Ankle Strengthening Exercises for Seniors: The Fall Prevention Move Most People Skip

Always talk with your healthcare professional before starting a new exercise program. This is especially important if you have diabetes, peripheral neuropathy, a history of ankle injury, recent surgery, or any condition affecting your balance or circulation.

Ankle strengthening exercises for seniors are the most overlooked pillar of fall prevention — and the research shows they can make a significant difference. According to the CDC, one in four adults over 65 falls each year — and that figure hasn’t shifted much despite decades of public health messaging. Most fall prevention programs focus on hip and core exercises. Both matter. However, there is a third link in the chain that almost everyone overlooks: the ankles.

Your ankles are the body’s first responders when balance is challenged. When you stumble on an uneven curb or catch a rug with your toe, it’s your ankles that react first — within milliseconds — to prevent that stumble from becoming a full fall. When ankle strength and proprioception (your body’s sense of where your foot is in space) decline with age, that recovery reflex slows. As a result, a stumble that a younger person absorbs easily becomes a fall for an older adult.

M.T. Groom, MSc MCSP, has found in clinical practice that ankle work is frequently the missing piece in a senior’s exercise routine. Most people have never been told to train their ankles specifically — and most exercise programs for older adults don’t include it. This article explains why ankles matter more than most people realize, and provides a 6-exercise ankle program that takes 15 minutes, requires no gym, and targets exactly the right muscles and nerve pathways.

See also: Fall Prevention Exercises for Seniors — our complete guide to reducing fall risk through targeted movement.

Why Ankle Strengthening Exercises for Seniors Matter So Much for Fall Prevention

The ankle is where balance begins. When you stand, walk, or step onto an uneven surface, your ankle muscles and sensory receptors are the first to detect a shift in your center of gravity — and the first to respond. That response happens before your hips, core, or vision even register that anything has changed.

Two components are involved in this process. First, ankle strength — particularly plantarflexion, the movement of pushing your foot downward like pressing a car pedal. This is the calf muscle action that propels every step and provides the push-off force needed for stable walking. Second, ankle proprioception — the nerve signals from receptors in your ankle joints, muscles, and tendons that tell your brain exactly where your foot is positioned, in real time.

A 2025 study published in Annals of Medicine identified ankle proprioception impairment as an “important and independent risk factor for falls” in older adults — on par with knee vibration sense and tactile sensitivity. In other words, it’s not just about muscle strength. Your ankle’s ability to sense and report position to your brain matters just as much.

Furthermore, research from a multidisciplinary fall risk review in MDPI Healthcare (November 2024), which analyzed 155 studies, found that ankle mobility exercises are “critical for maintaining balance and adapting gait to various surfaces.” Surfaces like grass, gravel, tile, and uneven pavement all require constant, real-time ankle adjustment. When that adjustment capacity declines, the risk of a trip or stumble increases accordingly.

What happens to ankles specifically with age? Three changes occur simultaneously. Dorsiflexion range decreases — meaning the ankle becomes less able to bend the foot upward, which is the motion required for clearing the ground during each step (a key mechanism behind tripping). Plantarflexion strength declines — the calf push-off weakens, slowing gait and reducing balance recovery speed. And proprioceptive nerve sensitivity reduces — the ankle’s ability to report accurate position information to the brain becomes less reliable.

So why is ankle work so frequently skipped? Hip and core exercises dominate fall prevention programs because they are easier to teach and feel more intuitive. Ankle-specific work — particularly exercises that challenge balance — requires a higher level of skill and attention to be done safely. Consequently, it gets left out. However, that’s precisely why it’s so important to include it deliberately.

To be clear: strong ankles are not primarily about athletic performance. You need them to walk safely, recover from a stumble, and navigate the uneven ground of everyday life — curbs, ramps, wet floors, garden paths.

What the Research Shows

The evidence for ankle-specific exercise in older adults is growing and consistent.

A January 2025 meta-analysis (PMID 39657220), a systematic review of randomized controlled trials, found that ankle and foot exercises improve ankle plantarflexion strength, ankle flexibility, and balance performance in older adults. Importantly, improvements were clearest in eyes-open balance — which is the most clinically relevant condition, since most real-world falls happen during normal daytime activity when vision is fully available.

Meanwhile, a landmark Cochrane review (2019, high-certainty evidence) confirmed that exercise reduces both the fall rate and the number of people experiencing falls in older adults. The Cochrane review also found that balance-challenging programs — those that specifically require coordination and stability work — produce larger effects than simple strengthening alone. That finding directly supports the inclusion of the proprioceptive exercises in the program below.

Additionally, the CDC’s most recent fall data (updated January 2026) identifies lower body weakness as one of the top modifiable fall risk factors. The ankle muscles are part of that lower body chain — and they are modifiable at any age.

As with all exercise claims for this population: these exercises are associated with improved balance and may reduce fall risk. The research suggests meaningful benefit. It does not guarantee that every individual will experience the same outcome — and these exercises do not replace medical advice or a full fall risk assessment from a healthcare professional.

The 6-Exercise Ankle Strengthening Program for Seniors — A Physical Therapist’s Approach

All 6 exercises below require no gym and no equipment — though a light resistance band is useful for Exercise 4, and is the only item that helps here. A sturdy chair or kitchen counter should be within arm’s reach for all standing exercises. Do this program 3–4 times per week.

1. Ankle Circles (Range of Motion — Do This First)

First, this is your warm-up exercise. It restores ankle mobility and prepares the joint for the strengthening work that follows. Age-related reduction in ankle dorsiflexion — the ability to flex the foot upward — is one of the key contributors to tripping, and regular ankle circles help maintain that range.

How to do it:

1. Sit in a sturdy chair, one foot raised slightly off the floor
2. Rotate the ankle in large, slow, controlled circles — 10 clockwise, then 10 counterclockwise
3. Switch feet and repeat

Suggested target: 2 sets each direction, each foot. Do this before every session.

Note: This exercise can be done anywhere — at a desk, watching television, or waiting for a kettle to boil. It requires no floor space and no equipment.

2. Calf Raises (Plantarflexion Strength)

Next, calf raises strengthen the gastrocnemius and soleus — the calf muscles responsible for the push-off phase of every step you take. Declining plantarflexion strength is directly linked to slower gait speed and reduced balance recovery. This is one of the most important exercises in fall prevention, and one of the most consistently underused.

How to do it:

1. Stand with feet hip-width apart, both hands resting lightly on a chair back or counter for support
2. Slowly rise onto your tiptoes, lifting both heels as high as comfortable
3. Hold for 2 seconds at the top
4. Lower slowly over 3 full seconds — do not drop
5. 12–15 repetitions, 2 sets

M.T. Groom’s note: The 3-second lowering phase is where the real strength work happens. Slow is essential. A quick up-and-down motion is far less effective than a controlled, deliberate descent.

Progression: Work toward single-leg calf raises — one of the most important progressions for fall prevention. Once double-leg raises feel easy, attempt the last 2–3 repetitions of each set on one foot at a time.

For more on the role of calf strength in balance, see our guide to balance exercises for seniors over 70, which includes calf raises as part of its core program.

3. Heel-Toe Walking (Dynamic Balance + Proprioception)

In addition to ankle strength, dynamic balance — balance during movement — is arguably more important for fall prevention than static balance. Most falls happen while walking, turning, or stepping, not while standing still. Heel-toe walking challenges proprioception and dynamic balance simultaneously, making it one of the most functional fall prevention exercises available.

How to do it:

1. Stand near a wall or counter with feet together
2. Walk forward in a straight line, placing each heel directly in front of the toes of the other foot — as if walking a tightrope
3. Take 10–15 steps forward, then carefully turn and walk back
4. 2–3 passes per session, eyes forward throughout

Safety note: Stay within arm’s reach of the wall. Slower is better. The goal is controlled, deliberate placement — not speed.

Progression: Once comfortable on a hard floor, try the exercise on a slightly softer surface such as a folded towel. The less predictable surface further challenges the proprioceptive system.

4. Resistance Band Eversion (Outer Ankle Strength)

Furthermore, weakness in the peroneal muscles — the muscles running along the outer ankle — is one of the primary causes of the “giving way” sensation that many seniors describe when walking on uneven ground. These muscles are almost never trained in standard exercise programs, which is precisely why they deserve specific attention here.

How to do it:

1. Sit in a chair, a light resistance band looped around the ball of one foot
2. Anchor the other end of the band with your opposite hand or under a chair leg
3. Turn your foot outward (away from the other foot) against the band’s resistance
4. Slowly return to the starting position over 2–3 seconds
5. 12 repetitions each side, 2 sets

Equipment note: A light resistance band (typically around $8–12) is the one item in this program that benefits from minimal equipment. For recommendations, see our guide to resistance bands for seniors.

5. Towel Scrunch (Intrinsic Foot Strength)

Meanwhile, the small intrinsic muscles of the foot — those that control the arch and the individual toe movements — are almost universally neglected in exercise programs for older adults. However, their role in proprioceptive feedback and push-off stability is significant. Decline in these muscles is associated with poor balance performance and flattening of the foot arch over time.

How to do it:

1. Sit in a chair with both feet flat on the floor, bare foot resting on a small towel on a smooth surface
2. Using only your toes, scrunch the towel toward you by curling your toes inward
3. Release, then scrunch again
4. 3 sets of 10 scrunch-and-release movements per foot

Note: This exercise requires no balance challenge and no floor space beyond a chair. As a result, it’s ideal for doing at a desk, watching television, or whenever seated for an extended period.

6. Single-Leg Stand (Proprioceptive Challenge)

Finally, this exercise is the most comprehensive proprioceptive challenge in the program — and the most important. Standing on one leg engages all the ankle stabilizer muscles simultaneously, while placing maximum demand on the sensory receptors that report balance information to the brain. Research consistently identifies single-leg standing ability as a meaningful indicator of fall risk in older adults.

How to do it:

1. Stand near a counter or wall with feet hip-width apart
2. Lift one foot just off the floor — an inch is sufficient
3. Hold for 10–30 seconds, then lower and switch sides
4. 3 repetitions each foot

Safety first: Begin with both hands available for support. Progress to fingertip contact only as confidence builds. Never fully remove the safety net of a nearby surface until balance is very well established.

Progression: Close your eyes for a significantly greater proprioceptive challenge — but only when standing within easy touching distance of a wall. Eyes-closed balance is considerably more demanding and should only be attempted once eyes-open balance is stable for 20+ seconds per side.

M.T. Groom’s note: If you can stand on one leg for 10 seconds without holding on, your fall risk is already meaningfully lower than average for your age group. That’s a useful benchmark — and a genuinely achievable one.

Your 15-Minute Weekly Ankle Program

The following sequence is designed to be done in order — starting with mobility, building through strength, and finishing with the highest balance challenge.

Session sequence:

1. Ankle Circles (warm-up) — 2 sets each direction, both feet
2. Calf Raises — 2 sets of 12–15 reps
3. Resistance Band Eversion — 2 sets of 12 reps each side
4. Towel Scrunch — 3 sets of 10 each foot
5. Heel-Toe Walking — 2–3 passes
6. Single-Leg Stand — 3 reps each side, 10–30 seconds

Time per session: Approximately 15 minutes.

Frequency: 3–4 times per week. These ankle exercises can be done on the same days as other exercise or separately — they complement rather than overlap with hip and core work.

Ankle strength is one part of a wider fall-prevention plan. For a fuller home programme that combines strength, balance and mobility, see the Senior Fitness Lab exercise books.

Progression schedule:

• Weeks 1–2: Both feet for all standing exercises; use full hand support on chair or counter. Focus on technique and deliberate movement speed.
• Weeks 3–4: Reduce chair support to fingertip contact. Attempt single-leg calf raises for the final 2–3 reps of each set.
• Month 2 onward: Progress toward full single-leg calf raise sets. Introduce eyes-closed single-leg stand (near a wall). Try heel-toe walking on a folded towel.

These ankle exercises pair naturally with balance exercises for seniors — together, they cover the lower body control most relevant to fall prevention. Adding 15 minutes of ankle work to any existing routine provides genuine additional benefit without significantly increasing session length.

When to See a Physical Therapist About Your Ankles

These exercises are a safe, evidence-based starting point for most older adults. However, some ankle problems require professional assessment before beginning a strengthening program.

Consider seeing a physical therapist if you have:

• Persistent ankle pain that hasn’t improved in 3–4 weeks
• A history of multiple ankle sprains, or a chronic “giving way” sensation
• Visible swelling around the ankle joint
• Significant difficulty with balance that limits daily activity

Red flags requiring prompt medical attention:

• Numbness or tingling in the foot or lower leg
• Pain during calf raises, especially if it’s sharp or stabbing
• Significant swelling following a minor stumble or twist

An important note for people with diabetes: Peripheral neuropathy — nerve damage that affects sensation in the feet — is a common complication of diabetes and significantly affects proprioception. If you have diabetes and experience any numbness, tingling, or reduced sensation in your feet, consult your doctor before beginning balance-challenging exercises such as the Single-Leg Stand. A modified program may be more appropriate, and a physical therapist or podiatrist can advise on the safest starting point.

A physical therapist can also assess which specific aspects of ankle function are most affected — strength, range of motion, or proprioception — and prescribe a tailored program accordingly. For guidance on what that assessment involves, see our article on balance exercises for seniors, which covers the broader context of balance assessment and training.

Ankle Strengthening Exercises for Seniors: The One Thing Most People Are Missing

Ankle strength is the overlooked pillar of fall prevention. Most seniors focus on hip and core exercises — which absolutely matter — but the ankle is where a stumble is either caught or becomes a fall. By the time your hips and core respond to an unexpected shift in balance, your ankles have already either stabilized the situation or failed to.

The 6-exercise program in this article takes 15 minutes, requires no gym, and targets exactly the muscles and nerve pathways most affected by aging. Start with calf raises and ankle circles this week. Add the single-leg stand within a fortnight. Build toward the progression benchmarks over the following month.

For a broader view of evidence-based fall prevention, including hip, core, and balance training, see our complete guide to fall prevention exercises for seniors. Ankle work is one piece of the puzzle — and now it’s a piece you have.

Also see our balance exercises for over 70 guide, our Senior Fitness Lab exercise books for complete structured programs, and our fitness myths for seniors guide — including the common misconception that ankle training is only for athletes.

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