Place Ankle Flex on an even floor.

Step onto the device with the affected foot, placing the ankle strap loosely over the top of the foot.

Fasten the ankle strap first, securing your heel to the back of the device and placing the strap underneath the inner and outer bones of the ankle (medial and lateral malleolus) in the hinge joint of the ankle. 

Create just enough tension to secure your heel to the back of the device, delivering a small/light amount of pressure (about 25% effort) to the front of your ankle joint. Place the cord in the cleat to secure your foot in this position. 

Place the calf cuff at your middle to upper calf, so the “TOP” indicator on the calf cuff faces up. Make sure the white pulley faces exactly forward towards the other pulley at the front of the device, so they are lined up. 

Place the unaffected foot on the outboard foam foot pad, hip-width distance and parallel to the secured foot. Keep both feet flat on the ground and bend your knees into a shallow squat. Your knee can go past your ankle when using Ankle Flex.

Set your interval timer for 15 intervals of 20 seconds stretching, 10 seconds resting.

For the first 10 intervals, you will hold a static
stretch for 20 seconds. Lower into a shallow squat into ankle dorsiflexion by bending the ankle and knee forward. You will feel a stretch in your calf muscles and ankle joint(s). Rest for 10 seconds in between each static stretch. 

You can reposition the unaffected foot a little behind or a little in front of the affected foot to vary the static stretching position, but do keep your feet hip-width distance apart. You can advance the stretch by using the mobility wedge to create an incline up to 10 degrees. Most people need to stay flat for a number of weeks before progressing the stretch using the mobility wedge. Listen to your body: don’t push yourself into pain; adjust the intensity based on your comfort level.

For the final 5 intervals, you will lunge up and down a little during the 20 second time period, moving from your static stretch shallow squat position and back to upright. This is a dynamic stretch to mimic walking, lunging, using stairs or doing mini squats.

Your unaffected foot on the outboard foam foot pad can be placed a little behind or a little in front of the other foot to vary the dynamic stretching position, but do keep your feet hip-width distance apart.

When you are finished, kneel down on the unaffected side or sit in a chair, and unhook both straps.

Use daily or as recommended by your practitioner to restore functional ankle dorsiflexion range of motion. In our study at Montana State University, participants benefited from daily use over 21 days. Ankle Flex can be used long-term, a few times per week, if maintenance stretching is indicated in order to maintain range of motion gains.