The Flexible, Stable Ankle and Fall Prevention

If you’re over 65, you have likely heard that you need to make sure you don’t fall. However, many people don’t know how to do that; how can you make sure something doesn’t happen? But since falls can limit mobility, well-being, and even lifespan, it’s important that you understand how to keep yourself safe and upright.

The ankle is key to stability

Dozens of factors contribute to falling in an older population, and ankle strength and flexibility are high on that list.

When you think about what is keeping you upright, you may not consider your ankles. However, they are part of your solid foundation. You probably don’t even realize that you are unconsciously adjusting your ankles when you’re standing.

Automatic adjustments are something your body does by itself. For example, your heart beats faster when you exercise. Just as you don’t tell your heart muscle to pick up the pace, you don’t consciously control how your ankles keep your weight evenly centered to avoid a fall. But you will find out when something goes wrong!

Don’t rely on other joints to do an ankle’s work

If your ankles are not strong or flexible enough, they will use more energy to make these adjustments and either stop adjusting, which throws your balance out of order, or completely give out. Then the “domino effect” kicks in: when one joint becomes weak, other joints have to pick up the slack. Your knees, hips and low back will try to make up where your ankles are failing.

You may have experienced this phenomenon if you’ve ever injured your hand. When one hand can’t function, the other has to do all the work. This can cause the overworked hand to get tired; if the injury lasts long enough, the other hand will get much stronger than the injured one.

While one hand has the structure to take over the other hand’s tasks, that’s not true of the joints trying to fill in an ankle’s gaps. Knees, hips and low back aren’t designed to do ankle work, and they can get injured when they try. These injuries compound your risk of falling.

Further, when the rest of your body tries to compensate for weak ankles, this can lead to chronic muscle imbalances. If one side is stronger than the other, or if your knees or hips become dominant over your ankles, balance control becomes harder.

Exercises to increase ankle strength and flexibility

Exercising your ankles is one way to build their strength and increase their flexibility to help you prevent falls. Our first video below demonstrates an exercise for building ankle strength. Try to do it at least three times each day to keep your ankles healthy. 

The next video shows you exercises for ankle flexibility. You can pick one or perform all of them. Do your chosen exercises at least three times each day, and watch your ankles get more flexible! 

Additional options for increasing ankle strength and flexibility, too:

• Braces that artificially strengthen the ankle. However, braces can decrease your ankle’s flexibility. Also, research does not yet show whether braces prevent falls.
• Daily walking to help your ankles gain both strength and flexibility.
• Treating underlying conditions that may be hampering your ankle flexibility or strength to help your ankles work better.
• Physical therapy using a strength and flexibility program designed specifically to your needs. A physical therapist can make sure the exercises are safe for you while working on your ankles’ strength and flexibility.

Paying attention to your ankle flexibility and strength is key to staying on your feet and thriving with an active lifestyle.

Citations

Abd El- Kader, S. H., El-Den Ashmawy, E. M. H. (2014). Ankle dorsiflexors strength improves balance performance in elderly: a corelational study. Eur J Gen Med 2014;11(2): 60-65. doi :10.15197/sabad.1.11.40

Bok, S. K., Lee, T. H., & Lee, S. S. (2013). The effects of changes of ankle strength and range of motion according to aging on balance. Annals of rehabilitation medicine, 37(1), 10–16. doi:10.5535/arm.2013.37.1.10.

Brenton-Rule, A., Dalbeth, N., Menz, H. B., Bassett, S., & Rome, K. (2016). Foot and ankle characteristics associated with falls in adults with established rheumatoid arthritis: a cross-sectional study. BMC musculoskeletal disorders, 17, 22. doi:10.1186/s12891-016-0888-z.

Melzer, I., Benjuya, N., Kaplanski, J., & Alexander, N. (2009). Association between ankle muscle strength and limit of stability in older adults. Age and ageing, 38(1), 119–123. doi:10.1093/ageing/afn249.

Menz, H. B., Morris, M. E., Lord, S. R. (2006) Foot and Ankle Risk Factors for Falls in Older People: A Prospective Study, The Journals of Gerontology: Series A, 61(8), https://doi.org/10.1093/gerona/61.8.866.

Schwenk M, Jordan ED, Honarvararaghi B, Mohler J, Armstrong DG, Najafi B. Effectiveness of foot and ankle exercise programs on reducing the risk of falling in older adults: a systematic review and meta-analysis of randomized controlled trials. J Am Podiatr Med Assoc. 2013 Nov-Dec;103(6):534-47. Review. PubMed PMID: 24297989.