Ankle Alphabet

In the ankle alphabet, you trace the letters A to Z in the air with your big toe. It moves the ankle in every direction in a gentle, controlled way, without putting weight on it. Physiotherapists use it after ankle sprains, after a plaster comes off and for stiff ankles in older adults.

Written by Dr. V. B. Rajendra Prasad, MPT, licensed in the US and UK.

1. Sit back in a chair and lift one foot a little off the floor
2. Trace the letters A to Z in the air with your big toe

How to do it

  1. 1

    Sit back in a chair, or lie on a bed with a rolled towel under the calf so the heel is clear of the bed.

  2. 2

    Lift one foot a little off the floor.

  3. 3

    Using your big toe as a pen, slowly write the capital letters A to Z in the air.

  4. 4

    Move only at the ankle. Keep the knee and thigh still.

  5. 5

    Rest, then repeat with the other foot if needed.

How many

Once through the alphabet with each foot, 2 to 3 times a day. In the first days after a sprain, keep the letters small.

Common mistakes

Moving the whole leg instead of the ankle. Keep the thigh still, with a hand resting on it if needed.

Making the letters too big too soon. Stay within a comfortable range.

Rushing. Slow letters build more control.

Make it easier

Make the letters smaller, or do half the alphabet. Ankle pumps, moving the foot up and down, are simpler still.

Make it harder

Make the letters bigger and add small letters as well. Then move on to standing exercises such as heel raises and single leg balance.

Who it helps

Recovery after an ankle sprain
Stiff ankle after a fracture or plaster
Ankle stiffness in older adults
Keeping the ankle moving after knee or hip surgery
Long periods of sitting or bed rest

When to stop and check

After a fracture, start only when your doctor says the ankle may be moved. After an ankle sprain, if you cannot take a few steps or the bone itself is tender, get an X-ray first. A calf that becomes painful, swollen, red or warm needs urgent medical attention.

Not sure these are the right exercises for you? A physiotherapist can assess you on a video call and build a programme around your problem, guiding each exercise and correcting your form in live sessions.

Get a personal programme

Frequently asked questions

How soon after an ankle sprain can I do the ankle alphabet?
Gentle movement in a comfortable range usually starts within the first few days, once the worst pain and swelling settle. If you cannot put weight on the foot or the bone is tender, get it checked first.
Does the ankle alphabet help a stiff ankle after plaster?
It is a common first exercise, because it moves the ankle in all directions. It is usually combined with calf stretches, heel raises and balance work as the ankle improves.

Related

Online physiotherapy: Fracture RehabilitationOnline physiotherapy: Post-Surgery RehabilitationFracture Recovery: What Happens Before and After the Plaster Comes OffShoulder and Knee Pain from Badminton: Why India's Favourite Racquet Sport Causes So Many InjuriesIs online physiotherapy right for me?

More ankle, calf and balance exercises

Ankle PumpsCalf StretchHeel RaisesSingle Leg BalanceAll exercises
Dr. Rajendra

Written by Dr. V. B. Rajendra Prasad, MPT. Licensed to practice in the US (NY state) and UK (HCPC).
20 years of clinical experience. About Dr. Rajendra