Begin with an assessment of their ability to control the musculature of the ankle with Tandem Stance, Blind Tandem Stance, Single Leg Stance, and Blind Single Leg Stance. Assessments are time to failure uninjured ankle vs injured ankle.
The higher the discrepancy the more low level neuromuscular re-ed exercises you should focus on. Also strengthen the Peroneals using bands and/or light cables. Also help facilitate their posterior talar glide.
As the stance tests improve begin phasing in performance exercises focusing of assisted lateral single leg movements.
Has the client had a history of ankle sprains? Any bone fractures? Ligament damage? What is the ROM at the ankle, knee, and hip? Any low back issues as well?
I start clients off with a foundation movements at all the joints. One, to see the ROM. And two, proprioception is often diminished in chronic injury/instability. Moving the joints through the ROM helps stimulate the PNS.
So for the ankles, dorsiflex/plantarflex/invert/evert/circumduction cw/ccw. All of those can be progressed with resistance slowly over time.
Without more info and actually seeing the client, I would be hesitant to suggest more.
Hello Amy Van Pelt,
I wonder if this person has feeling in their feet. I would find out what the root cause is and work from there to strengthen from the hip down and work to keep balance in check. It seems to me that balance is critical at this point to prevent injury. I do not know the history or may be able to help more.
Natalie aka NAPS 2 B Fit.
I would look at the foot and the hip. That is on the assumption that a ‘problem joint’ is often caught in the middle between two structures that are not working right.
For the hip I would look for both strength and flexibility. For the feet, I would look at the shoes, gait and flexibility.
I would also check whether she has information from a PT or orthopedist. This is a scenario where a trainer has to become a detective.