Ankle pains / plantar fascitis

[obelix]

I have some clients who have pains in the ankle area (some sprains, some PF). I know I have to strengthen the muscles in the area including the pereoneals

How do I go about this

I do have a wobble board for balance

[Ruth]

Hi obelix,

You don't say what your job is with these people? You will need to make sure you know about the stages of healing & recovery and relate these to the stage of rehabilitation that your clients are at.

You will need eventually to integrate in some proprioception and balance work into the rehabilitation and depending on what level you need to rehabilitate them back to, perhaps you may need to consider plyometrics, however I stress you need to know what level their injury is at before contemplating this.

I hope this is of some help - please don't forget to check out the Sports Injury Research reviews which might also provide you with some links to papers which are very informative!

[obelix]

Hi Ruth

My job is as their personal trainer. I work with them with balance (as I said I use a wobble board).

Lawrence

[Ruth]

Lawrence,

Take a look at the latest research pages here http://www.sportsinjuryclinic.net/research/index.php - there are lots of papers you could take a look at for ideas. Making the exercise sports specific would be a good starting point if the ankle is now healed and relatively stable.

Start them off with the least challenging - for example standing with both feet on the board and keeping it off the floor. Then add some challenges - if it's safe to do so, then have them close their eyes. Or perhaps get them to try just with one leg (make sure there's something to hold on to at first as it's quite difficult!

Then you could move on to some more challenging balance work without the board - for example draw the points of a compass on the floor (start with just north/south/east/west to begin, then introduce more) and have them start standing on one foot, reaching out to touch the end of the line with the other foot (make sure the lines are an appropriate length of course). This helps work on control and strength as well as balance, emphasise doing this in a slow and controlled manner. If this is easy, you could consider doing this on an air cushion which adds an element of instability and further challenges them.

There are numerous other ways that you can work on this, just try and have a picture in your mind what the anatomical structures are you want to train, and then think about how you can devise exercises to accomplish them! If they find it too easy, think how to make it more challenging and/or move on to a different exercise.

Hope this is of some help!