How to Exercise with a Knee or Ankle Injury, How to Prevent Future Pain

Are you dying for a work out but have been sidelined by a knee or ankle injury? Personal trainer Kathleen Trotter explains how to work around an injury, and offers some simple exercises that won’t interfere with healing.

Q: How do painful ankles and knees affect our ability to exercise?

A: People often equate ‘exercise’ with going to the gym, pushing one’s body to the limit and as Jane Fonda would say, “feeling the burn.” As a personal trainer, the first thing I teach my clients is that everyone’s individual gym/activity program should be unique and tailored to fit their fitness level, history and goals. What this means is that for some people ‘working out’ may be about how many sit-ups and push-ups they can do, but for people who have joint pain, exercise and staying active should be about improving or maintaining range of motion (ROM), increasing or maintaining bone density, training balance and proprioception (perception of movement and spatial orientation), and training the nervous system.

If you are discouraged from going to the gym, or even just being active because your ankles and knees hurt, and/or you feel working out will make your joints hurt more, talk with a physiotherapist or knowledgeable fitness professionals who can provide you with small functional exercises that will provide your joints both the stability and the mobility to carry out every day functional activities with decreased pain and increased ease of motion. Everyone can, and should, exercise in some capacity or another. The intensity, duration and type of exercise just has to vary depending on the fitness level, goals and fitness history of the individual.

Q: What are some of the most common causes of ankle and knee injuries? How should an exercise routine be augmented to accommodate ankle/knee injuries?

A: There are many common ankle and knee injuries such as arthritis, IT band syndrome and meniscus tears. I can’t diagnosis knee and ankle injuries so if you think you could have a chronic or acute knee or ankle injury talk with your health care provider.

What I can do from years of working in the fitness field is recommend you work the small stabilizing muscles that are often ignored. I suggest that you include what I call ‘prehab’ exercises into your exercise program. Many people only include exercises for the large, superficial aesthetically-appealing muscles and ignore the smaller muscles that are important for joint health. I suggest including exercises that strengthen the foot and ankle (to help keep you from falling) and the medial quad muscles (help with knee tracking). (See below for descriptions.)

Q: Can you suggest some exercises that protect and strengthen the knee or ankle?

A: Knee

Leg Squeezes

Purpose of this exercise: Strengthen the medial quad muscle that is important for proper tracking of the knee.
Execution: Sit in a chair with your feet on the floor, parallel and hip distance apart. Place your fingers on the inside of the knee. Squeeze your leg muscles and try to “turn on” the muscles on the inside of the knee. Do three sets of ten repetitions.
Main thing to focus on: These muscles are not strong. The rest of your leg muscles will try and take over. Try not to let that happen.

Foot and Ankle

1. Resistance Band Ankle Exercise

Equipment: Resistance band or towel
Purpose of this exercise: This exercise strengthens the little stabilizing muscles of the foot. These muscles are often ignored during traditional strength training routines.
Execution: Lie on your back. Left leg bent with your foot on the floor. Right leg fairly straight with the resistance band wrapped around the ball of your right foot. Make sure your shoes are off. Slowly point and flex your right foot. Repeat 15 times and switch legs.
Main thing to focus on: Go slowly and try to feel all the muscles in your foot. Try to differentiate between the muscles within the arch of your foot and your toes.

2. Towel Toe Pulls

Equipment: Towel
Execution: Sit in a chair with your shoes and socks off. Lie a towel down in front of you. Place your foot on the towel, close to you. Use your toes to pull the towel towards you.
Main thing to focus on: This will be slow, it is supposed to be. Take your time and really feel your toes moving. Try to pull the entire towel towards you. Feel free to reposition your foot whenever too much towel gets underneath your arch.