I have always supinated on my right foot, and the problem has gotten worse since I became partially paralyzed on the R side. I roll my R ankle on every other hike, and have sprained that ankle badly in 2009, and mildly in 2010.

I'm wondering if I can somehow strengthen the muscles that control the supination. I had always assumed that doing the stuff that I did -- long cross-country trips on rough terrain-- would be enough exercise, but the recent injuries make me want a better solution. I've started doing toe raises, and am back to running backwards uphill, which seems to do much the same. I tried to walk bowlegged, turning my feet out, and that caused substantial pain in the next week. Curiously, I get the most pain when I wear stiff, ankle-supportive boots.

Any ideas?

maybe consider barefoot running. After I rolled my right ankle bad I was having similar problems with constant re-rolls. I found that when I started running in five fingers the problem mostly went away.

I seem to remember that running barefoot increases leg and ankle stiffness. Basically, your muscles and tendons act like a brace for your ankle. Also, the ground reaction forces are less in barefoot runners, which is probably a good thing when it comes to a lax ankle. Also, the a handful of the muscles responsible for supination will get a hell of a work out when you run barefoot (larger eccentric force).

Anyway, If you want I can try and find some articles if that's of any help. Also, you don't have to run in five fingers, there are other types of "shoes" that mimick barefoot running. I just like them because they are surprisingly fun, and they do a good job of protecting the pads of your feet.

I'm barefoot about 70% of the time; my toe raises, stairs in my house, and exercise like chair squats are barefoot. The trailless hikes cross-country pretty much require shoes.

I think the key is, after starting exercises just against gravity, you need to increase the resistance progressively in some fashion. Hard to do with ankle...get some weight wraps maybe. Balance / proprioception exercises are nice for coordination, but don't really 'strengthen' per se, good to do both.

One other thing, problems at one joint may be caused by weakness elsewhere (say, for instance, the hip). Good to see a PT probably.

Barefoot running is a nice balance to shoes but can only be done in short amounts and gradually build up...it sure will definitely tax the calves as well as foot muscle supporting the arch, but may also lead to injury since it takes a while for people to get their muscles used to it. It's not some perfect form, but good to mix in.

Does your ankle feel unstable? I'm no expert, but if you've rolled your ankle many times, you might have strained your anterior talo-fibular ligament...and it's either loose right now or has scar tissue. I'm guessing tibialis anterior (dorsiflexion) and the peroneals (eversion) act in support of that ligament so you would want to strengthen and tighten them. just a guess

Ze wrote:Does your ankle feel unstable? I'm no expert, but if you've rolled your ankle many times, you might have strained your anterior talo-fibular ligament...and it's either loose right now or has scar tissue. I'm guessing tibialis anterior (dorsiflexion) and the peroneals (eversion) act in support of that ligament so you would want to strengthen and tighten them. just a guess

It doesn't feel unstable; maybe that's mental. Often when it rolls over, people behind me are shocked and think I'm headed for the hospital, but I just feel a momentary twinge. I'm pretty sure there is something going on with adhesions; sometimes it is really painful to do certain motions, but the pain seems to go away.

I've got lots of foot weights, so maybe I'll try that.

foweyman wrote:http://www.activeankle.com/
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Thanks-- the 1st is now on my bookmarks. I've tried some ankle braces -- they all seem to feel miserable in a boot. The best thing has been to tape my ankle, but I've done that just once. I always take tape and an ace-type bandage when I'm solo in the backcountry.

I know you're not the type to spend a lot of time on the couch, but when you are do alphabets. You hold your leg straight out and trace the letters of the alphabet with your foot, as if there were a pen extending from your big toe, getting all the motion from the ankle (not the leg.)

I've had a few significant ankle injuries and have done this during rehab. The variety of movements is great for range of motion and proprioception.

Drat. Hit enter too soon...

There are a lot of great ankle exercises you can do with a Bosu Ball. PT's use these a lot - I use mine frequently and my tendency to pronate went away.

I use a wobble board. Today I tried some of the "agility"-type exercises -- like we had in gym class tests -- and damn they tired me out quickly. My ankles seem to have come through OK, so I'll try those again.

I can't help you with the ankle, but if you don't already take hiking poles, now might be a good time to start.
I had one pole with me last year when I tore a calf muscle while heading up a steep ridge above Eureka Valley. I was able to gimp to the top with the pole and head back down the 'easy' way. It wasn't pretty, but at least I didn't have to crawl back to the car.

Greg Enright wrote:I can't help you with the ankle, but if you don't already take hiking poles, now might be a good time to start.
I had one pole with me last year when I tore a calf muscle while heading up a steep ridge above Eureka Valley. I was able to gimp to the top with the pole and head back down the 'easy' way. It wasn't pretty, but at least I didn't have to crawl back to the car.

I used poles only for snow before, partly because I am always going over rough terrain on non-snow trips. But this last Dec 4, I used them for a 22-mile, 8200'-gain trip over Villager and Rabbit and back, mainly because of the injury at the end of October, for the exact reason that I wanted a crutch if things got bad. I was really surprised how well they worked; I've always been hesitant to take the extra weight, and really want my hands free on rough terrain. But that particular trip had the right combination of potential ankle twists, isolation, and not very rough terrain, to justify the use.

MoapaPk wrote:

foweyman wrote:http://www.activeankle.com/
http://shop.bauerfeindusa.com/cgi-bin/cart.pl?Dynamic+products.txt+MALLEOLOC+template.html+3
http://www.mizunousa.com/equipment.nsf/AllProduct/7D6BF5FA414EB5E685257361007AD8D4?opendocument&div=volleyball&cat=accessories
http://www.asoankle.com/index.cfm?fuseaction=information.ShowAsoInformation

Thanks-- the 1st is now on my bookmarks. I've tried some ankle braces -- they all seem to feel miserable in a boot. The best thing has been to tape my ankle, but I've done that just once. I always take tape and an ace-type bandage when I'm solo in the backcountry.

I can see how these would feel lousy in a boot. Boots worn over these would also probably reduce the ankle extension and flexion that they are designed to allow. They are designed to be worn with low cut shoes and would replace/improve on many of the benefits of wearing boots. They are all far more comfortable, durable, and supportive than even the best tape job.

I guess you should get custom insoles.

Petro wrote:I guess you should get custom insoles.

Any experience with those "Dr Scholl" stations that are popping up in drugstores?