Ankle and knee injuries are something that most people will experience at least once (and probably many times) in their lifetime. These joints are vulnerable for several reasons, including: their complex designs. They have numerous working parts which can go wrong; they take a pounding during everyday activities as weight bearing joints; added to which are the effects of additional stresses such as certain exercise regimes and extra body weight.
Common ankle and knee injuries
The most common injury is a sprained ankle, accounting for around 85 per cent of reported cases. In most of these cases the ligaments are either badly stretched or torn, with occasional cartilage or tendon damage. A basic sprain will leave bruising for up to two weeks, and can take months to heal. Even then it will probably be weaker than before, and more vulnerable to repeated injury.
For more serious sprains (grade 2 or 3) then you’re looking at longer period on the sidelines and maybe even surgery to repair the ligament.
Most acute knee injuries are related to certain types of sport or physical recreation, or a sudden movement made at home, with the remainder being caused by a fall or twist which sprains the ligaments or tendons supporting the kneecap. Dislocation and fractures are possible but are less common and are generally connected with a more immediate serious incident such as a car crash.
Doctors in A&E are familiar with injured football and rugby players presenting with damage to their anterior cruciate ligament having made a sudden movement, twist or jump during a game.
Overuse injuries to the knees are caused by repetitive activity such as jogging, skipping, and biking which irritates and inflames the joint and surrounding tissues.
Spot exercises are important
Since it is common for a once-damaged ankle or knee to be injured again far more readily, it is crucial that relevant exercises and activities are adopted as a routine in order to both strengthen them and to prevent further incidents insofar as possible.
Unfortunately the truth is that exercising can easily feel more like a chore than a benefit, and can thus become something to avoid. The best exercises are those which you can do easily at home, with little or no special or difficult to source/expensive equipment, for a short time each day.
Exercises to strengthen the ankles
If you have had a previous ankle injury, the chances of a further problem are far higher, making it vital that strengthening exercises are undertaken regularly. These should be started as soon as you can comfortably bear weight again.
Isometric exercises are the usual starting point, and they involve two stages. To strengthen the ankle invertors simply push the foot against a solid, fixed object such as a sofa, while trying to fight resistance and turn the inside section of the foot against it. To do the same for evertors repeat but this time try to turn the foot outward.
Exercises to strengthen the knees
Some exercises are specific, and therefore more useful when they target previous or potential knee injury triggers. For example, runners with no prior knee problems should focus on exercises which strengthen muscles such as the vastus medialis (the ‘teardrop muscle’), and stretch the iliotibial band (ITB).
If done properly as part of their warm-up or cool-down routine the benefits will be fairly immediate.
General knee strengthening exercises can be adopted by anyone, assuming that they cause no pain and do not contradict medical advice. They include:
Knee bends: Standing around a foot away from a wall with feet pointing just slightly outwards bend knees slowly, allowing your back to slide against the wall, with knees mirroring toes. Come back up slowly and focus on creating tension in your teardrop muscle. Build up to completing 3 sets of 10.
Thigh strengthener: Sit straight on a (high-backed if possible) chair. Slowly raise one leg, keeping it straight and your foot pointing slightly out as in the previous exercise. When fully extended, tense thigh muscles and hold for ten seconds, paying particular attention to the teardrop muscle. Lower the leg and repeat with the other. Work up to completing 3 sets of 15 seconds on each leg.
Leg raises: Sit straight on a chair and raise one leg until straight, with your foot pointing slightly out, as you did for the thigh exercise above. Then simply move the leg up and down while tensing the teardrop muscle. Repeat with the other leg and work up to 3 sets of ten raises of each leg.
Hamstring stretching: This time sit on the edge of the chair, with one leg bent as normal and the other straight with the heel on the ground and the foot pointing slightly out. Slowly bend from the hips towards the straight leg, stretching the hamstring and tensing the teardrop muscle simultaneously.
ITB stretch: While standing, cross your right leg behind your left; both feet should be flat on the ground. Lean to the left while pushing your right hip out and keeping your back straight. If done correctly you will feel the muscle stretch on the outside of your right thigh. Work up to doing 3 sets of 15 on each leg.
Squats: Stand straight with your feet aligned to your shoulders and pointing a little outwards. Your hands may be in front to help you balance, or relaxed at your side. Bend knees to a right angle while keeping your back straight. Aim to get to three sets of ten reps each.
Activities to strengthen the knees and ankles
Yoga and Pilates are popular forms of exercise which are also excellent activities for strengthening knees and ankles and preventing injuries, albeit for different reasons.
Pilates, with its focus on targeting specific points in the body through non-intense movements allows for target areas to be worked on without over taxing specific muscles. It is the controlled nature of this approach which pays off, together with the other benefits such as endurance, a heightened awareness of particular areas of your body, and a subtle building of strength.
Yoga, on the other hand, is great for improving flexibility in both general movement and joint mobility, better posture, strength, and balance. The latter is essential as poor balance is thought to be major contributor to ankle injuries.
Both yoga and Pilates can be studied and practised at home in your own time, and the major principles can be adapted to suit your individual circumstances. For example, some of the exercises mentioned above adopt Pilates principles, while standing on one leg to improve balance is not so different from a basic yoga pose.
We put immense pressure on all our joints simply during the course of daily life, but none feel it as much as the knees and ankles. Having strong and healthy knees and ankles is important in order to live a life of movement and minimal pain, but achieving this takes considerable effort and commitment.
By incorporating simple exercise and activities into your daily or weekly routines the potential benefits are immense, ensuring that the muscles around the joints are as strong as physically possible.