Most of us never think about our ankles until one gives way, yet these quiet joints carry us through every step, and a substantial share of emergency visits in the UK begin with them. Against that background, the physiotherapist Genevieve Tawiah argues that much of this harm is avoidable, if we learn to sense our feet, rebuild their strength and balance, and choose footwear that suits the task at hand. Her advice reads less as a set of rules than as a gentle reminder that the body's foundations deserve attention before they fail.
Ankle injuries are more common than you think, and three habits can help protect yours
Most people give their ankles no thought until the moment one rolls.
Mark
Five percent of A&E visits is a striking number. Why does it matter here?
Mimi
Because Tawiah's point is that it's largely preventable. Ankles are what we rely on for balance and shock absorption, yet we barely think about them until they hurt.
Mark
Where does she start?
Mimi
With awareness. Being able to feel what your ankle is doing without looking. She uses small toe exercises, like pressing the big toe down and watching the arch engage.
Luke
Worth being clear, though: the 5% figure is NICE's, and it tells us how common injuries are, not how many were preventable. The claim that they can be avoided is Tawiah's own view.
Mark
Fair. And the exercises, are they backed by evidence in the piece?
Luke
No studies are cited. It's one practitioner's programme, based on her experience with performers. Reasonable, but not proven here.
Mimi
She does tailor it, though. Ball-catching balance work for sprains, slow heavy calf raises for tendinopathy.
Mark
What about shoes?
Mimi
Her test is imagining the top of the shoe removed: would your big toe be pushed over? And she cautions that barefoot shoes need a strength base first.
Luke
Notably, even hiking boots get a caveat: they protect on rough ground but can stiffen the ankle if worn all day. There's no simple rule, just matching shoe to task.
The Pulse
- Ankle injuries account for about 5% of UK A&E visits, a steady drain on people who never saw the danger coming.
- Sprains, tendon pain and rolled ankles disrupt daily life, sport and work, often without warning.
- Tawiah urges people to first reconnect brain and foot through small, watchable toe movements before heavier training.
- Strength drills such as heel raises, balance walks and controlled stair climbing are the path forward, with footwear chosen to match each activity.
- The outlook is encouraging: with awareness and gradual progress, many of these injuries can be prevented.
Most of us never think about our ankles until one gives way, yet these quiet joints carry us through every step, and a substantial share of emergency visits in the UK begin with them. Against that background, the physiotherapist Genevieve Tawiah argues that much of this harm is avoidable, if we learn to sense our feet, rebuild their strength and balance, and choose footwear that suits the task at hand. Her advice reads less as a set of rules than as a gentle reminder that the body's foundations deserve attention before they fail.
Most people give their ankles no thought until one rolls under them. Yet these joints absorb shock, hold us steady and carry us through every step, and NICE figures show that ankle injuries make up 5% of all UK A&E visits. Genevieve Tawiah, a performance physiotherapist who has worked on shows including Strictly Come Dancing, believes many of these injuries can be avoided.
Her approach begins with awareness. She wants people to sense what their ankles are doing without looking down, starting with small toe movements. Pressing the big toe into the floor and feeling the arch engage, or sliding a toe toward a pen laid on the floor, builds the connection between brain and foot that everything else depends on.
From there comes strength and balance: heel raises beside a sturdy surface, walking a line heel to toe, and rising from a chair on one leg. Tawiah tailors the work to the person, whether that means catching a ball on one leg after a sprain or using slow, heavy calf raises for tendon pain. She also asks people to notice habits, such as always leading with the same leg on the stairs.
The last habit is footwear. Narrow toes, flat pumps and unsupported soles can push the big toe out of line and disturb how weight travels through the foot. Barefoot shoes can help, but only once strength is in place, and each activity suits a different shoe. The path, in her telling, runs from feeling the foot, to training it, to dressing it well for the task ahead.
Most people give their ankles no thought at all until the moment one rolls. They absorb shock, keep us balanced, and carry us through standing, walking and running. Genevieve Tawiah, a performance physiotherapist who has worked on shows including Strictly Come Dancing, says injuries to them are common. NICE figures put ankle injuries at 5% of all visits to A&E in the UK.
Tawiah's argument, made on the What's Up Docs? programme, is that many of these injuries can be avoided. The condition she sets is that you are strong and aware of your foot and ankle, and of the chain of the body that affects them. She breaks the work into three habits.
The first is building what she calls brain-to-body awareness: being able to sense what your ankles are doing without looking down at them. She describes it as sending information from the brain to the foot and ankle to ground us, a foundation for any exercise training that follows. To get there, she starts people with exercises where they can watch their foot at work. She favours small toe movements because they influence how weight is loaded through the ankles. In one, you press the tip of your big toe into the floor, hold it, and watch how the arch of the foot engages. It should feel like something pulling through the arch. In another, you lay a pen on the floor parallel to your big toe and try to move the toe toward it, a movement known as toe abduction.
The second habit is strength, control and balance. Tawiah says the ankle's job is to help us balance, bear weight and transmit force. For strength she suggests heel raises: stand beside a sturdy surface, lift the heels and roll onto the toes, keeping the ankles from wobbling or flaring outwards. For balance, walk with one foot directly in front of the other, like a gymnast on a beam, while keeping control of the foot. Moving from sitting to standing on one or two legs, and going up and down stairs, also train control. If you notice you always lead with the same leg on the stairs, she advises practising with the other.
She tailors the work to particular problems. People recovering from sprains might balance on one leg while throwing and catching a ball, or practise landing control by stepping to either side and balancing on the landing leg. For tendinopathy, chronic pain in a tendon, she says slow, heavy loading matters, such as weighted calf raises on a leg press.
The third habit is choosing the right footwear. Tawiah says many people fall into the trap of flat ballet pumps, pointed shoes, or trainers that narrow at the front. Her test is to imagine the top of the shoe removed: would your toes have room, or would the big toe be pushed over? She also recommends a degree of arch support, since it affects how weight passes through the foot during a task.
Barefoot shoes, increasingly popular, can be useful, she says, but only after a good baseline of foot and ankle strength, and with the pace of adoption kept gradual. Different activities call for different shoes. Squats suit a flatter shoe, because a spongy sole makes it harder to balance and take weight in the right place. Running calls for a cushioned trainer that absorbs impact. On longer all-terrain walks, hiking boots often reduce the risk of big sprains, though wearing them for long stretches day to day can stiffen the ankle by limiting its mobility to a degree.
The advice runs from small and observable to more demanding: learn to feel the foot, then train it, then dress it sensibly for the task at hand.
Notable Quotes
Ankle injuries can be avoided if you are strong and aware of your foot and ankle and the chain that affects it.— Genevieve Tawiah, performance physiotherapist
Barefoot shoes can be useful, but build a good baseline of foot and ankle strength first and pace yourself.— Genevieve Tawiah
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