Stiff Ankles and Calves --- Hidden
Cause of Falling
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Last updated March 11, 2017 (originally published October 12, 2015)


By Susan Callahan, Associate Editor and Featured Columnist






Accidental falls are a leading cause of disability in older
Americans. Between 28% and 35% of people over the age
of 65 who live in their homes fall every year, according to
the World Health Organization.  As you age, you fall more.
Between 32% and 42% of people 70 years old and older fall
each year.

Less well known are the reasons many older people lose
their balance in the first place. Apart from
medical conditions
such as Meniere's disease that cause falling, the reason for
falls often can be traced to stiffness or inflexibility in ankle
joints and calves.  

If you think about it, it makes sense. Your ankle joints have
the job of not only supporting your body weight as you
stand upright, but also adjusting quickly to changes in the
position of your upper body. As you begin to tilt, and lose
your balance, your ankles must bend and stretch to find a
new center of stability. If your ankles are unable to adjust
quickly, you fall.


Are You Standing on Stilts?


If your ankles are stiff, your balance is much like trying to
walk around on stilts.

On stilts, there is no natural bend in either your knees or
your ankles. You tend to “swing” your entire leg forward,
rather than moving smoothly with a slight bend in the knee,
smoothly rotating hips and a heel-to-toe gait as your foot
contacts the ground.  


And, like the man in the circus on stilts, you have to fight to
maintain your balance if your ankles are stiff because you
have no “feel” for the ground.  Your feet are like pieces of
wood attached somewhere down there.

Because you don’t know where your limbs and feet are, you
are more prone to falls.


A Bit on Ankle Anatomy


Your ankles joint is capable of 4 distinct motions. You should
try to do these motions at least once per week as a test to
isolate ankle weakness:

1) Plantar flexion: try to point your toes away from the
knee. You will feel your calves flex. This is the motion you
also use when you stand on your toes.

2) Dorsi flexion: pull your toes up toward the knee. You will
see the muscle next to shin bulge
.

3) Inversion: pointing your toes inward toward each other.

4) Eversion: pointing your toes outward away from each
other.


None of these motions should produce pain.


Until fairly recently, there were no guidelines for that is a
"normal" range of motion for your joints. The
Centers for
Disease
solved that by studying 600 people in various age
groups ranging from the age of 2 to the age of 69.

What they found is that our ankles become stiffer gradually
as we age. In fact, the range of motion that you have in your
ankles from age 2 to age 8 is on average about 24.8
degrees. By the time you are age 20, that average range of
motion has decreased to 13.8, a loss of over 44% of your
flexibility.





Causes of Weak or Stiff Ankles as You Get Older


The leading causes of stiff or inflexibility ankles are:


-inadequate exercise

-diabetic
neuropathy (nerve damage, which makes it harder
to feel your ankles)

-rheumatoid
arthritis

-frailty ( older than 65, fatigue, lower muscle strength, low
physical activity, loss of weight)


Exercising with Ankle Weights Helps Prevent Falls




























A 2012 study from the University of Sydney led by Dr. Li
Clemson showed that a 12-month program of exercise with
ankle weights can lower the number of falls among elderly
by an astonishing 31%.

The program included people over age 70 who had
experienced two or more falls in the year prior to the start of
the study.  


The exercise program was designed to improve balance and
strength, including ankle strength. Specifically, the exercises
challenged participants to


“reduce base of support”,

“move to limits of sway”,

“shift weight from foot to foot”,

“step over objects”, and


“turn and change direction”.


The types of exercises included

standing on one leg,

-raising up on your toes,

-knee bends,

-walking sideways,

-tightening muscles and

-performing a test of sitting in a chair and standing as many
times as you can within 30 seconds (the “sit and stand”
test).


Exercises to Improve Ankle Flexibility and Strength


1.  Deep Lunges  

Very few exercises challlenge the large muscles in your legs
as much as a lunge does. But lunges also challenges your
ankles to maintain your posture as you move through the
pose, which is a strength and a balance challenge.


2.
Kneel and Bend Back

Kneel down on your knees and try to sit down on your
ankles. This move stretches the ligaments of your ankles.


3.  
Up on Your Toes

Raising yourself on your toes challenges your calves and
your ankles and strengthens them both.


4.
Swim in Water or Air

Swimming forces your ankles to work dynamically against
the weight of water, which strengthens them.

Can’t get to a pool?  Flutter your ankles in your bathtub or
try dry swimming. Lie on your stomach with small ankle
weights on your ankles. Now, practice swimming strokes as
you flutter your feet as though you are under water.


5.
Walk on Sand, Towel  or Pillow

Walking on sand challenges your ankles to maintain your
balance as the earth shifts beneath you, which again,
strengthens ligaments and muscles. Short of sand? Just fold
a thick towel or a pillow and stand on it. After you master
this move, try standing on one foot on the towel.

Aim for doing this type of balance exercise 5 to 10 minutes a
day.














































































































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Improving the flexibility and strength
of your ankles helps reduce falls by
31%.