Asanaverse

Chronic Ankle Instability

6 Week Yoga Program for an Ankle That Keeps Giving Way

It went over once, years ago, and then it went over again. Now you pick your way across wet cobbles, you notice every kerb, and on uneven ground you are watching your feet instead of where you are going. Nothing hurts most days. It just cannot be relied on.

Our yoga teachers built this six week program on the balance and neuromuscular training protocols that beat conventional physiotherapy in a head to head trial. Six weeks to get the ankle reporting properly again, build the whole leg that holds it up, and stop watching the ground.

Three sessions a week, six weeks, five sequences. That is not a round number picked for the look of it. Three of the four trials behind this program ran exactly six weeks at three sessions a week, and the sessions were twenty to thirty minutes rather than an hour.

Length

6 weeks

Practices

18 in total

Rhythm

Three sessions a week

Made for

Adults whose ankle has gone over more than once and still feels unreliable

What the research says

This program is built on four randomised trials of chronic ankle instability, and the shape of it comes straight from what they did. A trial of 40 amateur athletes compared breathing-centred stabilisation training, balance training and conventional physiotherapy over six weeks. Both of the specialised approaches beat conventional physiotherapy on every outcome measured, with large effect sizes, and no serious harms were reported in any group.

The dose is just as consistent. A trial of 39 people ran balance and strength protocols for twenty minutes, three times a week, for six weeks: both improved strength, balance and functional performance, and the control group improved in nothing. A balance programme with 70 athletes ran the same six weeks and improved dynamic balance in every direction measured along with the athletes own sense of how stable the ankle was.

One more study explains why this is a yoga program and not a set of exercises. A trial of walking meditation put deliberate, attentive movement up against a resistance band programme, and the walking meditation group was the one that improved ankle proprioception, the sense of where the joint is without looking at it. That is the deficit at the centre of this problem, and paying attention turns out to be part of the treatment.

See every study and guideline behind this program →

How the program works

3 phases, and you stay with the same practices for the whole of each one. That repetition is the plan rather than a shortage of ideas. A body changes when the same ask comes back often enough, and the trials this program follows repeated for weeks before they made anything harder.

Weeks 1 to 2MoveGet the ankle through its whole range and the foot reporting back again.Weeks 3 to 4BuildBuild the leg that holds the ankle up, from the calf to the hip.Weeks 5 to 6IntegrateStay stable while something moves, which is when an ankle actually gives way.

Each phase runs two weeks with one longer session and one short one, and you stay with them for the whole phase. Open a session below to see every pose, its timing and the reason it sits where it does. Bare feet and a folded blanket cover everything you need.

Who this is for

  • ·Your ankle has gone over more than once and still feels unreliable on uneven ground.
  • ·It is a chronic thing rather than a fresh injury. Nothing is swollen and nothing is acute.
  • ·You can stand and walk on it without pain.
  • ·You have started watching where you put your feet.
  • ·You can find twenty-five minutes three times a week.

Before you start

This is a program for an ankle that is chronically unreliable, not for one that is currently injured. Practise every balance position within reach of a wall and take the support away when you stop needing it rather than before. The practice guide has the rest of how to set the dose.

Read the full safety notes in the practice guide →

The practice

Two practices per phase. Open one to see every pose, its timing and the reason it sits where it does.

Move · Weeks 1 to 2

Wake the Foot Up

Get the ankle through its whole range and the foot reporting back again.

Two weeks of range and sensation, mostly on the floor and in still standing. Spreading your toes without help, feeling the three points of contact under each foot, taking the ankle to both ends of its range. It looks like very little is happening. It is the part that everything else is built on, because an ankle that cannot feel the ground cannot react to it.

  1. 1.Easy Pose2 min
  2. 2.Staff Pose2 min
  3. 3.Butterfly Pose2 min
  4. 4.Thunderbolt Pose1 min
  5. 5.Hero Pose1 min
  6. 6.Child's Pose1 min
  7. 7.Mountain Pose3 min
  8. 8.Standing Forward Bend1 min
  9. 9.Half Standing Forward Bend30 sec
  10. 10.Garland Pose1 min
  11. 11.High Lunge45 sec each side
  12. 12.Chair Pose30 sec, twice
  13. 13.Tree Pose30 sec each side
  14. 14.Mountain Pose1 min
  15. 15.Corpse Pose2 min
Open the full sequence →

Week by week

Week 1Find out what the foot can still doTry spreading your toes without using your hands. Most people cannot, and that is the deficit the research means when it talks about foot control. It changes faster than you would expect.
Week 2Same sessions, longer standingAdd a minute to the standing weight shifting and keep everything else the same. Then try thirty seconds of it with your eyes closed, on two feet.
← Back to the chronic ankle instability practice guide

Build · Weeks 3 to 4

Stand and Load

Build the leg that holds the ankle up, from the calf to the hip.

The session stands up and stays there. An unstable ankle is never only an ankle: it sits at the bottom of a chain that runs through the calf, the knee and the hip, and a chain gives way at whichever link nobody trained. In the trials, the programmes that worked loaded that whole chain rather than treating the joint on its own.

Week by week

Week 3Learn the standing shapes before you hold them longHold each standing pose for thirty seconds rather than a minute and spend what you save on where your weight sits on the foot. Expect the calves to be sore the next day. That settles.
Week 4Full holds, and take the wall away in TreeFull length holds, three sets of Chair. Then try Tree without the wall at the end of the session, when the leg is already tired. If it is not there yet, keep the wall and try again next week.
← Back to the chronic ankle instability practice guide

Integrate · Weeks 5 to 6

Balance in Motion

Stay stable while something moves, which is when an ankle actually gives way.

An ankle rarely rolls while you are standing still. It rolls while you are turning, stepping down or reaching for something. That is why the balance tests in this research measure how far you can reach in different directions on one leg rather than how long you can hold a pose. These two weeks live there: every single leg position asks for something else to happen at the same time.

Week by week

Week 5Close your eyesTake the vision away, first on two feet and then for ten seconds on one. Sight is the sense you have been leaning on, and removing it is what forces the ankle to report for itself.
Week 6Move while you balance, then pick what staysTurn the head, lift the arms, look away from your fixed point. Then compare a kerb, a wet step and uneven ground against week one, and keep the fifteen minute session once or twice a week.
← Back to the chronic ankle instability practice guide

The 25 poses in this program

Every pose has its own page with alignment, common mistakes and the energetic effect. Look one up when a shape does not make sense in your body.

Easy PoseStaff PoseButterfly PoseThunderbolt PoseHero PoseChild's PoseMountain PoseStanding Forward BendHalf Standing Forward BendGarland PoseHigh LungeChair PoseTree PoseCorpse PoseWarrior IITriangle PoseExtended Side Angle PosePyramid PoseWarrior IWarrior IIIKnees to Chest PoseEagle PoseOne-Legged Chair PoseHalf Moon PoseTree Pose B
Go to the Asana Lab →

The guide behind this program

Why these poses and not others

The Chronic Ankle Instability practice guide explains what each pose does and why it belongs to this goal. It also carries the safety notes and every study this program is built on. Read it if you want the reasoning rather than the plan.

Read the guide →

Frequently Asked Questions

Why six weeks and not twelve?

Because six is the length three of the four trials settled on, and the fourth ran shorter still. It divides evenly into the three phases: two weeks waking the foot up, two building the leg, two staying steady while something moves. Twelve would look more serious and would rest on nothing.

What if I just hold Tree Pose for six weeks?

Then you get good at Tree Pose. The programmes that worked did not repeat one position, they raised the difficulty every fortnight, and that is what the three phases here are. The same pose with your eyes closed at the end of a tired leg is a different exercise, and the plan is built to get you there rather than to start there.

What if I miss a week?

Pick up where you left off. A phase is only two weeks long, so a missed week costs you half of one and nothing more. If you have been away longer than a month, run phase one again before you go back to the balance work.

Do I have to do all three sessions every week?

Three is the dose the trials used, and it is the part worth defending when a week gets tight. This problem responds to how often the ankle gets asked rather than to how long a session runs. Two will hold the plan. One will not.

What comes after week six?

The fifteen minute standing session, once or twice a week. This kind of instability is a pattern that runs over years with the same ankle rolling again and again, rather than a problem that gets fixed once, so it is worth keeping something small in the diary.

Creator of this program

Manish Rana

Manish Rana

Founder of Asanaverse.de. Manish writes about yoga, Ayurveda and meditation, and owes his deep connection to yoga to his Indian roots. With over 1,000 hours of Yoga Alliance Teacher Training, he shares his knowledge with the community.

More about Manish →
Registered Experienced Yoga Teacher, E-RYT 500

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Every program here was built around one complaint and around the trials that studied it. Back, neck, knees, hips, sleep and stress, each one running for as long as the research says it takes.

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