I have a client who has fused ankle (no dorsiflexion or plantarflexion). She has a doctor’s release to exercise but no plyometric movements or anything that would “bang” the ankle. She needs to lose weight to fit into the wedding dress she bought for her son’s wedding in August. What type of exercises would you do, specifically cardio?
Tough one Steve. I’ve trained someone with similar. I’d probably try biking (seated stationary inside) and see if that got her CV system taxed enough (in HR/VO2 training zone) for weight loss while allowing the ankle to operate pain free. Sometimes pp can wear a Dr’s approved brace to help protect the area without reducing body awareness. I’m assuming stepping is also out. Otherwise, I’d also do plenty of HIIT/circuit style workouts with exercises like ball throws (partner or wall), battling ropes, TRX, KB & DB: vary a circuit w/one heavier strength move and one HR elevating move for sequences of 30, 60, and ultimately 90 seconds each. All you’d need is 10 each workout. I’d be very careful not to create further body imbalances with exercises chosen.
The only thing I might add to Kimberly’s excellent response is to make sure that any cycling exercise is done from heel only on the fused ankle side. If you eliminate any plantar and dorsi flexion, keeping the ankle in neutral, the work on the quads will be sustained. Clip in on the opposite foot to bring in the hamstrings on that leg.
How about swimming? Do you have access to a pool? Great cardio if she works hard enough. And no need for plantar or dorsi flexion.
Swimming is a good choice. It can be done for fitness without the focus on improving ability. But make sure that form does not compromise the shoulders.
Aquatic deep water exercise is probably even better. Highly adaptable, no stress on the ankle, very therapuetic for the body (all tissues and systems), and widely available access.
I utilize aquatic exercise for clients from seniors/post rehab to collegiate/elite athletes. This along with a well designed resistance training program will be very beneficial.
I teach CEC courses on aquatic fitness, “Beyond Basic H2O” and “HIH2O” (high intensity water exercise). There is so much that can be done and undone using this medium for fitness. It very underrated. Personally, I would say that I would be only half as functional without it.