Ankles serve as the body's primary shock absorbers and are essential for balance, standing, walking and running, yet most people give them little attention until an injury occurs. These injuries happen frequently, with ankle problems accounting for approximately 5% of visits to accident and emergency departments across the UK. According to BBC News, performance physiotherapist Genevieve Tawiah, who has worked on television productions including Strictly Come Dancing, explains that such injuries can be prevented through targeted strengthening and awareness.
Tawiah emphasises that ankle injuries are avoidable "if you are strong and aware of your foot and ankle and the chain that affects it". A 2021 cohort-study protocol notes that ankle sprains represent a significant portion of emergency-department visits in the UK, with approximately 5,600 injuries occurring daily. The following three strategies can help strengthen ankles and reduce injury risk.
How can you develop better awareness of your ankle movements?
The foundation to building strong ankles and reducing injury risk is developing what Tawiah calls "brain to body awareness" - the ability to sense what movements your ankles are making without looking down at them. This involves sending signals from the brain to the foot and ankle to establish a solid foundation before undertaking more demanding exercise training.
To build this awareness, Tawiah recommends starting with smaller toe movements, as these directly influence how weight is distributed through the ankles. Two practical exercises include pressing the tip of your big toe into the floor while holding it and observing how the arch of your foot engages - a sensation that feels like something pulling through the arch. Another approach involves placing a pen on the floor next to and parallel with your big toe, then attempting to move the big toe towards the pen in a movement called toe abduction.
What strength and balance exercises support ankle stability?
Tawiah explains that the ankle's primary functions are to help maintain balance, support body weight and transmit force through the body during movement. Several exercises can develop these capabilities.
Heel raises involve standing next to a sturdy surface and lifting your heels off the floor to roll onto your toes, ensuring your ankles remain stable without wobbling or turning outward. Balance work can be practised by walking with one foot directly in front of the other, similar to a gymnast moving along a beam, while maintaining precise foot control throughout. Control exercises include moving from a sitting to standing position on one or two legs, as well as ascending or descending stairs with deliberate, controlled movements. Tawiah suggests that if you notice you lead with one leg when climbing stairs, you should practise leading with the other side to develop balanced strength.
For individuals recovering from ankle sprains, Tawiah recommends balancing on one leg while throwing and catching a ball, or practising controlled side steps and landings. These exercises help rebuild stability and proprioception following injury. For those experiencing tendinopathy - chronic pain in the tendon - a slow and heavy load approach is beneficial. Weighted calf raises, such as those performed on a leg press machine, can effectively strengthen the calf and improve tendon resilience.
How should you choose footwear to protect your ankles?
Selecting appropriate shoes plays a crucial role in supporting ankle health. Tawiah cautions against common footwear choices that provide inadequate support, including flat ballet pumps, pointy shoes and trainers that narrow at the front. She recommends imagining whether your toes would have sufficient space if the top of the shoe were removed, or whether your big toe would be forced over the edge.
Barefoot shoes have become increasingly popular and can offer benefits, but Tawiah emphasises that you should establish a good baseline of foot and ankle strength first and gradually introduce them into your routine. She also recommends seeking shoes with "a degree of arch support" as this affects how weight is distributed through your foot during activities.
Different activities require different footwear choices. For squat exercises, a flatter shoe is preferable, as a spongy-soled shoe makes it harder to balance and distribute weight correctly, whereas running requires a trainer that provides more cushioning for impact and shock absorption. For longer all-terrain walks, hiking boots can be useful in reducing the risk of significant sprains. However, wearing them continuously throughout the day can increase ankle stiffness by limiting ankle mobility to some degree.
A related podcast episode featuring Genevieve Tawiah was published on 22 September 2026, discussing ankle health, injury management and ways to protect the joints. The episode is part of the What's Up Docs? series, in which presenters Drs Chris and Xand van Tulleken explore practical approaches to personal health and wellbeing.
