Lower Extremity Physical Therapy Exercises

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P ERFORMANC

O RTHOPEDICS

Ankle Rehabilitation Program

Kenneth A. Jurist, M.D.

Joseph H. Guettler, M.D.Kenneth Soave, Director of Physical

Therapy Services

Ankle stretches:

Ankle Plantarflexion:

With your foot relaxed, use your

hands to gently move your ankle intoa position where your toes are

pointed down. Continuing moving

the ankle until you feel a stretch.

Hold this stretch for 30 seconds.

Ankle Dorsiflexion:

With your foot relaxed, use yourhands to gently move your ankle

into a position where your toes are

pointed up. Continuing moving theankle until you feel a stretch. Hold

this stretch for 30 seconds.

Ankle Eversion:

With your foot relaxed, use yourhands to gently move your ankle into

a position where your ankle is rolled

in and the bottom of your foot is fac-ing out to the side. Continuing mov-

ing the ankle until you feel a stretch.

Hold this stretch for 30 seconds.

Ankle Inversion:

With your foot relaxed, use your

hands to gently move your ankleinto a position where your ankle is

rolled out and the bottom of your

foot is facing in towards your other

foot. Continuing moving the ankleuntil you feel a stretch. Hold this

stretch for 30 seconds.



Ankle Rehabilitation Continued

Ankle Strengthening:

Towel Scrunches:

Begin with a towel flat on the floor, and take your sock and shoe off. Start at the end clos-

est to you and scrunch the towel with your toes, continue grabbing the towel with yourtoes and scrunching it until you reach the end of the towel. Once you reach the end of the

towel, begin doing the same thing in the opposite direction, so that you are pushing thetowel with your toes. Once you reach the end of the towel, lay the towel flat again and

this time start at the left side of the towel. This time you grab the towel with your toes

and pull it to the left. Once you reach the end of the towel do the same thing in the oppo-site direction, this time pulling the towel to the right side.

Pulling towards you Pushing away from you

Starting Position Ending Position

Ending PositionStarting Position




Theraband exercises:

Ankle Plantarflexion:

Start by tying the theraband around a table leg. While

seated on the floor wrap the other end of the therabandaround your foot. Position your body so that your leg is

straight in front of you and the table leg where the theraband

is tied is behind your ankle (you are sitting next to the table

leg). Make sure that the theraband is over the ball of yourfoot and push forward (i.e. pushing down on the gas). Do 3

sets of 10 repetitions several times per day.

Ankle Dorsiflexion:

With the theraband still in place, position your body so that yourleg is straight in front of you and the table leg where the thera-

band is tied is in front of your ankle (you are sitting facing the

table leg). Make sure that the theraband is over the top of yourfoot and pull backward. Do 3 sets of 10 repetitions several times

per day.






Ankle Eversion:With the theraband still in place, po-

sition your body so that your affectedleg is straight in front of you and fur-

thest from the table leg where the

theraband is tied. Make sure that the

theraband is wrapped around the topof your foot (close to your toes) and

pull out away from your body. Do 3

sets of 10 repetitions several timesper day.

Ankle Inversion:

With the theraband still in place, po-sition your body so that your affected

leg is straight in front of you and

closest to the table leg where thetheraband is tied. Make sure that the

theraband is wrapped around the top

of your foot (close to your toes) andpull in towards your other foot. Do 3

sets of 10 repetitions several times

per day.

Start position

End position

End position

Start position




Alphabet exercise:

With your sock and shoe off, hang yourfoot over the edge of a table and write

the alphabet with your big toe. You can

first write the alphabet in all capital let-ters, then repeat with lower case letters.

Repeat several times.

Balancing exercises:

While standing on your affected leg, lift

your unaffected foot to knee level. Youcan extend your arms out to the side to

help you balance. You should balance

on the affected leg for one minute. If

this is too easy, you may do the samething with your eyes closed. Once that

gets too easy, you may progress to bal-

ancing and leaning (i.e. trying to throw

yourself off balance and then steadyingyourself). Repeat this exercise several

times per day.



Heel Cord stretching:

While standing, place your hands against a wall and placeyour unaffected foot in front (closer to the wall) of your af-fected foot. Keep your affected leg straight and lean towards

the wall making sure to keep your heel on the floor and your

toes slightly pointed in. To enhance this stretch, move your

affected foot further from the wall and perform the samestretch. Repeat this stretch with your knee bent. Hold these

stretches for 30 seconds and repeat 1-2 times per day.

Knee straight Knee bent



Lower Extremity Rehabilitation ProgramKenneth A. Jurist, M.D.


Therapy Services

P ERFORMANC

O RTHOPEDICS

Lower Extremity Basic Stretching:

Hip stretching in all four directions:

Hip Extensors (gluteus):

While standing on your unaf-

fected leg, place the foot of your affected leg on a step

stool. With your knee bent,

lean towards the stool. Hold

this stretch for 30 secondsand repeat 1-2 times per day.

Hip Adductors (groin

muscles):

While standing with yourfeet wider than shoulder

width apart, slowly bendyour unaffected leg while

leaning to the same side.

Hold this stretch for 30

Hip Flexors (muscles in

front of hip):While standing on your

affected leg, place your

opposite foot on a chair orstep stool. Making sure to

keep your affected legstraight, lean towards thechair or stool until you

feel a stretch in the front

of your hip. Hold this

stretch for 30 seconds andrepeat 1-2 times per day.

Hip Abductors (muscles at

side of hip):

While standing with yourlegs apart, lean over to your

unaffected side until you feel

a stretch on the side of your

hip, on the affected side.Hold this stretch for 30 sec-

onds and repeat 1-2 times per

day.



Knee Rehabilitation Continued:

Heel Cord stretching:

While standing, place your hands against a wall and place

your unaffected foot in front (closer to the wall) of your af-fected foot. Keep your affected leg straight and lean towards

the wall making sure to keep your heel on the floor and your

toes slightly pointed in. To enhance this stretch, move your

affected foot further from the wall and perform the samestretch. Repeat this stretch with your knee bent. Hold these

stretches for 30 seconds and repeat 1-2 times per day.

Knee straight Knee bent

Knee Flexion:

While lying on your back, bend at the

hip and grab your leg at the back of your thigh. Let gravity bend your knee

and stretch it for 30 seconds, then re-

peat 1-2 times per day.

Knee Extension:

While sitting, place a rolled up towel under the

ankle of your affected leg. Make sure your legis straight in front of you, let gravity pull your

knee towards the floor, which will stretch be-hind your knee. To enhance this stretch, you

may place extra pressure (with your hand or alight weight) on your knee. Hold this stretch

for at least 30 seconds. Repeat this stretch 10

times, 1-2 times per day.



P ERFORMANC

O RTHOPEDICS

Lower Extremity Rehabilitation Program

Kenneth A. Jurist, M.D.


Therapy Services

Lower Extremity Strengthening:

Quad sets:

While sitting, extend your legstraight in front of you. Tighten

you quad (thigh) muscles until

you see it contract. Hold the con-

traction for a few seconds, thenrelease. Repeat this exercise sev-

eral times.

Straight Leg Raise:

While sitting with your leg straightin front of you, raise your leg

straight into the air. Hold it up for a

few seconds, then slowly lower itback down. Repeat this exercise

several times.

Short Arc Quads:

While lying down, position a bolster, ora few pillows under your knee. Proceed

to straighten your leg, then hold it up for

a few seconds and slowly lower it back down. For added resistance, you can

secure a cuff weight to your ankle. Re-

peat this exercise several times.

Start position End position


End positionStart position


Long Arc Quads:

While sitting in a chair, extend your affected leg

straight in front of you, then hold it up for a fewseconds and slowly lower. For added resistance,

you can secure a cuff weight to your ankle. Re-

peat this exercise several times.



Lower Extremity Rehabilitation Continued

Hamstring Curls:

While standing, lean over a table or

counter to brace yourself, then bend yourknee and lift your foot off of the floor

while contracting the hamstring muscles.

For added resistance, you can secure a

cuff weight to your ankle. Repeat thisexercise several times.

Mini Squats:

While standing on your affected legonly, slowly bend your knee making

sure to keep your knee lined up over

your second toe. Bend your knee farenough so that your knee is over

your toes, but do not go past your

toes. Repeat this exercise several

times.



Toe Raises:

Begin standing on both feet and slowlyraise up onto your toes. Once this be-

comes easy (after a few days), progressto raising up on 2 feet and loweringdown with your affected leg only. Once

that exercise becomes easy (after a few

more days), progress to raising up anddown on only the affected leg. Repeat

this exercise several times.

Start position End position Advanced




Theraband Exercises:

Hip Flexion:

Begin by wrapping the therabandaround a table leg and wrap the

other end around your ankle. Turn

your body so that you are facingaway from the table leg where the

theraband is tied. Proceed to kick

your leg straight forward makingsure to keep your leg straight. Do 3

sets of 10 repetitions several times

per day.

Hip Extension:

With the theraband still in place,turn your body so that you are fac-

ing the table leg where the thera-

band is tied. Proceed to kick yourleg straight behind you, making

sure to keep your leg straight. Do 3sets of 10 repetitions several timesper day.

Hip Abduction:

With the theraband still in place,turn your body so that your affected

side is furthest from the table leg

where the theraband is tied. Pro-ceed to kick your leg straight out to

the side, making sure to keep your

leg straight. Do 3 sets of 10 repeti-tions several times per day.

Start Position

Start Position

Start Position End Position

End Position

End Position



Hip Adduction:

With the theraband still in place, turn your body so that your af-

fected side is closest to the table leg where the theraband is tied.

Proceed to kick your leg straight across your body, making sure tokeep your leg straight. Do 3 sets of 10 repetitions several times

per day.


Hip External Rotation:

With the theraband still in place, sit in a chair with your body positioned

so that you affected leg is furthest from the table leg where your thera-band is tied. Keeping your knee bent, slowly rotate your ankle up and

out while keeping your knee in the same position. Do 3 sets of 10 repe-

titions several times per day.

Hip Internal Rotation:

With the theraband still in place, sit in a chair with your body positioned so

that you affected leg is closest to the table leg where your theraband is tied.Keeping your knee bent, slowly rotate your ankle up and in while keeping

your knee in the same position. Do 3 sets of 10 repetitions several times per

day.

Start position

Start position

Start positionEnd position

End position

End position




Step ups:

Using a step stool, step onto the stool

with your affected leg first, then yourunaffected leg. Then step down with

your unaffected leg first, followed back

your affected leg. Repeat this exercise

several times.

Hip abduction:

While lying on your unaf-fected side, slowly lift your

affected leg straight up into

the air, making sure to keepyour leg straight. Do 3 sets of

10 repetitions and repeat a

few times per day.

Hip adduction:

While lying on your af-fected side and the foot

of your unaffected leg

placed in front of youraffected knee, slowly lift

your affected leg straight

up into the air, makingsure to keep your leg

straight. Do 3 sets of 10

repetitions and repeat a

few times per day.




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Lower Extremity Physical Therapy Exercises