Ankle injuries occur at the rate of 23,000 a day, but ankle strengthening doesn’t usually happen until a er an injury, which begs the question: How important is the ankle? t 8FBLBOLMFTMJNJUBOBUIMFUFTBCJMJUZUPSVOBOEKVNQUPIJTPSIFSQPUFOUJBM t 8FBLBOLMFTJNQBDUUIFOFYUDMPTFTUMJOLJOUIFDIBJOoUIFLOFFT t 8FBLBOLMFTDBVTFUIFCPEZUPDPNQFOTBUFJOBWBSJFUZPGXBZTEVSJOH NPWFNFOU One ounce of attention or prevention can make a di erence in your entire season! Risk factors for ankle injuries: t 4USFOHUISBUJPTPGEPSTJĘFYPSTBOEQMBOUFSĘFYPST t%FMBZPGQFSPOFBMT 8IJMFUIFGPDVTPGUIFBOLMFQSPUPDPMJTPOTUBCJMJUZBOENPCJMJUZ CPEZNFDIBOJDTBOE TUSFOHUIFOJOHUIFDPSFJTBMTPGPVOEBUJPOBM e Titan Ankle protocol includes: Assessment of knee *UTFWJEFOUUIBUQSBDUJDBMMZBMMMBXTPGOBUVSFPSJHJOBUFJOTZNNFUSJFT*UPOMZNBLFT sense that joint rotation is designed to be symmetrical! A simple rotation test can NBLFTVSFUIFMPXFSMFHNVTDMFTBSFCBMBODFE Isometrics to Facilitate Neuromuscular Reeducation ćFHPBMPGOFVSPJTOPUIZQFSUSPQIZBTXJUIUSBEJUJPOBMUSBJOJOHCVUSBUIFSUPJNQSPWF UIFBCJMJUZPGUIFNVTDMFUPDPOUSBDUBOEUIFUJNJOHPGUIFNVTDMFDPOUSBDUJPO e spiral diagonal pattern is used for a stronger contraction of muscle to t *NQSPWFEFĕDJFOUNVTDMFBDUJPO t 3FTUPSF30. t &OIBODFTUBCJMJUZ Rotational stabilization 3BQJEGPSDFEFWFMPQNFOU QPXFS SFRVJSFTBTUBCMFDPSFBOEKPJOUNPCJMJUZPGUIFIJQ ćFQSFMPBEXJUISPUBUJPOJTCBTFEPOUIFQSJODJQMFPGQMZPNFUSJDTćFFOESFTVMUJT JNQSPWFERVJDLOFTT
symbols to help you to see the procedure and objective of the exercise more quickly. ćFEFHSFFNPWFNFOUPGUIFSPUBUJPOXIFFMDIBMMFOHFTCBMBODFBOE QSPQSJPDFQUJPO*OBEEJUJPO FWFSZNPWFUIBUUBLFTUIFFYUSFNJUZBXBZGSPNUIF NJEMJOFBDUJWBUFTUIFTUBCJMJ[FSTJOUIFIJQBOEDPSF 1SFMPBEJOHJTBDPVOUFSNPWFNFOUUIBUBMMPXTBWBSJPVTBNPVOUPGUPSRVFJO JOUFSOBMPSFYUFSOBMSPUBUJPOJOPSEFSUPBDUJWBUFTQFDJĕDNVTDMF1SFMPBEJOH BDUJWBUFTNVTDMFTPOUIFPOTFUPGUIFFYFSDJTF e preload may be loaded and rotated to a neutral position or rotated further into JOUFSOBMPSFYUFSOBMSPUBUJPO$POUSPMMJOHUIFQSFMPBEQBTUOFVUSBMDBOJNQSPWF NVTDMFUFOEPOTIPSUFOJOHBOESFMFBTFPGFOFSHZ XIJDIJTJNQPSUBOUJOEFWFMPQJOH QPXFSBOERVJDLOFTT 1SFMPBE*3]&3SPUBUFUPOFVUSBM 1SFMPBE*3]&3]3PUBUFQBTUOFVUSBMJOUPGVSUIFS*3PS&3 3PUBUJPOFYFSDJTFTNBZBMTPCFQFSGPSNFEXJUIFRVBMSFTJTUBODFJOCPUIEJSFDUJPOT ćJTPQUJPOVUJMJ[FTUIF7UVCFXJUIPVUBQSFMPBE Rotation Resistance Free Moving Wheel Resistance V-Tube Lower Body Cuff Upper Body Handle Loop None Locked Preload Preload & Rotate Resisted Rotation Control Rotate Assess
with traditional training but rather to improve the ability of the muscle to contract. The closed chain rotational IRUFHVSHFL¿FDOO\WDUJHWVZHDNVWDELOL]HUVLQVWHDGRIGRPLQDQWSULPHPRYHUV Preloading creates a greater stimulus for muscle contraction. The isometric work performed in the preload is necessary to reach inhibited muscles. IR|ER Preload Resistance 3UHORDG,5IRUUHVLVWDQFH against internal rotators 3UHORDG(5IRUUHVLVWDQFH against external rotators Resistance 3UHORDG,5IRUUHVLVWDQFH against internal rotators 3UHORDG(5IRUUHVLVWDQFH against external rotators Starting Position Internal Rotation External Rotation Side Facing IR|ER Preload Rotation Preload 5RWDWHSDVWQHXWUDOIRU greater muscle activation Starting Position Internal Rotation External Rotation Rotation Preload 5RWDWHSDVWQHXWUDOIRU greater muscle activation
Motion: ,OFF]EFHSFFT The knees can pay the price for improper ankle mechanics. Additionally, altered knee kinematics and reduced muscle activity is often associated with Achilles injuries, so it’s important to evaluate the muscles that act upon the knee. The knee assessment a simple range of motion test that can identify potential weaknesses. SET-UP: Face #1; one foot on diamond, lunge position with weight centered ACTION: Keep knee facing GPSXBSESPUBUFUJCJB*3BOE&3 Assessment | (YDOXDWHPXVFOHEDODQFH 7LELDO5RWDWLRQ Rotation Keep Knee Facing Forward Starting Position Internal Rotation External Rotation Knee Assessment Starting Position Internal Rotation External Rotation Variation: Seated Position
#7 knee bent to 90 degree angle; ankle, knee, BOEIJQJOMJOF MVOHFQPTJUJPO ACTION: Preload, rotate into neutral; hold, rotate tibia into further IR, feel the arch li Objective: *NQSPWFUIFiBSDIw muscles of the foot Treatment: Hold 10 seconds; release, rotate tibia into further *3XJUIUFSNJOBMĘJDLT ]YSFQT Bene t: Balance of lower leg, BMJHONFOUPGUIFQFMWJT NEURO | Post Tib, Popliteus 3UHORDG,5+ROGRU5RWDWH tibia toward #6 V-Tube Selective activation of the lower leg muscles is necessary to provide an optimal environment of muscle strengthening or rehab. This Titan ankle exercise strengthens lower leg muscles and improves tibial control in the transverse plane. Keep Knee Straight Preload IR Line foot up with #8 Rotate to #7 Starting Position Internal Rotation Side Facing IR|ER Preload
#1 Knee bent to 90 degrees ankle; ankle, knee and hip in line ACTION: Preload, rotate into neutral, decrease angle of shin UPEFHSFFT Objective: 3FBDIiNJEEMF ĕCFSTwSFTQPOTJCMFGPS neuromuscular proprioception Treatment: TFUTPG Bene t: Gain stability & JNQSPWFĘFYJCJMJUZ NEURO | 'RUVLÀH[LRQZLWKHFFHQWULFFRQWURO Preload V-Tube 7KHUHLVDFRQVHQVXVWKDWHFFHQWULFWUDLQLQJIRUWKH$FKLOOHVLVEHQH¿FLDO7KHWUL SODQHUSUHORDGLVWKHNH\PHWKRGWRUHDFKWKHPLGGOHUDQJH¿EHUVWKDWDUHVHQVLWLYH to muscle length change. Control Knee, foot alignment Starting Position Preload on External rotation Control decreasing ankle angle
#1, hold uprights, one foot on diamond ACTION: Preload, reach hips CBDL BDUJWBUJOHUIFIBNTUSJOHT Objective: *NQSPWFBCJMJUZUP store and release elastic energy Treatment: Hold position for 20 seconds release and repeat up to 3 times Bene t: Reduced contraction time or greater mechanical e ciency NEURO | +DPVWULQJ6WUHWFKZLWK3UHORDG 3UHORDG+ROGDQG5RWDWH V-Tube The same facial line connects the Achilles tendon, calf muscles and hamstring PXVFOHV'RUVLÀH[LRQOLPLWDWLRQDQGKDPVWULQJVKRUWQHVVDUHFRPPRQFRPSHQVDWLRQ patterns that can be corrected with the tri-planer activation of the hamstring stretch. Pelvis Level Rotate From Femur Knee and Ankle in Line Starting Position Internal Rotation External Rotation IR|ER Preload
Treatment: TFUTPG Bene t: *NQSPWFNFOUJO DSPTTPWFSBOETJEFTUFQQJOH tasks Resistance Rotation SET-UP: Face #1 foot lined up with diamond, hold resistance in opposite hand ACTION: Press through ball of foot and raise heel up CALF RAISES | Dynamic medial & lateral gastroc activation Control Upper body handle 6WXGLHVVKRZDGH¿FLWLQSODQWHUÀH[LRQZDVLGHQWL¿HGLQIXQFWLRQDOO\XQVWDEOHDQNOHV The rotational component creates the ideal stimulation for activating the medial and lateral gastroc muscles. Soleus activation is greater if the knees are bent. Lightly hold Lower ankle with control Resistance None Bent knee for soleus activation Lightly hold Neutral Spine One leg variation - use center diamond Variation:
Hip Hinge Preload and rotate Preload V-Tube Studies show that the pattern of muscle activation in subjects with previous ankle injury differed from those without ankle injuries. Ankle injury caused a delay in the activation of the gluteus maximus. The hip hinge activates the glutes and can be SHUIRUPHGLQDQXPEHURIZD\VZLWKYDU\LQJGHJUHHVRIVWDELOL]DWLRQUHTXLUHG SET-UP: 0OFGPPUPODFOUFS diamond, knee slightly bent; shoulders square; lightly hold uprights ACTION: Preload, hinge at waist, control eccentric lengthening toward the bar, hold hinge position and rotate leg, hips remain forward Objective: *NQSPWFEFĕDJFOU muscle inhibition Treatment: TFUTPG Bene t: "DUJWBUFUIFEFFQ ĕCFSTPGUIFHMVUFVTNBYJNVT Hinge at hips Legs may also be positioned to the front or side Squeeze Glutes Resistance Control eccentric pull of resistance Variation: Neutral spine or add an anterior pelvic tilt Squeeze glutes
Reach deep, NJEEMFĕCFSTPGHMVUFVTNFEJVT VUJMJ[FFMBTUJDFOFSHZ Treatment: TFUTPG Bene t: *NQSPWFERVJDLOFTT Resistance Rotation SET-UP: Face #7 with neutral spine ACTION: 1SFMPBE ĘFYBOLMFT LOFFT FYUFOEIJQTJOUPTRVBU position; rotate NEURO | Clam V-Tube +LSVWDELOLW\DQGPXVFOHEDODQFHDUHULVNIDFWRUVLQPHGLDOWLELDOVWUHVVV\QGURPH commonly known as shin splints. Training muscle groups that fail early like the gluteus medius can help avoid injury. The tri-planer motion (preload + rotation) XWLOL]HVHODVWLFHQHUJ\ LPSURYHVTXLFNQHVVEDVHGRQWKHSULQFLSOHVRISO\RPHWULFV Starting Position External Rotation Stay in squat position and rotate from hip Neutral spine
7ULSODQHUH[FXUVLRQ 3UHORDG5RWDWH ,PSURYLQJ IXQFWLRQDO EDODQFH LQYROYHV PRWLRQ QRW VWLOOQHVV ,W¶V LPSRUWDQW WR SD\ DWWHQWLRQWRFRPSHQVDWLRQVRQWKHVWDQGLQJOHJDQGWKHÀXLGLW\RIPRYHPHQW7KH frontal plane rotation improves stability in crossover and sidestepping motion. Adding DSUHORDGURWDWLRQWRWKHVWDQGLQJOHJLPSURYHVWKHVWRUDJHDQGUHXWLOL]DWLRQRI elastic energy. Closing the eyes creates a different challenge. SET-UP: Face side #7, one foot on center diamond; align CPEZWFSUJDBMMZ ACTION: Preload, lower and SFBDIIFFMGPS BOE FYUFOEVQBęFSFBDISFBDI TUBZ in reach position and rotate leg VARIATION: &ZFTDMPTFE Objective: Restore range of NPUJPOJOEPSTJĘFYJPO Treatment: TFUTPG Bene t: &OIBODFETUBCJMJUZ V-Tube Keep weight over the ball of the foot and heel Maintain alignment Squat Preload
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