You Want To Walk Better After Stroke – Do This

If you want to walk better after your stroke, there is something that you have to understand. Just like concrete is the foundation of a house, the ankle is like the foundation of your body, and they can often be the weakest link, especially for stroke survivors. Today I'm going to explain why this is the case, and I'm going to give you an exercise protocol that you can do at home with minimal equipment to help you walk better after your stroke. But before we jump in, please make sure to support the channel. Like this video, subscribe to the channel, become a channel member by clicking the join button, or leave us a super thanks by clicking in the YouTube bar below. All right, let's get into it. Now, before I show you the exercises, I want to quickly explain why it's so important to focus on the ankle to help you walk better after your stroke. If that's something that you don't care about, go ahead and skip to this timestamp to get right to the exercises. Your ankle has three critical jobs when you're on your feet. And the first is to dorsiflex, AKA clearing your foot so that you can take a step and move forward. Your ankle needs to dorsiflex or lift the toes up to avoid dragging the foot and help you take that step forward. And problems with this ankle dorsiflexion are where we see foot drop issues after a stroke. This is typically a combination of problems, including calf spasticity or high muscle tone and weakness of those ankle dorsiflexors leading to you dragging the foot and the foot dropping. The second critical job is that your ankle is a stabilizer when you're standing or walking. Your ankle is constantly making tiny adjustments, shifting weight, absorbing impact, and keeping you from rolling your foot inward or outward. When your ankle is unstable, everything above it has to compensate. And the third critical job is it provides push-off power when you walk. At the end of each step, the muscles that help to plantar flex the ankle or point the toe down help you to push off so that you can propel yourself forward into your next step. And that push-off is what helps to give you power and speed. So after a stroke, if your ankle is weak or unstable, you can see problems in all of these three areas. And that means that you have trouble walking, standing safely, and that your balance can really make you feel off-kilter. So with that understanding, let me walk you through a six-exercise protocol to help make this better. Of course, always check with your doctor or therapist before starting any new exercise or therapy routine. So first, you need to know how many and how often you should be doing this exercise protocol. I'd recommend doing the protocol around two to three days a week. You can start slower if you need to, but you definitely need to be taking rest days in between each working day to give your muscles a chance to recover. For most of these exercises, you're going to want to aim for two to three sets of eight to 15 repetitions. We're not going for super high reps because our primary focus with this protocol is strengthening. In between each set, you're going to want to take a 90-second to two-minute long rest break, again, to give your muscles a chance to recover before you start into the next set. As far as safety goes, you want to make sure that you either have somebody with you, that you are safe enough to do these in standing on your own, or that you have something sturdy to hang on to, as many of these exercises are going to challenge your balance. And recognize that you might not be able to do all of these exercises. Just start with the ones that you can do and progress over time. Now, the first one I'm going to show you is optional. If you experience calf tightness or spasticity, you are going to want to start with a calf prolonged stretch. So you're going to sit down, maybe on your bed or on the couch, with your affected leg extended. You're going to grab a towel or a bed sheet, and you're going to wrap it around your foot. Pull the ball of your foot back to give your calf a nice stretch. You want to hold this for at least 90 seconds, if not longer, but it shouldn't feel painful. It may be tight and uncomfortable, but stop if you feel significant pain. If you experience spasticity, this prolonged stretch is going to help temporarily reduce that spasticity, so that you're going to get a better effect out of these exercises. Now, the first official exercise in the protocol is the ankle alphabet. And this is to help warm up the ankle to help get the mobility going and work on control. Now, to do this, you're going to be sitting with your affected leg extended slightly, enough to clear your foot from the floor, or have it hanging off of a surface, like hanging off of a bed or a couch. You want to use your ankle to write each letter of the alphabet with your toes. You want to move through as much range of motion as you can, and you want to keep your movements controlled. Do not rush through these. Now, you don't need to do 8 to 15 repetitions of the alphabet, but I would say for each of your 2 to 3 sets to try to go through the entire alphabet. The second exercise is seated ankle dorsiflexion. So, this is where you're going to be sitting with your feet flat on the ground. You want to try to lift your toes up off of the ground so that they're pointing up towards the ceiling. Now, this may be very difficult, and if that is too hard, you can sit with your leg crossed over your other knee and try to do it that way. However, if you do have some movement and you want to make it a little bit more challenging, place a cuff weight that's been flattened out or a bag of rice or beans over the top of your foot to add some resistance and really amp up the strengthening. And you want to make sure that you're doing a slow return to your starting position, and again, not rushing through the exercise. The third exercise is either seated or standing calf raises. This just depends on where you're at in your recovery and what you're able to tolerate and do safely. So, for a seated calf raise, you're going to be sitting in a chair with your feet flat on the floor. You want to raise your heel up and contract your calf muscles as you do it. You're going to hold for a couple seconds at the top and then slowly lower to your starting position. And you can progress this by adding some type of resistance across the top of your thigh to add more resistance as you lift up your heel. Now, if you're able to do this safely in standing, make sure that you're holding onto something sturdy and come up on your toes, raising both of your heels up off of the ground. Hold for a couple seconds at the top and then slowly lower yourself back down. To progress this, you can take away some of your support. So, maybe you're just using your fingertips on a counter for support or taking that support away altogether. You could even try wearing a weighted vest to add more resistance and amp up your strengthening. The next exercise is standing weight shifts, and this is to work on ankle stabilization and postural control. So, for this one, you're going to be standing up and holding onto a sturdy surface for support. My recommendation would be to practice half of your repetitions in a side-to-side weight shift and then practice the other half of your repetitions in a forward-to-back weight shift. You want to make sure that you move slowly and with control. And if you want to amp up your progress, you can try closing your eyes while you do these weight shifts, or again, add resistance where you can. Wear a weighted vest or even hold dumbbells in your hands if you're able to do it. The next exercise is a single leg stand. Now, like I talked about, these get progressively more difficult. So, if you're not able to do this one, that's okay. Start with the exercises that you are capable of doing right now. This exercise is great to challenge your balance, improve your ankle stabilization, and also help to improve your proprioception or retraining your body to understand where it is in space. So, you're going to stand up, holding your sturdy surface, come up on one leg, and try to hold for 5 seconds, 10 seconds, up to 30 seconds before lowering back down. And then you're going to come up on the other leg. This is really important. You want to try to do this with both of your legs, not just the affected side, because you're giving each ankle the chance to work on stabilizing and giving the body a chance to relearn balance with each leg up. You can progress this by closing your eyes, again, wearing a weighted vest, or just using your fingertips for support. And our last exercise in the protocol is a heel-to-toe stand. This, again, is going to work on balance and ankle stability and control. So, for this exercise, you're going to place one foot directly in front of the other so that your heel and your toes are touching. You want to try to stand in that position for 5, 10, 15 plus seconds before switching and doing the other foot in front. With this one, you are likely going to feel those ankles really shaking and shimmying around on you, but that is all part of retraining your ankle stabilizers. Start out by holding onto your sturdy supportive surface. To progress it, you can go to fingertip assistance for support or taking away your fingers altogether. Remember that recovery timelines vary dramatically from person to person. Some people are going to see changes much more quickly while others will see them come much more slowly. But consistency and continual challenge, they are what are going to help you see progress faster. Leave me a comment and let me know what has been helpful for you to walk better after your stroke. And of course, a huge thank you to all of our donors on PayPal and our monthly Patreon members, with a special thank you to Joseph M. and Modus Nova in our Empower tier. Thank you all so much for watching. I'll see you next time.