By Kim Saha: International Sports Physiotherapist 



Yes it is possible to stay fit, motivated and driven with a foot and ankle injury or surgery. There is PLENTY to keep you occupied! My new course 'Stay Fit with a Foot and ankle Injury' will give you complete guidance throughout. Go to https://kimsaha.thinkific.com/courses/stay-fit-with-foot-and-ankle-injury (copy into browser). All advice and pictures are taken from this course. 

This article describes how to keep yourself psychologically motivated to stay fit and strong safely whilst going through various stages of your recovery.

While you cautiously train with your injury it will be more important than ever to have some good equipment. This is not essential but could make things a whole lot easier. I would suggest the following things: gym ball, small pilates ball, range of hand weights, adjustable ankle weights, foam roller, ankle brace and loop / mini bands. You may want to consider a massage gun from Pulseroll for release and recovery. Also in order to maintain the tone in the muscles of the injured leg you may consider a Compex muscle stimulation machine. This should be used with the guidance of a professional.

Non Weight Bearing (NWB)

If you have had a lower leg injury or surgery that requires you to be NWB, this means you should not be putting any weight through the leg at all. This doesn't mean you can't keep the rest of your body fit and strong! You may be in an Aircast boot or alike, a NWB cast or a protective shoe. You may not have any protection on your foot this is all normal and specific to your injury. 

Depending on your injury or surgery you may be advised not to do any activity during this NWB period. I am purely showing you what is possible to do without putting your foot to the floor. However extra care must be taken as to not compromise healing of the injury or surgery site. PLEASE ALWAYS CHECK WITH THE CLINICIAN IN CHARGE OF YOUR RECOVERY, or contact me directly if you are unsure. 

In this NWB phase the focus is on recovery, healing and protection. Remember what this journey is all about! - to have a healed, pain-free, functional lower leg and whole body for that matter!. This section aims to keep you fit while you 'persevere' through this NWB stage and prepare you for the next more pro-active phases. 

The main things to remember whilst PWB: 

1. Rest with the leg elevated unless there's anything functional you must do or if you are doing one of my workouts.

2. Ice for pain relief of you are able to access the effected site of injury.

3. Gently compress the effected site and generously above and below if possible with tubigrip. 

4. Gentle active movements if permitted

5. Gentle massage if permitted

6. Compex/ other muscle stimulation to maintain calf tone if permitted

7. Take painkillers and or anti-inflamatories if recommended by your doctor

8. Always keep the foot off the floor whilst moving around using the advice given by your managing professional. 

Now the exciting part!

There are 5 types of workout you can do: 

Pilates: Mainly on the floor using ankle weights on the un-effected leg to equal out the weight of the boot. 


Arm Weights: Can be done n the floor to keep the weight off the effected leg


Leg Weights: Mostly with resistance bands and ankle weights for now, with no weight through the leg.


HiiT: This is the exciting part. There are many exercises you can do for arms, abs, and glutes that perfectly get your heart rate up! and with the weight of the boot and counterbalancing ankle weights you'll be pooped! 


Stretch: You can do some lovely stretches which will ease the pain from the use of crutches and the over-use of your other leg. You may end up more flexible than before! 

I suggest you do Pilates x3, HiiT, legs and arms x2 and stretch x3 per week. An example of this could be: 

Mon: Pilates + Arms 

Tues: HiiT + stretch

Wed: Stretch + Legs 

Thurs: Pilates + Arms 

Fri: HiiT + stretch

Sat: Pilates +Legs

Partial Weight Bearing (PWB)

You are now able to put your foot down to the floor!  If you have both feet to the floor you have 50% of your weight through the injured side so along this much is permitted it opens up a whole load of double leg exercises in standing. 

There are now 6 types of workout to do. Rehab, Pilates, HiiT, Arm Strength and Leg Strength and Stretches.

Rehabilitation: includes lots of resistance band work in sitting and standing work with crutches. Along as you have been advised to take the boot off to rehabilitate. 


Pilates: you can now do some lovely standing exercises with the boot on.


Arm Strength: can be done sitting on a ball: this is useful to gain some core strength and posture. You will also be putting a little weight through the foot therefore using some of those muscles gently.


Leg Strength: Again it is now possible to have equal weight thorough both feet whilst exercising.
 

HiiT: is still mostly on the floor but there are some PWB exercises you can do in standing! 


I suggest you do Pilates and rehab x3 per week, legs and arms both x2, and HiiT x2. An example of this could be:

Mon: Pilates + Arms 

Tues: Rehab + HiiT 

Wed: Stretch + Legs 

Thurs: Pilates + Arms 

Fri: Rehab + HiiT

Sat: Pilates +Legs

Sun: Rehab

These workouts can be done with the brace on or off depending on what you have been advised - I would suggest keeping it on if in doubt. 

Remember to use something to lift up the heel and ankle weights to balance out the boot on the unaffected side. 

Full Weight Bearing (FWB)

So... you are able to weight bear through your foot now! make sure you give the foot a week of purely walking with your full weight to see how it will react before starting any of the FB workouts. Rest, ice, elevate and compress if it does react and always get out your boot and or crutches if needed. 

Important!:

FWB could mean various things: 

1. FWB in your cast, boot or shoe with one or two crutches for balance 

2. FWB in your cast, boot or shoe without walking aids at all 

3. FWB without cast boot or shoe in normal footwear or bare feet but still using crutches or a stick.

4. FWB with no aids at all. 

You have a new set of Rehab, Pilates, Arm and Leg Strength and HiiT sessions. 

Pilates: Most of my Pilates workouts will be good for you now and some good standing Pilates can serve well as foot and ankle rehab! 

Rehab: Sometimes simple is best! purely concentrating on daily calf raises, stretching and balance (take note that with some injuries this needs more caution e.g. achilles repair / bunion surgery.)


Leg Strength: Perfecting squats, split squats, single leg RDL (Romanian Dead Lift) and calf raises will put you in a good position to work towards more dynamic workouts in future


Arm Strength: We can challenge you in standing now with your arm strength - even on one leg at times! 


HiiT: No jumping yet but we can still be very dynamic and get heart rate up wonderfully in standing now.



How to structure your week: I suggest 3x Pilates and Rehab, 2x HiiT Legs and Arms and at least one Stretch

Mon: Pilates + Arms 

Tues: Rehab + HiiT 

Wed: Stretch + Legs 

Thurs: Pilates + Arms 

Fri: Rehab + HiiT

Sat: Pilates +Legs

Sun: Rehab

Please remember you will still be weak through your lower leg. If you have followed my regime so far you will have maintained some strength through your thigh, core and arms but the lower leg of the injured side will still be weak despite use of the Compex and the resistance band rehab. It is therefore vulnerable to re-injury.

This is why I suggest wearing an ankle brace for the leg strength and HiiT workouts. I suggest the Aircast 360 ankle brace: And to also take very good care.

Listen to your body, if you have pain then stop and reassess and contact a professional if need be. Rest, ice and employ other recovery techniques. Ice, rest, elevate and re-try with more support and or go back to the previous sessions. 

If you found this article useful and want to sign up to the fully guided course copy and paste this into your browser: https://kimsaha.thinkific.com/courses/stay-fit-with-foot-and-ankle-injury

In order to progress onto the next level of HiiT workouts and get stronger and fitter to enable you to get back to running and other sports; you should consider purchasing 'Get Fit with Kim Saha'. This will get you there safely in a structured manner. Sign up here! (copy and paste into your browser: https://kimsaha.thinkific.com/courses/get-fit-with-kim-saha