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Ankle Prehab


Shaf
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Coach Sommer provided some good stuff for wrist strengthening/prehab in an early post. I'm interested in a similar approach to the ankles as well. Ankle injuries are very prevalent among young athletes, and the girls on my U19 rugby team are no exception.

Any ideas?

I am going to focus on tibialis strengthening, ankle and foot prioreception, and side-to-side strength/stability training with jumpstretch bands in our upcoming offseaon, but would like to hear some other ideas.

Thanks

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George Launchbury

Hi Shaf,

Running zig-zags through cones (forwards and backwards), and other drills with lots of changes in direction might help, too - and I recall there's a lower risk of (non-impact) injury from staying on the toes while doing them. Although it sounds odd ...get them to stand on one leg while cleaning their teeth in the morning, and the other leg at night. There is then a cue to do it regularly, and the fine motor skill and mental focus required also provides a reasonably good distraction.

Cheers,

George.

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Coach Sommer

Ankle Stability Exercises

Here are several recommendations for you.

1) High rep work: Due to the nature of the connective tissues themselves (a metabolic rate 1/10th that of muscle tissue), the repetition range for promoting tendon/ligament health should be relatively high (50-100). This can be accomplished by either counting reps or working for time and thereby getting an approximate number of reps. The second method works especially well in group training sessions.

Some suggestions for a workout structure:

Standing heel raises; three separate sets with toes turned inward, forward and outward. Focus on complete ankle extension on the top of the rep. It is not necessary to elevate the heels for a traditional bodybuilding ankle stretch at the bottom of the repetition. Heels flat on the ground at the bottom of each rep will be fine. The tempo of the exercises can also be quite fast as long as the athletes are continuing to reach full extension at the top of the repetitions. Maintaining this full extension will become more difficult as they get farther into each set.

Seated ankle circles (will often degenerate into ankle triangles as fatigue becomes an issue); inward and outward.

High rep work for the ankles should be done each time practice occurs and should only require approximately five minutes to complete. For reasons of fatigue and the resulting temporary instability, I always perform these movements at the conclusion of practice as part of our cool down.

Start conservatively with either 50 reps or a time frame that allows completion of that approximate number of reps. Maintain this repetition range for at least 6-8 weeks, at which time you may increase to 75 reps. Maintain again for 6-8 weeks and then make the final increase to 100 reps. It is not necessary to increase past 100 reps.

2) Strength work: Generally the focus here is solely on calf raises which is a common error. One of my most serious ankle injuries occurred when I rolled my ankle playing tennis years ago. At the time, I was doing calf raises for reps with 400lbs, but my ankle still rolled sideways like it was tissue paper. The solution here is a emphasis on seated inward and outward turns of the ankle against resistance.

The resistance may be in the form of a theraband or pressure applied by a training partner. My personal preference is the training partner as much more pressure may be both more comfortably and more effectively applied. It also works quite well in a group training session.

To perform inward ankle turns, sit on the ground with the working leg straight. The working ankle should be at a 90 degree angle with the toes of the foot pointing straight up. This orientation of the toes pointing up is important and should be maintained at all times; even later when turning the foot inward to the maximum ROM. Now turn the foot inward against pressure. When applying pressure as a partner, I trap the foot between two hands and have the athlete struggle to turn their foot inward against my resistance. During inward turns, the heel of my palm is pressing strongly against the bottom outside edge of their working foot.

Once the athlete has reached the limit of their ROM, release the pressure and have the athlete turn their foot as far outward as possible and then begin the new repetition from there. Be sure to apply steady pressure throughout the entire ROM. Three to five hard struggling reps is usually all that is required. I require the athletes work very hard here with a repetition generally taking 5+ seconds to complete.

Outward ankle turns are quite similar to inward ankle turns, however the pressure from the palm of the hand will now be applied to top outside edge of the working foot. Begin with the athlete's foot turned inward as far as possible (don't forget to maintain the vertical position of the foot) and then turn outward as far as possible. The same repetition range and tempo from inward ankle turns applies here as well.

As with all new movements, begin with only medium intensity and then gradually increase intensity over time to give the connective tissue time to adapt to the new training demands.

Yours in Fitness,

Coach Sommer

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I was taught that pistols are something of ankle strengthening movement as well as hitting other points ( knees, hips, glutes ).

Something about the ability to balance in the bottom position or move up and down in the movement. I was shown to do them eventually on an unstable surface to strengthen the ankle as well.

Your thoughts, Coach?

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Pistols? A fine exercise and one that can create a very beneficial training effect, however, the point, for me, is a bit moot in the fact that it's a movement that's complete inappropriate for the level of strength the vast majority of my girls exhibit.

Coach Sommer, and the others whom offered suggestions, thanks!

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Besides just having my girls work on releve holds ( heel off the ground planted on the forefoot like the top of a calf raise ) for eventually 1-2m, we do all the calf variants and do each on one foot as well ( besides just working the hold ).

As a warmup, we do one foot bounces across 40 or 50' while circling the arms. We also do another variant of this, where we pump the arms like running to try to see how much distance can be covered per bound.

I've been thinking about implementing them to do the rotational one foot work with light weights of some kind to step it up. I just haven't set my mind on how to do this to supply enough of the girls...cheaply.

I totally didn't see the part where your girls are in Rugby. I'm not really sure if you are implying that your girls are strong beyond pistols or cannot do them at all because of their level of fitness.

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This video has some useful info about ankle conditioning as well, htough some of it is better than others. Definately worth watching.

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I can't say that their S&C is where I would like it to be. It's the first season for the club, and my debut as a rugby coach.

I wouldn't be surprised if a few could do a pistol. I've got former gymnasts and figure and speed skaters, and a few cheerleaders and pom poms on the squat...but the majority of them struggle with a regular bodyweight squat...just some motor learning, I'm hoping.

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Edward Smith

Coach Sommer, is elevating the toes unnecessary or unwanted?

Also Ido mentioned a toe raise in another post (as did you after re-reading it) would you not suggest adding this in as well to prevent imbalances?

Thanks,

Ed

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