Lower leg and ankle rehabilitation exercises for ankle, shin, and calf injuries. Once pain allows, isometric or static exercises can begin, followed by dynamic strengthening exercises. It is important to include balance or proprioception exercises, as well as more functional or sports specific exercises.
On this page:
- Isometric ankle exercises
- Dynamic ankle exercises
- Proprioception & wobble board exercises
- Plyometric & functional ankle exercises
The following guidelines are for information purposes only. We recommend seeking professional advice before beginning rehabilitation.
Isometric ankle exercises
Isometric or static ankle exercises can be performed in the early stages of rehabilitation from a lower leg injury. Isometric exercises strengthen the muscle without putting any stress or weight on the injured area. After this stage, more dynamic exercises can be introduced to the rehabilitation programme.
Isometric inversion and eversion. This exercise is used to begin to strengthen the ankle invertors (tibialis posterior) and evertors (peroneals) in the early stages of treatment.
To strengthen the invertors, the athlete pushes the inside of the foot against a table or chair leg, trying to turn the foot inwards against resistance.
To strengthen the evertors, the athlete pushes the outside of the foot against a table or chair leg, trying to turn the foot outwards.
This exercise can also be performed with a therapist providing the resistance.
Dynamic ankle exercises
Dynamic lower leg and ankle exercises involve the movement of the joints. They can usually begin as soon as pain allows, often following initial static or isometric exercises.
Active mobility exercises where the athlete physically moves the joint through a range of motion are often done early on.
They will help to increase movement at the joint and also pumping the ankle up and down will help reduce swelling. Exercises can be performed seated or standing.
If an ankle sprain has occurred then only up and down movements should be done initially, protecting the lateral ligaments at the side.
As it heals, sideways mobility and writing the alphabet with the toes may also be performed. These active motion exercises can be performed seated to improve the flexibility of the ankle after an injury.
Pumping the ankle up and down and writing the alphabet with the toes may also help to decrease swelling, especially if performed in an elevated position.
The calf raise is a widely used exercise to strengthen the calf muscles. There are many variations and resistance machines are also available.
Start on a step with only the forefoot on the step, the heels off the back. Rise up onto the toes and then slowly back down.
To make this harder it can be performed with a weight in each hand, barbell over the shoulders or on a single leg.
The seated calf raise exercise is used to strengthen the calf muscles, especially Soleus. It is an early stage exercise which can be progressed to standing once this is pain-free.
To strengthen the Soleus muscle, the athlete performs a heel raise in a seated position. Bending the knee relaxes the overlying Gastrocnemius.
A bar weight can be added to the thighs to increase difficulty. Ensure the downward phase is performed slowly and under complete control.
The posterior tibialis exercise targets this muscle specifically by combining the two movements which it performs. This muscle may need strengthening to help reduce overpronation.
The band is looped around the forefoot of the exercising leg with the other leg crossed over the top.
The athlete simultaneously pushes the foot down and turns the sole of the foot in against the resistance.
The combination of plantarflexion and inversion work the Tibialis Posterior.
Return to the start position under complete control.
Toe raise or foot raise exercises work the shin muscles at the front of the lower leg. This is an early stage exercise which can be progressed using a resistance band.
To strengthen the shin muscles the athlete raises the toes and forefoot up off the floor.
Initially, this should be seated, before performing in a standing position and then on an incline with the toes lower than the heels.
When standing, ensure you have something to hold onto for balance purposes.
Ankle eversion is also sometimes known as supination and is the movement of turning the foot so the sole faces outwards (away from the other foot). A resistance band is very useful for ankle exercises.
The athlete sits on the floor as shown with the band wrapped around the foot to be worked. The other end of the band is attached to something sturdy on the other side of the body.
The starting position is with the foot in inversion (sole turned in to face the other foot). At this point, the band should just be taught to ensure resistance throughout the whole movement.
Turn the foot outwards as far as is comfortable before slowly returning to the starting position.
The athlete starts in a side-lying position with the ankle to be worked on top. Start in inversion (with the ankle turned in) and move the foot upwards, turning the sole of the foot out.
Slowly return to the starting position under control. An ankle weight can be added to the foot as shown to increase difficulty.
Dorsiflexion is the movement of pulling the foot upwards. Using a resistance band to perform this movement will strengthen the shin muscles.
A resistance band is wrapped around the forefoot and anchored to a fixed point in front of the foot.
The athlete starts with the foot pointed away and dorsiflexes or pulls the foot up so the toes point to the ceiling.
Return to the starting position slowly and under complete control.
lantar flexion is the ankle movement of moving the foot down, pointing the toes away from the body. Using a resistance band is an early stage exercise for calf strengthening.
A resistance band is wrapped around the forefoot with the ends held in both hands.
Starting with the toes pointing up, the athlete pushes the foot down against the resistance of the band.
This can be done with a bent knee to target the Soleus muscle more than Gastrocnemius.
Return to the start position slowly and under control before repeating.
Inversion (also known as pronation) is the movement of turning the foot so that the sole faces inwards. A resistance band is great for this exercise and other ankle exercises.
A resistance band is wrapped around the forefoot and anchored to a table leg or held by a partner.
This exercise works the ankle inverter muscles as the athlete turns the foot in against the resistance of the band.
Start with the foot fully everted (sole turned outwards) and the band just taught so that resistance is felt throughout the whole movement.
The eccentric heel drop places the emphasis of the movement on the downward phase so that the calf muscles must contract as they lengthen to control dorsiflexion. This exercise is the gold standard for treating Achilles tendinopathy.
Start on a step with the heels off the back so only the forefoot is on the step. Stand on one leg on tiptoes with the knee straight and slowly lower the heel down below the level of the step.
Place the other forefoot on the step and use both legs evenly to lift back up to the toes. Go back onto one leg and repeat.
Resisted eccentric inversion is a great exercise for using after ankle sprains to help reduce the chance of future injuries. This helps by eccentrically strengthening the peroneal muscles so they can control excess inversion.
A therapist or partner is required to move the ankle. The patient is seated with the legs out straight.
The therapist starts to move the ankle into inversion (so the sole faces inwards). The patient then tries to control and slow this motion.
Proprioception ankle exercises
Proprioception or balance type exercises for lower leg rehabilitation. Proprioception is about our spatial awareness and sense of where parts of our body are. After injury, this is damaged making us more susceptible to re-injury, especially with ankle sprains.
Wobble boards are effective for improving your sense of proprioception, which is strongly linked to balance.
Exercises can start at a very easy level which is suitable for everyone and can easily be progressed to more challenging exercises for even the most advanced athlete.
The medicine ball catch exercise is designed to challenge the single leg although various progressions can be added to make it more difficult.
This develops proprioception after lower limb injuries. Start off standing on a single leg. Get a partner or therapist to throw a ball towards you so you can catch it. Maintain your balance throughout.
Start with gentle throws directly towards your body. As you improve try slightly harder throws or throws slightly off to the side or overhead.
A further challenge is to do the same exercise whilst balancing on a wobble board.
The heel-toe balance exercise, sometimes called a tandem stance is designed to start to work on proprioception and balance. This is a good build-up to wobble board work.
The athlete stands with the involved foot immediately behind the other foot, with the toes touching the front heel as shown.
This position should be held for 30 seconds without losing balance.
The stork balance is a simple single leg balance exercise, although various progressions can be added to make it more difficult. It improves balance and proprioception.
The athlete begins by standing on the injured leg only for 30 seconds. Once this is accomplished the athlete closes their eyes to increase the difficulty.
The next step is to balance on an unstable surface such as a trampette, wobble cushion or half foam roller.
Heel toe walking is a great exercise for the ankle and calf muscles. It will strengthen all muscles of the lower leg, as well as
Walk slowly across the floor. Start with a heel strike and once you get to the forefoot push-off, come up onto the toes.
Swing the other leg forward and heel strike with the next foot to continue.
Functional & Plyometric exercises
These functional or plyometric type exercises can be performed later in the rehabilitation process. These strengthening exercises are more dynamic and prepare the muscles for when full training is resumed. They include explosive movements such as jumps which work the muscles in a similar way to full training such as sprinting.
Start standing on a small step. Take one leg backwards, touch the foot on the floor and push off with the forefoot to move it back onto the step.
Alternate legs. This can be increased in difficulty by performing on a higher step or at a faster speed.
The resistance band jump exercise is a great late stage proprioception test! Hops and jumps can be used in the early stages but using the band adds an extra challenge!
A resistance band is wrapped around the waist and anchored or held behind the athlete. They then perform side to side or forwards and backward jumps.
The resistance from the band provides a challenge to the balance.
Hopping exercises are important in
Start with a small hop on the spot and gradually increase the height jumped.
Try hopping to the front, to the side and backwards. Try hopping from one leg and landing on the other.
Equipment such as hoops, agility ladders, and minim hurdles can all be used to add further challenge.
Box jumps are a form of advanced exercises called plyometrics. They strengthen the entire leg ready for powerful, explosive movements and also aid proprioception development.
Numerous exercises can be created using a box or step to jump over.
To start the athlete may jump sideways over the box, moving rapidly from one foot on one side, to the other foot on the other side. This may also be performed front to back.
A further progression is high jumps over the box, firstly landing on two feet and progressing to one.
With the feet flat on the floor, press the toes downwards into the floor.
Do not allow them to curl, or the ankle to move whilst performing the exercise.
Hold for the count of 3, repeat 10 times. Perform this exercise 3 times a day if possible.
Progress the exercise by holding the contraction for longer.
Spreading the toes
Place feet flat on the floor. Spread the toes as far as they will go and then return them together.
Repeat this 10 times, rest and the perform a further 2 sets of 10 repetitions.
Aim to repeat this exercise 3 times a day, as above.
Place the back half of a foot on a suitable book, and the forefoot on a set of weighing scales, ensuring the foot is horizontal as far as possible.
Press down with the forefoot onto the scales to see who much force you generate. Repeat 10 times for each foot.
Perform this exercise daily. It is an excellent way of seeing exactly how the strength of the foot is improving.
Place feet flat on the floor and try to lift each toe up in turn. Aim to keep the others flat on the floor – not easy, is it?
Perform three sets of each toe. Try to perform this exercise twice a day – at least once.
Pick up a pencil in the toes. Hold for a count of 6, repeat 10 times.
Aim to perform this exercise 3 times a day. An alternative version of this is to repeatedly scrunch up a towel in the toes.
Walking on the toes
Simply walk about on tiptoe. Do not wear shoes but perform the exercise barefoot.
Aim for 8 sets of 15 to 20 seconds with 20 seconds rest between.
Complete the exercise 2 times a day. Progress by increasing the duration of the walks.
Walking on the heels
As above but walk on the heals. Aim for 8 sets of 15 to 20 seconds with 20 seconds rest between.
Complete the exercise 2 times a day. Progress by increasing the duration of the walks.