education and Intervention for Musculoskeletal Injuries: A biomechanics Approach. Understanding Injury, Health, and adaptations of the musculoskeletal system. 2012
Lloyd Jacob Evans, Angela Clough. Prevention of ankle sprains: A systematic Review 2011
Terada Masufmi, Pietrosime Brian and Gribble Phillip. Therapeutic Interventions for Increasing ankle dorsiflexion after ankle sprain: A systematic review. 2013
Hoch, Matthre C, Mckeon, Patrick “Peroneal Reaction Time after ankle Sprain: A systematic Review. Medicine & Science in Sports & Exercise 2013
Vairo Giampietro et al “Systematic Review of Efficacy for Manual Lymphatic Drainage Technique in Sports Medicine and Rehabilitation: An evidence-based practice approach. The journal of manual and manipulative therapy.
Hubbard et al ” Ankle ligament healing after an acute ankle sprain: an evidence-based approach. Journal of athletic training 2008.
Sivakumar et al. Effectiveness of proprioception training and mulligan’s mobilization in subjects with lateral ankle sprains
Huh et al “Two-Week Joint Mobilization Intervention improves self-reported function, range of motion, and dynamic balance in those with chronic ankle instability. Journal of Orthopedic Research 2012
Shakked Rachel, Karnovsky Sydney, and Drakos Mark. Operative treatment of lateral ligament instability. Foot and Ankle Sports Medicine 2017.
Rogier M et al. “What is the clinical course of acute ankle sprains? A systematic literature review. The American Journal of medicine 2008.
Dr. Gabriel Ignacio PT, DPT, OCS, TPI
Dr. Marco Lopez PT, DPT, CSCS
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