Bulletproofing Your Lower Body Part 2

If you watch SportsCenter, you’ll probably agree that the worst part of the broadcast comes when the highlights show one player stepping on another’s foot and rolling their ankle. This is particularly jarring if you’ve had your own injury issues in the past, as you’ll probably get that horrible feeling that you know all too well as you watch the injured athlete limp off the court or field. 

You’re far from alone. According to a 10-year study of NCAA basketball published in the Orthopaedic Journal of Sports Medicine, “An ankle ligament sprain is the most common injury in high school and collegiate athletics, accounting for 22.6% of all injuries.” The authors went on to state that this is the most prevalent injury among male and female basketball players¹. Participants in certain other sports are even more susceptible to ankle-foot complex issues. A review of 11 studies published in the Journal of Sports Science & Medicine found that 26 percent of running injuries occurred in this area².  

So what is it about this area of the body that makes it particularly vulnerable? The NCAA study identified frequent changes in direction, contact with other players (particularly when coming down from a rebound), and frequent jumping and landing as the chief culprits in basketball. The forces involved in such movements subject players to high and acute loads on their lower legs and feet, whereas in a sport like running, the loads are lower but more persistent as the activity typically lasts for longer and there are more foot strikes involved. 

In both cases, you should be able to avoid or at least significantly reduce your chances of injury if the support structures in your ankles, feet, and calves are strong and resilient enough. But if the force applied exceeds your ability to tolerate it, you could sustain an injury like a ligament sprain or muscle strain or develop a chronic condition like plantar fasciitis or Achilles tendonitis. Of course, contact-related issues are sometimes unavoidable, but we can at least prepare your body to better handle them. Let’s zoom in on this part of your lower body and explore some strategies to improve its durability. 

Building Higher Tolerance in the Lower Leg

Regardless of what sport you play and which daily activities you choose, your legs and feet will bear the brunt of the forces you put into the ground and those that come back from the environment you’re moving through. When I first started considering the lower body zones that athletes need to strengthen and safeguard, I recognized that we have to work from the floor up, which means starting with your feet, ankles, and calves. This zone includes the plantar fascia, foot bones (there are 26 in each foot), Achilles tendon, tibia and fibula, ligaments and tendons that insert at the ankle, and muscles like the gastrocnemius and soleus. 

Depending on the type of athlete you are, you need to prepare your body by loading all these structures in different ways. If you play a power sport like basketball, football, or rugby, we’ve got to get you ready for the jumping and landing, cutting, and sprinting that you’ll be doing on the court or field. Or if you’re a runner, we have to take into account the cumulative impact of thousands of foot strikes over a longer duration using a more linear motor pattern. 

If you’re in that first category, you’re going to need to generate large amounts of power explosively and then resist the counteracting force that your lower legs are subjected to when you decelerate, land, and change direction. So we’re going to include quite a lot of plyometrics to stimulate the demands of practices and games on your lower legs. You’ll also be doing a low number of reps with a higher load. 

Whereas if you’re more of an endurance athlete, you will benefit from some plyometrics but won’t need to do as much in this area because the requirements of your sport involve lower power production. Yet as you’ll need to sustain this for longer, you should be doing a higher number of repetitions in each set (sometimes up to 40-50) and in total. Your loads might be a bit lighter, but you will still benefit from resistance training with moderate weight. 

Knees Bent vs. Knees Straight

Taking our thought progression a little further, we also need to consider what position your legs are in when they apply and resist force during your sport. In basketball, if you’re going up to try and grab a rebound, you probably bend your legs a little before leaping upward. Alternatively, if you’re coming over from the weak side to try and block a shot, you likely get into a deeper squat and swing your arms more. So we need to get your lower leg tissues used to maintaining stability in both bent and almost straightened knee positions. If you’re a runner, your knees bend a little but not much (though this might vary a bit depending on your gait and when you're running faster over shorter distances, you’ll probably bend your knees more). So we should focus our efforts on exercises that mimic this pattern and the increased load on your gastrocnemius and soleus. 

If you’re in that power athlete category, you should regularly include eccentric loading in your program to get your body ready for game time. Given your need to jump and land multiple times, alter direction, and toggle between running fast and slow (acceleration and deceleration), you’d do well to combine this eccentric loading with concentric work.

For example, if you’re a basketball player, I might have you do a seated kettlebell raise (where the weight is resting on your knee) in an explosive way that’s like jumping rope while sitting. We call it the pogo. But if you’re a runner, I’d ask you to perform the same exercise more slowly without the bouncing action, and you’d do more reps – maybe as many as 30 or 40 per set – while taking three seconds to lower your active leg at the end of each one. Both exercises are targeting the soleus in a knees-bent position, but we’re taking into account the specific demands of your sport in how we dose and deliver the load. 

DB Seated Heel Raise w/ Cont. Bounce

DB Seated Heel Raise w/ 3s Iso

Taming the Achilles Tendon 

The Achilles tendon is one of the lower leg structures that gets the most attention because if you suffer a partial or complete rupture, you’re looking at nine to 12 months on the sidelines. It is also susceptible to overuse, which manifests itself as painful tendonitis or tendinopathy. Doing isolated resistance exercises a couple of times a week also makes this key connective tissue more durable.

Rather than babying it, we’ve found that the Achilles – and tendons in general – responds well to high-load exercises. A study published in the American Journal of Sports Medicine found that participants who suffered from Achilles tendinopathy saw greater improvements after training with heavy loads for 12 weeks³. 

It’s also beneficial to blend eccentric and concentric loading. For several years, S+C coaches and PTs focused on isometric work, but with the benefit of more practical experience and research-driven insights, this is no longer the gold standard. With this in mind, you don’t need to be doing a lot of long holds to strengthen your Achilles. Rather, as your load tolerance increases, you’ll be able to progress through slower loaded exercises and into the greater forces created by plyometrics. 

Taking a 360-Degree View

The Achilles is an example of one of the structures that runs up the back (or posterior) side of your lower legs. This is also where the gastrocnemius and soleus reside. While it’s this seam that gets the most attention, we also need to consider the tissues that act as guidewires around your whole lower leg. For example, the posterior tibialis that runs down the inside of the lower leg. We can hit this with a heel raise variation in which you squeeze a tennis ball between your heels as you rise up. 

Reducing your risk of an ankle sprain and other lower leg injuries also necessitates conditioning the tissues on the sides of your calves. A great way to emphasize the peroneal muscles (outside of leg) as well as the tibialis anterior muscle along the outside of the shin is to duck your feet out, put your weight on your heels, and walk like a penguin. Another way to use a wraparound approach is to move a weight around your body while you’re standing on one leg. This way, you’re not just working on “balance” per se (which typically just makes you better at the balancing exercise itself) but also enhancing your proprioception – in other words, where your body is in three-dimensional space.

Stationary Penguin

DB 1-Leg ATW Tap

Athletes often don’t realize this, but they frequently get stuck on one leg in their sport while having to resist force from contact (think about a football player catching a long pass or a runner adjusting to avoid tripping on a curb when they step awkwardly).  If we can hit the front, back, and sides of your lower legs, you’ll be able to move powerfully and safely in all planes of motion with greater confidence.  

Check back soon for part 3, in which we’ll show you how to improve the durability of your hamstrings and adductors. 

Miss part 1? Click HERE to catch up.

1. Sailesh V. Tummala et al, “10-Year Epidemiology of Ankle Injuries in Men’s and Women’s Collegiate Basketball,” Orthopaedic Journal of Sports Medicine, November 5, 2018, available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240983/. 
2. Peter Francis et al, “The Proportion of Lower Limb Running Injuries by Gender, Anatomical Location and Specific Pathology: A Systematic Review,” Journal of Sports Science & Medicine, March 2019, available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370968/. 
3. Rikke Beyer et al, “Heavy Slow Resistance Versus Eccentric Training as Treatment for Achilles Tendinopathy: A Randomized Controlled Trial,” American Journal of Sports Medicine, July 2015, available online at https://pubmed.ncbi.nlm.nih.gov/26018970/.

⠀
Have you been held back by nagging injuries or struggled to reach your workout goals? Let's talk.

Schedule a free call below to learn about training with me online or in-person:

Was this helpful? Share this with a friend who could benefit!