Most of us seldom give much thought to our ankles, unless something goes wrong. But ankle strength is crucial to helping prevent falls and injuries and maintaining independence and quality of life. Falls and injuries are common and can occur any time without warning. We’ll give some suggestions for assessing your ankle strength and improving if needed.
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Imagine this: you’re walking in the park, strolling across your lawn, or stepping off a curb. Something you do regularly and take for granted without giving it much thought.
Without warning, your foot slips, and you suddenly find yourself on the ground with a broken ankle. It happens in a split second. Now you’re facing an emergency trip to the hospital, possibly followed by surgery and months of rehab.
Dan Baumstark doesn’t have to imagine. Something like this actually happened to him.
The 52-year-old physical therapist was enjoying a sunny day at the beach with friends, when he decided to take a dip in the water. Suddenly, a large wave broadsided him and shoved him headfirst toward the sand.
He managed to land on his feet, but the impact broke his right ankle and lower leg. “I felt a horrible series of snaps as my right ankle turned a full 90 degrees outwards in relation to the rest of my leg,” he wrote.
There is a silver lining to what happened, though: “My left leg has become much stronger as a result of the damage to my right leg. I can say with confidence now that I am much more comfortable balancing and generating strength from my left leg than I used to be.”
Weak Ankles Put You at Greater Risk for Injuries
You might think ankle injuries only happen when you’re playing sports, such as waterskiing or sliding into second base. In fact, many people get injured in the course of everyday activities.
Just walking across a yard with dips and bumps or strolling down a steep trail could do it. Every year, one in three people aged 65 and older suffers injuries during falls. One physically active, 75-year-old grandfather fractured his ankle when he simply collapsed from dehydration.
An ankle injury can degrade your quality of life for years afterward. It can lead to balance problems and increase your risk of falling. It can make your ankle feel unsteady and affect your ability to move around.
Few of us think about our ankles most of the time. But these crucial, delicate joints help form the foundation that enables us to stand, walk, and climb stairs.
Ankle injuries can occur at any age, but they are more common as people age. Balance problems, being overweight, and a sedentary lifestyle can increase the chance of ankle issues. Being overweight puts extra stress on the ankles, which can increase the risk of fractures, while a sedentary lifestyle can lead to muscle loss and weak ankles that are prone to injury.
Why Your Ankles May Be Weak and What to Do About It
It is natural for our ankles to become weaker as we age, but there are things we can do to slow or even reverse this trend.
Here are some common reasons our ankles may be weaker than before:
Age‑Related Muscle Loss (Sarcopenia)
Sarcopenia is a loss of muscle mass and strength that happens progressively as we get older. The main causes are a breakdown of muscle protein and a decline in the formation of new muscle protein that are a natural result of aging.
We gradually begin losing muscle mass and strength in our 30s and 40s, and this process accelerates after age 65. We may lose as much as eight percent of our muscle mass each decade. Physical inactivity, obesity, and certain health conditions like diabetes, rheumatoid arthritis, and malnutrition can contribute to sarcopenia.
Limited Range Of Motion
Chronic conditions like arthritis, tendon issues, peripheral neuropathy, and diabetic nerve pain can affect the movement in our ankles.
Climbing, running, and even walking require careful coordination and timing in our legs; ankle issues can throw off our timing and lead to falls and injuries.
Previous injuries like sprains, strains, and fractures can also affect our ankles, particularly if they did not heal properly. Studies find ankle strength and range of motion are predictors of balance and functional ability in older adults.
Lifestyle Factors
Sitting instead of walking, poor footwear, and lack of exercise can contribute to the risk of ankle injuries. Ankle issues have dramatic effects on gait, walking speed, and the ability to climb stairs or even get up from a chair.
Weak ankles can also make you feel more tentative because of the fear of falling. This leads you to reduce activity even further, which leads to further weakening of the ankles. Eventually, you may lose your independence and begin relying more on other people to perform everyday tasks.
Are Your Ankles Weak?
Here are some simple tests to assess your ankle strength and compare it against the norms for your age group.
Single Leg Balance Test
The single-leg balance test (SLBT) is a popular tool to determine balance and leg stability. You simply try to stand on one leg for as long as you can.
To perform this test, first stand near a chair, table, or other sturdy object in case you must catch yourself.
Place your hands on your hips or cross your arms across your chest, and focus your eyes on a spot in front of you.
Raise one leg off the ground and keep your balance as long as possible for up to 45 seconds without uncrossing your arms, shifting the stance leg, or moving the raised leg excessively.
Repeat the test with eyes closed as well – this will be significantly more difficult.
Take the best of 3 attempts as your final score.
Below are the norms with eyes open and eyes closed for various age groups:
| Age | 18-39 | 40-49 | 50-59 | 60-69 | 70-79 | 80-99 |
| Eyes Open | 43 sec | 40 sec | 38 sec | 27 sec | 15 sec | 6 sec |
| Eyes Closed | 9 sec | 7 sec | 5 sec | 3 sec | 2 sec | 1 sec |
This video demonstrates the SLBT.
Here is a video that explains the importance of single-leg balance for older adults.
Single-Leg Heel Raises
To perform this test, stand facing a wall or sturdy object.
You may touch the object lightly for balance, but do not use your hands to assist in the movement.
Lift one foot off the ground and perform a heel raise with the planted leg as high as you can lift, then lower back down in control.
End the test when you reach 25 repetitions, or experience pain, or have a significant decrease in heel height.
Repeat the test with the other leg.
This video demonstrates the SLHR.
Weight-Bearing Lunge Dorsiflexion Test
This test measures the flexibility of your ankles, which is crucial for walking, running, and climbing.
To perform this test, remove your shoes and stand close to a wall with your toes touching the wall.
Move one foot back slightly away from the wall. Push your knee forward so it touches the wall, but don’t raise your heel. Keep your foot flat on the ground.
Measure the distance from your toes to the wall.
A normal test is if you can place your toes five inches from the wall and touch the wall with your knee without raising your heel off the ground or experiencing pain.
This video demonstrates the test.
What to do if Your Ankles Are Weak or Have Limited Flexibility
If you didn’t do so well on these ankle self-assessments, don’t despair. Orthopedists suggest simple, effective exercises you can easily do to improve your ankle strength. Below are a few.
One-Leg Balance
With your hands on a chair back or countertop, slowly raise one foot. Hold this position for 30 seconds and gradually increase the time.
Ankle Alphabet
Sit on a chair or sofa. Extend one leg and write the letters of the alphabet in the air with your big toe. This improves ankle flexibility in various directions.
Heel and Toe Walking
Walk on your heels for 30 seconds and then walk on your toes for another 30 seconds. Gradually increase to 60 seconds.
Heel Raise
Heel raises strengthen the calf muscles in the back of your lower legs, which support your ankles. Stand while holding onto a chair or table in front of you. Stand straight and tall. Move yourself up and down using your calf muscles. Keep your weight over your big toe and second toe, and keep your feet pointed straight in front, not inward or outward.
Be sure to move straight up and down and keep your ankles straight. Don’t roll your ankles outward.
This video demonstrates how to properly perform heel raises.
If you want more easy ankle exercises, here are eight more recommended by the Cleveland Clinic.
When to Consult a Doctor or Physical Therapist
You should consult your healthcare provider before starting or changing your diet or exercise routine. Additionally, podiatrists suggest some signs of ankle issues that warrant medical attention.
Sudden Pain, Swelling, Inability to Bear Weight, or Nerve Damage
If you experience sudden leg pain, swelling or bruising; cannot put weight on your leg; or have symptoms of possible nerve damage like persistent numbness or tingling, consider consulting a doctor.
Chronic Instability, Pain, or Stiffness
If your ankle feels unstable, like it might give way, or is frequently painful or stiff, a doctor will be able to provide an evaluation.
No Improvement with Exercise
If you have performed ankle exercises like the ones described previously, but your ankle has not shown improvement or has gotten worse, consult a doctor for further assessment.
Conclusion
Strong ankles are foundational for staying active, preventing falls, and maintaining independence as we age. Many ankle injuries happen while performing everyday activities: walking, climbing, or stepping off a curb.
Although you cannot completely eliminate the risk, stronger ankles help to reduce the chance of sudden falls that can lead to injury.
It’s never too late to start strengthening your ankle muscles. Regular, small improvements can make big differences over time.
If you want stronger ankles, try a simple test this week. Pick two or three exercises and commit to doing them regularly.