Load with simple weight shifting

In the beginning, you can start with simple weight shifts on the ankle joint. First in a sitting position and then in a standing position as a starting position. In a sitting position, the foot can be loaded more by shifting the body’s center of gravity more forward.

1. heel and toe position The aim is to work out the heel and toe position. It may be useful to work out the body’s center of gravity beforehand in order to get to know the patient’s limits. This is important for the physiotherapist as well as for the patient himself in order to reduce fall risks.

When standing on his heels, the patient stands on a non-slip surface with his feet parallel to the front, preferably barefoot. The task now is to pull the tips of the toes towards the ceiling or to the knees and hold them for approx. 3-5 seconds to begin with.

For the toe stand, ask the patient to push off in the same starting position and lift the heel a few centimeters from the floor. During the two exercises, care must be taken to ensure that the body does not get too far forward or backward. This exercise can be increased by using a different surface, which is more unstable and therefore promotes more intra- and intermuscular balance.

The exercises can be performed on one or two legs. The tip-toe position is also suitable for training on stairs in overhanging terrain. The two exercises can also be used together as a combination exercise.

2. rope balance This exercise is used to direct the concentration to the pacing and possibly to work on the stability in the joint with smaller steps, i.e. with less support surface. The patient places foot by foot on a straight line, which has been previously taped on with adhesive tape or given by a rope. At the beginning, larger steps are first chosen.

The gaze should be as straight as possible and the body should be upright and straight. 3. scales The patient walks from a standing position with the upper body horizontal and one leg backwards at the same time, so that the affected leg has to carry the body weight. The arms are stretched out sideways to maintain balance.

The upper body is now parallel to the floor. Hold this for at least 15 seconds and then change the leg. 4. foot grab Place a well graspable towel in front of you with your feet.

Put weight on the unaffected leg and try to lift the towel with the affected foot. Now move the foot with the towel up and down (15 times). Then change the supporting leg and “grab leg”.

5th Alphabet – Exercise Starting position is the upright seat on a chair. The affected leg is placed on the other leg, as with a cross-legged seat. Now you write the letters of the alphabet in the air with your foot.

6th Clock Exercise The patient stands upright on the floor. Now the 12, 3, 6 and 9 o’clock position is marked around him in a circle, like a clock, with the help of adhesive tape. This is followed by a weight transfer to the affected leg. The patient should now show with his healthy foot the times that the therapist gives him. Further exercises to improve ankle stability can be found in the articles:

Torn ligament at the foot – what to do?
Physiotherapy for ankle fracture
Stress after an ankle fracture