Complete the alphabet 3 times per day. Perform this exercise before any symptomatic activities, especially putting weight on the foot after resting, such as when getting out of bed in the morning or rising from a sitting position.
Symptoms in the lower leg are often related to immobility. This exercise can help to increase your range of motion without putting excessive strain on the sensitive structures of the ankle. It may also help with the resolution of swelling and inflammation, making it a good way to prevent symptoms brought on by weight-bearing.
In any position, use the foot to trace the capital letters of the alphabet in the air. Make the movements as big as possible without causing pain above a 3 to 4 out of 10 (where 0 is no pain and 10 is the worst pain imaginable). Trace the entire alphabet, using the maximum range of motion available. This exercise may seem stiff and uncoordinated at first but will become more fluid over time as range and coordination improve.
• Using the leg to draw the letters instead of the ankle. When the ankle is stiff, it is common to move the leg instead. Try to isolate the ankle as much as possible, as this will improve your control and range of motion at this joint.
• Not pushing into resistance. The purpose of drawing the alphabet is to incorporate movements that may have been lost due to ankle dysfunction. If you only draw letters in your easily available range of motion, it will decrease the effectiveness of the exercise. Try to explore new areas of each letter with the foot and ankle, pushing into resistance when moving the ankle to the inside, outside, and upwards directions.
Progress to the next exercise when you can lift your heels off the ground without experiencing more than a 3/10 pain.