Pain Management Physiotherapy


Today’s blog is dedicated to one of the most commonly injured joints “The Ankle”. Research says that 1 in 4 people experience ankle injury or instability at some point in their lives. As a clinician can validate this as I see a similar presentation in my clinic.

Ankle though a small joint in size is biomechanically big in walking or any weight-bearing activity. The foot up and down activity at the ankle helps to clear the ground while walking and propel us forward by pushing the ground back. The tilting movements at the ankle or foot in and out helps to stabilize the foot and knee.

Being so functionally important it often gets overused and injured. Ankle injury presents compensation in standing and walking. A few compensations are as below

Limp and hop walk to avoid putting weight on the affected side.

Clawing and scrunching the toes.

Rolling the knee inwards causing a lot more push off from the inner border of the foot.

Reduced hip range of motion so the length of the step is shortened.

As with any compensation any of the above would make walking painful, inefficient, and injury-prone.Due to the pain, most patients start reducing or avoiding moving. Lack of movements reduces our balance system called Proprioception and makes the joint more unstable and injury-prone. A classic Pain – spasm – weakness cycle where I find most of my patients in. I am listing a few corrective movements which help us to get optimal balance and hence be pain-free.

  1. Walk barefoot on as many surfaces as possible. You can try walking on a pebble way, sand, grass, or carpet.
  2. Cushion walk- Put 3-5 cushions on a non-slip surface 5 cm apart. Stand on 1 cushion with feet hip-width distance. Take a step onto the cushion in the front without losing balance. Then you can move back to the starting cushion. Start with 2 cushions at a time and can move up to 3-5 cushions. You can repeat 2-3 times every hour.
  3. The balance on 1 leg- Stand as above on a non-slip stable surface. Lift 1 leg up such that the hip and knee are bent to 90 degrees. Hold this position for 30 sec to 1 min each side and can repeat as above. 
  4. You lift 1 leg to the side 5-6 coms from the midline of the body without tilting. Hold as above. Repeat as above.
  5. Vrikshasana
  6. Chair pose in yoga

The secret to a pain-free and strong ankle is good body balance. I hope all of these help you to improve the balance and be pain-free… Stay happy and healthy.

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