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Page 1 of 8 Apinporn (Nikke) Chaiwanichsiri 131027 Ankle The ankle joint is like a hinge but it is an important part of our

body. It has a very complex structure of bones, joints, ligaments, tendons, and muscles. Each of these structures helps us move our feet in a different direction, be able to walk, and balance our bodies. Bones and joints make our foot bend up and down and move side to side. Ligaments and tendons support the movement of the ankle, foot, toes and the arches of the foot. Achilles tendon is the most important tendon which joins calf muscles and heel bone together. It helps us walk, jump and run. Muscles also control the movement of the ankle and foot when it contracted. The ankle joint is also a very important body part for dancers because it supports the body weight of the dancer when they are dancing. However, from Foot and Ankle Injuries in Dance journal, 34% to 62% of professional ballet dancers and 23% to 45% of musical theatre dancers injuries are their feet and ankles (Kadel, N. MD., 2006). To make the ankle function well, all of the structures have to work properly. One part damage can affect every other part of the ankles and feet (Quinn, E., 2006). Thus, stretching, strengthening, and conditioning exercise is used to help sustain the ankle mobility, prevent and decrease ankle injuries. Stretching exercise (Black, K) Stretching exercise is very important for dancers because they need their ankles to be flexible before they start dancing. This exercise will help them prevent to ankle injury when they are landing from their jumps or turns. It also helps ballet dancers to flex their ankle better because they usually stand on their point. This exercise can be done by stretching the muscles and tendons around your ankle, calf and shin.

Page 2 of 8 Apinporn (Nikke) Chaiwanichsiri 131027 1. Heel Cord Stretch (gastrocnemius and soleus complex

and Achilles tendon) (AAOS., 2010) (You should feel the stretch in your calf and into your heel) Stand facing the wall with arms and hands lean against the wall. Move one leg forward and slightly bend the knee while another Keep both heels flat on the floor and press your hips forward

leg is straight at the back. toward the wall. Hold for 30 seconds and relax 30 seconds Repeat 2 sets of 10 2. Heel Cord Stretch with Bent Knee (Soleus and Achilles tendon) (AAOS., 2010) (You should feel this stretch in your calf, the sides of your ankle, and into your heel) knees forward. Keep both heels flat on the floor and press your hips forward toward the wall. Hold for 30 seconds and relax 30 seconds Repeat 2 sets of 10 3. Standing ankle stretch (gastrocnemius and soleus complex, Achilles tendon and Anterior tibialis) (Drake, J., 2011) (You should feel the stretch in your calf and shin muscle) Stand facing the wall with arms and hands lean against the wall. Bend your foot toward your shin that the heel touches the ground and toes touch the wall. Lean your upper body toward the wall and feel the stretch in your Achilles tendon and ankle. Hold for 10 seconds and then relax. Repeat 2 sets of 10 Stand facing the wall with arms and hands lean against the wall. Move one leg forward and one leg behind. Then slightly bent both

Page 3 of 8 Apinporn (Nikke) Chaiwanichsiri 131027 4. Towel Stretch (Stretch Gastrocnemius-soleus

complex and Achilles tendon) increase ankle dorsiflexion (AAOS., 2010, Vanderheiden, T) (You should feel this stretch in your calf and into your heel) Sit on the floor or on a bed with your knee and leg straight Loop a towel around the ball of your foot and grasp it with 2 hands Sit up tall and pull the towel toward you until you feel the stretch in your calf muscles. Hole for 30 second and then relax for 30 seconds Repeat 3 sets of 10

5. Ankle Dorsiflestion/ Plantar Flexion (Anterior tibialis, gastrocnemius-Soleus complex) (Shape fit, 2013) You should feel this exercise at your calf, shin, the back of your heel, and the top of your foot Sit on the floor or bed with your legs straight in front of you. Dorsiflexion Pull your toes toward yourself and return to the start position. Plantar flexion Point your toes as far as you can and slowly return to the start position. 6. Foot Inversion and Eversion Active (Shape fit, 2013) Sit up with your back straight on the chair.

Eversion Slowly turn your foot outward and hold for 6 seconds. Slowly

turn your foot back to the first position Inversion Slowly turn your foot inward and hold for 6 seconds. Slowly turn your foot back to the first position Do two sets of 10 to 15 repetitions, two to three times a day

Page 4 of 8 Apinporn (Nikke) Chaiwanichsiri 131027

7.

Golf Ball Roll (Plantar fascia ligament)

(AAOS., 2010) ( You should feel this exercise along the bottom of your foot) minutes. 8. Plantar Fascia Stretch (Arch Stretch) (Inverarity, L., 2007) Stand on a stair or stack of book. Slide your feet back until only the ball of the foot is on the stair. Start push your heel down toward the floor until your feet the stretch in the arch of your foot. Hold for 3 second To make it more challenge do it one foot at a time. 9. Seated ankle stretch (plantar muscle) (Vanderheiden, T) (You should feel the stretch in your plantar muscle) Sit on a chair with feet on the floor. Tuck your toes beneath your foot and rest the tops of the toes on the floor. Gently press the arch of your foot forward until you feel some tension in the arch and ankle. Hold for 10 seconds and then relax Repeat 3 to 4 times Sit up tall in a chair with feet flat on the floor Roll a golf ball or ball under the arch of your foot for 2

Page 5 of 8 Apinporn (Nikke) Chaiwanichsiri 131027 Strengthening Exercise (G. Gustafson., 2009) Strengthening exercise is also an important exercise for dancer because they need their ankle to be able to support their body weight. It also helps the dancer to hold their balance and turns better. For ballet dancer it also improves their point. In order to do that we have to make the muscle around the ankle become stronger by adding some resistance to the exercise.

1. Heel Lift (Calf Lift) (Gastrocnemius-Soleus complex and Achilles tendon) (Finch T., 2009) (You should feel this exercise in your calf)

Stand with your feet apart. (Put your hand on the chair or against the wall to balance your body).

Slowly rise up your feet and standing on your toes and so not bend your knees. Hold for 5 second and lower heels on the floor. Repeat 2 sets of 10 and make it 6 to 7 days per week 2. Heel lift Single (Gastrocnemius-Soleus complex and Achilles tendon) (AAOS., 2010) (You should feel this exercise in your calf) Stand with left foot and bend right foot off the floor. Slowly rise up the left foot and standing on your toes and do not

bend your knee. Hold for 5 second and lower heel on the floor Repeat 2 sets of 10 and make it 6 to 7 days per week

Page 6 of 8 Apinporn (Nikke) Chaiwanichsiri 131027 3. Ankle Range of Motion (Dorsiflexors, plantar flexors,

invertors, evertors) (AAOS., 2010) (You should feel this exercise at the top of your foot and throughout your ankle) Sit on the chair with your feet off the floor Use your foot to write each letter from A to Z in the air using your big toe. Repeat 2 sets and do it every day 4. Marbles/rocks Pickup (Plantar flexors) (AAOS., 2010) (You should feel this exercise at the top of your foot and toes) Sit on a chair with both feet flat on the floor Place 20 marbles on the floor near where you sit. Use your toes to pick up one marble at a time and put it in

a bowl until there is no marble left on the floor.

5. Towel Curls (Plantar flexors) (AAOS., 2010) (You should feel this exercise at the top of your foot and your toes) Relax Repeat 5 sets Sit on a chair with both feet flat on the floor Place a small towel on the floor near where you sit. Use your toes curls the towel toward you

Page 7 of 8 Apinporn (Nikke) Chaiwanichsiri 131027 6. Ankle Dorsiflexion/Plantar Flexion with Theraband (Anterior tibialis, gastrocnemius-Soleus complex) (AAOS., 2010) You should feel this exercise at your calf, shin, the back of your heel, and the top of your foot Sit on the floor or bed with your legs straight in front of you. Dorsiflexion Loop one side of the band with the chair and the other side around the ball of your foot. Pull your toes toward yourself against the band and return to the start position Plantar flexion Loop the band around the ball of your foot and hold another end with your hands. Point your toes as far as you can against the band and slowly return to the start position. Repeat 3 sets of 10 and do it 3 days per week 7. Foot Inversion and Eversion with Theraband (Sandor, R. M.D. 2007) Sit on a chair Tie and loop one end of the band to the table or heavy object and loop another around the ball of your foot. Eversion Slowly turn your foot outward against the band and hold for 6 seconds. Slowly turn your foot back to the first position Inversion Slowly turn your foot inward against the band and hold for 6 seconds. Slowly turn your foot back to the first position Repeat 2 sets of 10 to 15 two to three times a day

8. Toe Taps Sit in a chair Keep heels on the floor then start tapping Doing it for 1 minute and increase the time you tap or the speed you tap after 1 minute.

Page 8 of 8 Apinporn (Nikke) Chaiwanichsiri 131027 Conditioning Exercise (AAOS., 2010) Many dancers have faced their ankle injuries once in their life. Ankle conditioning exercise is a repetitive exercise to improve the performance of your ankle before and after injuries. However, for rehabilitation case, the exercise should be perform under doctors supervision. These exercise include both stretching and strengthening exercise. For conditioning exercise program, we have to warm up for 5 to 10 minutes with non-intense activities such as waking, riding a stationary bicycle.

Proprioception Exercise (AAOS., 2010) Proprioception exercise help the dancer on their balance ability. This also help dancers ankle because if they can balance well it could prevent their ankle sprain. 1. Single leg Stand (Calf) (Sandor, R. M.D. 2007) Stand on the floor Slowly lift one foot and hold for 30 seconds. Repeat 2 set of 10

2. Single leg stand with towel (Calf)( Sandor, R. M.D. 2007) Stand on the towel Slowly lift one foot and try to balance yourself for 30 seconds. Repeat 2 set of 10