Neuropathy, Foot, and Ankle Mechanics and Their Effect on Balance
Balance issues caused by poor foot and ankle mechanics and peripheral neuropathy can seriously increase fall risk and negatively impact activities of everyday living. These conditions reduce sensory feedback, weaken structural support, delay muscle responses, and alter your gait—making you more prone to falls, especially in challenging environments like uneven surfaces, dimly lit walkways, or on rocky terrain. Fortunately, with the right fitness strategies and resources, you can regain stability and confidence.
Gait is compromised by neuropathy because it reduces your ability to sense where your feet are in relation to the ground, reducing proprioception, coordination, and reaction time. It also can change the way you walk and stand, which changes the way your muscles work in your feet and ankles over time, causing inefficient walking and early fatigue in utilized muscles. Injuries, foot misalignment, and poor gait mechanics can also affect structural stability. Foot-turn out during walking, sitting for long periods, overpronation or supination can weaken some foot, ankle and shin muscles while tightening others. This creates imbalances in the way muscles coordinate to move your ankle and foot joints. These mechanical issues can undermine the muscular support your body needs for balance and may increase fall risk.
Listed below are some exercises and resources to help improve balance with foot and ankle issues, including neuropathy:
Ankle Circles: While sitting or lying down, slowly rotate your ankles in both directions. This boosts mobility and strengthens supporting muscles. Do 1-3 sets of 10-12 reps.
Heel to Toe Raises: Stand with support and lift your heels off the ground, then rock back onto your heels. Repeat 12-25 times to strengthen the back and front of your lower legs. If your neuropathy makes it painful to stand when doing this, do this exercise sitting. This builds both calf and shin strength and improves stability.
Heel Raises Only: Holding onto a chair or wall, rise onto your toes, then lower your heels back down. This builds calf strength and improves stability. If your neuropathy makes it painful to stand when doing this, do this exercise sitting.
Balance Training: Practice standing on one foot, first with support, then unassisted as you gain confidence. Balancing exercises retrain your brain and muscles. At first hold for 10-20 seconds and work into 60 seconds or more.
Foot Rolling: Use a tennis ball, fascia ball, or foam roller under your arch to gently massage the feet, stimulating nerves and improving circulation.
Self-Foot Massage: Take an empty shoe box and fill it with dried beans or dried beans and rice. You can store it in a cool, dry place. Stick one foot at a time in the box, moving your foot in all ways in the box, letting the bean or beans and rice move between your toes and massage your foot. Start at 2-3 minutes and work up to 5 minutes or longer for each foot.
If you’re struggling with any foot or ankle challenges, don’t hesitate to consult a physical therapist, exercise physiologist, or a qualified personal trainer for personalized guidance. Regular exercise, focused on strengthening your feet and ankles, can help restore stability, improve your balance, and prevent falls.
Join Karen for the 8-week online series “Solidly Planted” to get expert guidance on strengthening your core and balance: