One of the biggest mistakes I have ever made in sporting career is not treating my ankle sprains with enough respect and ensuring I had full mobility, stability and strength before going back to playing and training. I cannot tell you how many times I sprained my ankles, my left ankle in particular suffered at least 3 grade 3 tears plus several smaller tears! Nearly all of us have sprained our ankle at one point in our life and almost all of us are also guilty of under-playing the consequences just like me. After the initial searing pain, we limp home, reach for the pain-killers, get the frozen peas out of the freezer and on the swollen ankle, before resting on the couch with our foot up for an hour or two. After a few days of hopping around we try to soldier our way on, and before you know it the pain has gone, the ankle is a bit stiff, but we feel we will be back to normal in a week or two. It is about this time we think we are okay have got away with just a sprain. But, as I am going to show in this article it is at this time that even the simple grade 1 sprains can create a dangerous chain reaction of compensatory movements that are conspiring to create much more severe and painful problem.
Why Ankle Mobility Is So Important
Dorsiflexion is something we all tend to take for granted in daily life and in sport and trust me you can ask the people with walking impairments how hard it is to walk when your foot does not do this. Every time you squat, lunge, and move your legs for almost any daily activity you require optimal ankle mobility in order to dorsiflex the ankle. If you do not have adequate range of motion in the ankle your body has no choice but to compensate and place stress onto another joint.
Below is a great exercise to help improve ankle mobility for anyone who has suffered with multiple sprains like myself.
Mobility is great to work on but it is not going to prevent future sprains. This is where you need a combination of mobility and stability.
In sports this is even more important with high powered multi-directional movement patterns (eg, tennis, football, basketball etc), requiring high levels of ankle mobility to be able to move in several directions all in a split second, while maintaining perfect balance and control. The risk is much higher for this reason which is why any sportspeople who suffers recurring ankle ligament injury must have a strong focus on regaining optimal mobility as fast as they can.
In almost all ball sports a sprained ankle will be the most common injury and very few people have escaped suffering from one at some time or other in their sporting career. The worst part of this injury is even after you’ve ‘recovered’ from a sprain, your ankle is temporarily weaker than normal, and you’re at a greater risk of suffering another one or a worse injury.
One of the best ways to overcome this is to use balance training.
Exercises with BOSU’s and balance board are especially effective at improving the strength, mobility, flexibility, and elasticity of the muscles, tendons and ligaments which run between the knees and toes. These structures include the intrinsic muscles of the feet, the plantar fascia, the plantar and dorsiflexors of the ankle, and the Achilles tendons.
All of these anatomical components help to stabilize and control the foot and lower part of the leg during the foot-strike portion of the gait cycle and, in particular, govern and coordinate ‘pronation’, the natural inward movement and rotation that occurs at the ankle immediately after the foot hits the ground.
Balance-board exercises mimic what happens to the muscles, tendons, and ligaments of the feet, ankles, and lower legs during running –and thus fortify them for the stresses they must endure.
While these exercises are a great start there are many other things you still need to do such as strengthening. One of the worst injuries that can result from calf weakness is Achilles Tendonitis or worse a full Achilles rupture as seen recently in the 2025 NBA playoffs with several star players Jason Tatum, Damian Lillard & Tyrese Halliburton all suffering this injury.
What Is Achilles Tendonitis?
While Achilles injuries are common to many sports and running they are not limited to these activities as it can be a huge problem with older adults that can severely impact their daily life. Treating the symptoms with massage and stretching will do absolutely nothing to get rid of this problem if you fail to address the underlying cause/s.
It is often the result of overuse from repetitive actions seen in running and jumping sports and statistics show that it is one of the most common of all overuse injuries, accounting for 10% of all running injuries. This is a much different injury to an acute stress or accident-type injury such as an ankle ligament sprain from rolling an ankle or a collision injury often seen in sports like football.
Like all overuse injuries, once it sets in it can be extremely difficult to get rid of so it is vital you prevent it from happening in the first place. Ignoring the warning signs is dangerous and can lead to full Achilles ruptures which is something that is seen a lot in professional sports.
I see a lot of similarities with this injury and ACL injuries in relation to the underlying cause. In order to prevent the problem you need to know what causes it. Unfortunately, it is not a simple answer to explain as the cause can differ from person to person and can be a multitude of factors you need to keep in mind.
The Achilles tendon connects muscle to bone, like other tendons, and is located at the back of the lower leg. The Achilles tendon connects the gastrocnemius and soleus muscles to the calcaneal tuberosity on the heel bone.
Tendons are the tough fibres that connect muscle to bone. While a tendon injury may seem to happen suddenly, it results from many tiny tears to the tendon that have occurred over a long period of time. I used to get confused with the different terms used to describe Achilles injuries as I wasn’t sure if it was tendonitis or tendinopathy.
Tendonitis: This means “inflammation of the tendon,” but inflammation is rarely the cause of your tendon pain.
Tendinosis: This refers to tiny tears in the tissue in and around the tendon caused by overuse.
Most health professionals will refer to it as tendinopathy.
The injury involves damage to the fibres on the Achilles tendon unit, often at the narrow point of the tendon just above the heel. This area is most at risk because it has a smaller blood supply than the rest of the tendon, and so is unable to repair itself as easily. The symptoms involve pain in the Achilles with motion and exercise if it is prolonged and it will be painful to touch.
Like plantar fasciitis the stiffness and pain is worse when getting up out of the bed first thing in the morning.
Common causes of Achilles injuries include:
•Excessive pronation, producing a whipping action on the Achilles tendon during stance phase of the running action
•Poor flexibility of the ankle and Achilles tendon
•Weak calf muscles
•Poor running shoes
•Rapid increase in training load, over-training and poor recovery methods
However, while I agree all of these factors can be playing a part in creating the injury I would like to add a few other things to this list that are often overlooked.
1.Poor hip mobility
2.Poor hip movement and glute function
3.Poor running technique
Let’s discuss each of these factors in more detail so you can pinpoint where your underlying cause may be if you have the injury. And if you don’t have an existing calf injury, how you can prevent it.
Excessive Foot Pronation
For a long time many (myself included) believed the main cause of Achilles and calf related problems was all to do with the concept of excessive pronation. This is where there is excessive inward rotation of the foot during the stance phase running. This pronation tends to bow or twist the tendon and after several thousands of repeated foot strikes there is inevitable damage and inflammation caused to the Achilles.
The video below gives you a good visual of this and an exercise I often use to correct it.
Our feet are designed to do 2 critical things.
1.ABSORB shock and then.
2.Provide the ability to PUSH off the ground when we walk, run or jump.
The foot needs to act like a spring being soft flexible foot to cushion the stress of each step we make, and then instantly become stiff enough to provide enough power to move us forwards or upwards.
This is also known as being able to lock the foot at one point and then being able to unlock the foot at the very next part of the movement. Problems arise if we lose either one of these two things, and ultimately lose our spring. This is where injuries will occur at other joints.
There are many different foot types, so it is important to know what type of foot you have before you do anything so you can make the correct adjustments. You can see below a very simple diagram of the different foot types. If you are the normal foot, then you have great news. If however, you are either the flat foot or the high arch you will be at risk of Achilles problems.
Rigidity of the big toe and toe gripping are other give away signs there is a problem you must address at the feet.
Flat feet are the most common of all the feet problems associated with excessive pronation and Achilles injuries. This foot is basically very unstable, has become over stretched along the bottom of the foot, which makes it almost impossible to become a rigid lever to create the “spring” and release energy the foot needs during running and jumping activities.
This foot type is the most commonly one fitted with orthotics to help correct the fallen arch. Unfortunately, this does not “fix” the problem as the foot will remain weak, and the orthotic does not provide the spring, if anything it dampens it!
Now I am not necessarily saying to get rid of your orthotics altogether. In some cases people have such weak feet that this is the best option, however it is always wise to try and correct these problems with strengthening drills first, in particular with young kids.
The key to correcting the weak foot is with improved stability strategies and strength exercises. See article – How to strengthen weak feet
Remember this foot type problem is all to do with instability and weakness, and like any muscle or joint it needs work. A quick note on pronation. Pronation is not bad, in fact it is absolutely essential, the problem is when you have too much of it in the case of weak feet. So understand we don’t want to get rid of it altogether we just need to limit how much we have.
Watch the video below for ideas of how to do this.
Poor Flexibility Of The Ankle
Tightness in the calf will lead to extra tension being placed on the Achilles tendon, during running and walking, especially up hills. This lack of mobility at the ankle will cause the foot to pronate more during running to compensate for this lack of motion.
It is very important to address mobility problems PRIOR to strengthening.
Every time you improve flexibility and mobility new opportunities are created to alter and change movement patterns, and increase strength in weak and lazy muscles. For if there is a tight muscle, there is also an opposite, a weak lazy muscle.
The big mistake people make in rehab is trying to strengthen the weak muscles first. Your calf muscles may need to be strengthened, but they can never achieve their potential while they lack range of motion, timing and freedom of movement that can only be restored using flexibility and mobility methods first. All that will happen if you skip this stage is you will force the body to compensate and find another way.
You can easily assess your own ankle mobility by using the wall test shown in the video below that also features several mobility drills you can use to help release stiffness.
Strengthen Weak Calf Muscles
Another big factor to address is calf weakness.
With Achilles tendon injuries the tendon is often unable to cope with the repeated eccentric contractions which the calf muscles must perform as the foot makes contact with the ground.
Eccentric strength refers to tension being applied to a muscle as it lengthens. This is also when the muscle’s force-producing capacity is at its most optimal.
If the calf muscles did not contract eccentrically when your foot hits the ground during the action of running the ankle would collapse. These eccentric contractions produce forces which may cause excessive stress on the tendon if repeated too often and the muscle is not strong enough. This is where you regularly see people prescribed calf muscle strengthening programs using exercises like calf raises to combat this problem. Using exercises with a concentric movement ignores how the muscles and tendons interact during a movement like running.
There are many problems associated with assuming Achilles injuries are all to do with calf weakness, for this could be a result of muscle inhibition from poor mobility, or poor movement from other joints compensating. Strengthening the muscle in isolation without changing these things at the same time will prove to be pointless. Blaming a single muscle like the calf for a problem in a complex pattern of movement like running is ignoring the role of multiple muscles and joints and the interaction they have as synergistic partners.
Watch the video below for ideas of how to strengthen the ankle and calf.
The other thing to keep in mind is that concentric strength is not of most importance when it comes to quality movement, in particular running.
During the running cycle the energy from the push comes from the tendons and not from active contractions of the muscles. The muscles are still important but they are mostly concerned with eccentric contractions during the cushioning phase to control the impact with the ground.
The body is very smart and can anticipate pain before you even move. It can instantly rearrange and change motor programs and movements to protect itself from harm and is another factor to consider when observing what appears to be a tight muscle or a weak muscle. Using a thorough assessment process is essential to ensure you do not miss the protective mechanism at work in a movement. It can be difficult to spot the real problem as you will see many other things happening that are a compensation to protect the real underlying problem.
When applying strength methods specifically aiming at the calf make sure you emphasize endurance.
For example, with single leg calf raises I will prefer to aim for high repetitions of low loads, over high intensity loading for maximal strength gains. Many calf related injuries occur once fatigue sets in and the calf muscles are heavily reliant on endurance.
With the single leg calf raise I aim for at least 30 repetitions on each leg as an indicator of great endurance. If you fail to reach 30 reps, or if there is a difference between each leg I will know that there is a weakness that will be exposed during running or sports.
One of my favorite drills for strengthening the ankle and calf with endurance is the line drill shown below. This is a great change of direction exercise as well as ankle strengthening.
Now if you think this is all you need to do you will be very disappointed so make sure you read on.
Poor Footwear
As we have already discussed our feet and ankles are meant to withstand incredibly high forces and should provide more in terms of shock absorption than perhaps any other body part. Unfortunately, we begin to gradually lose this ability once we start wearing shoes.
Over time, the feet, ankles, and toes become inhibited. And as we expose our feet to some trendy shoes with all types of padding and support, this only make matters worse and exacerbates the lazy and weak feet muscles. Besides minimizing the ability to withstand intense ground reactive forces, the body gradually begins sending fewer and fewer signals to the feet, leading to distortions in pro-prioception and loss of innervation all the way up the kinetic chain.
This is where Achilles and calf injuries are born!
I won’t go into too much detail about what shoes are best to buy, but I would encourage you to go and see a qualified Podiatrist or shoe specialist to pick the right shoe for your body, to rule this out as a potential cause.
Rapid Increases In Training Volume & Over-training
This is a big factor with many distance runners and sports who play on a regular basis. The good news is the solution for this is pretty simple as all you need to do is rest more often. We all want to be the best athlete we can be but sometimes our determined focus on progression and performance can lead us to push too hard, train too long, or simply do way too much. It is in our nature to strive for progression and constant improvement which is a good thing but we can easily set goals that may be out of reach. We must respect exercise and acknowledge that recovery is equal in importance as the training itself.
With high intensity exercise like strength training and sprinting most people understand the body needs time to rest between workouts. However, with low intensity training like distance running this principle is often ignored and this is where over-training can become a real problem.
At first you get away with the high volume of activity, it is only after a few months that little niggles and annoying injuries start to surface. These niggles are created from excessive training and lack of recovery and if ignored they elevate to chronic injuries that can take a long time to repair.
In addition to too many workouts is the principle of ‘gradual progression’. This means any increase in mileage or intensity of training must be slow and steady, otherwise injury risks are greatly heightened. A guideline of a 5-10% increase in mileage per week is a good rule of thumb. Adopting this measured approach allows the muscles and tendons time to increase their strength to cope with the extra stress.
Many Achilles injuries in distance runners are caused by athletes increasing volume or intensity too rapidly.
I have often seen many calf injuries occur in basketball players who participate in tournaments that run for several days that require players to play multiple games on one day. As the players are not used to this type of stress and demand the muscles, tendons, and ligaments are exposed to excessive forces that can easily lead to stress injuries.
Correct training methods and programs are required to fully prepare players for this type of tournament play.
You can read more about how to structure your training workload in this article – How to avoid over-training and maximize your results
If you have implemented all the changes mentioned so far there is a good chance you will be starting to get on top of your problem. However, you must continue with these last three steps to ensure it never comes back.
Hip Mobility
The hip is very often a problem for joints in the lower limb and can play a big part in directing forces into the Achilles tendon.
Dr Vladimir Janda says it best,
“The pelvic chain is the key in most musculoskeletal dysfunction”.
If the gluteus maximus and hip abductors do not control the hip sufficiently during the cushioning phase, then the hip may drop laterally on the swing-leg-side, or the pelvis could tilt backwards. Either of these would result in a greater inward rotation force on the knee which would result in causing a greater inward rotation of the tibia, which in turn inwardly rotates the ankle, eventually increasing the amount of pronation at the foot.
Remember how I said in the introduction how closely this injury relates to ACL injuries? This is known as “the point of no return” with knee injuries, and why you see over 70% of ACL injuries sustained in non-contact situations. See article – Why females are more at risk of ACL injuries
To protect the knee from damage the foot will compensate by pointing outwards. While this may help the knee it now causes huge problems for the ankle joint and this is where your calf and Achilles tendon are exposed to injury.
This is a perfect example of how the whole leg chain is dependent on all the links working correctly. If one area, such as the hip, does not perform its correct function, then other areas are adversely affected. Simply performing some calf stretches and calf raises will do very little to change this problem.
Where do you start, and what exercises should you use?
This is impossible to give you a definitive plan to follow for each person is different. You will need to complete a thorough assessment looking for mobility restrictions or compensatory weakness and dysfunction at the hip and pelvis.
You will get a ton of ideas in the article – 10 ways to improve hip mobility
Gluteal Strength
Anyone who has read any of my previous articles about injury in the hip or knee region will know how much I emphasise using the Romanian deadlift (RDL) to correct movement dysfunction and muscle imbalance. The deadlift is such a great way to improve hip mobility while simultaneously improving core stability of the spine and gluteal strength of the hip.
In the rehab field the RDL is often referred to as a hip-hinge as it requires very little knee movement but a large degree of hip movement. Anyone working with lower limb injuries will know how much influence the hips have with these injuries and often tightness with the hip flexors and weakness with the hip extensors is a big part of the problem.
The deadlift and in particular the RDL is a perfect remedy for these injuries as it demands hip mobility with strength from the posterior chain.
While the bilateral RDL is a great start to retraining the anterior pelvic tilt, improving hip mobility, and gluteal strength, it will have little effect on correcting the weakness permanently.
Why?
Firstly, it is very rare to find two hips with the identical problem and the single leg exercises expose any compensation and weakness you will not see in the bilateral exercises. Secondly, the bilateral exercise neglects the important role the feet must play in providing stability of the leg and its critical interaction with the hip during the action of walking.
This is where I progress to the single leg stance for it demands significant more stability from the feet as much as the hip and it is these areas that most lower-limb injuries like Achilles tendon and calf strains are created. The muscles of the feet must provide adequate stability to guarantee optimal alignment of the ankle, knee, and hip when we walk.
This is where I like to progress to the multi-joint sling training but first we need to address single leg stability.
Single Leg Stability & Strength
This is where I will use exercises like the hip airplane or the single leg squat to find out what is going on when the person moves.
They may have passed every test up to this stage where we have pulled things apart or made it simple, but now they must integrate the entire system together within a blink of an eye. It is amazing how much information a single leg exercise can reveal about where the compensation and weakness is coming from. It is also very important to understand that this movement will relate very closely to the running action.
Without control of the single leg stance the person will have no chance of implementing an efficient running stride.
When assessing this movement we start at the ground and work our way up, looking for clues as to where joints are not functioning correctly. What you will see is that every second joint needs mobility, and the other joints need the exact opposite being stability.
In nearly every case of injury the joints needing stability are compromised, and forced into excessive movement due to a loss of mobility at the joints demanding this ability. This information is crucial to know in determining what course of action you may need to take, or what to investigate further when you see dysfunctional movement or pain.
Watch the video below as I take you through a detailed look at the single leg squat and all the things that it can influence poor movement.
I also suggest to read this article to see a more detailed explanation of all things used to correct a single leg stance – How to use the single leg squat as an assessment tool
We are nearly finished. Now we have to take a look at the running technique.
Running Technique
The impact and strain running puts on your body is substantial.
With each step, up to 3 times your body weight goes through your joints. Times that by however many repetitions you do in a session (thousands), and you now begin to realise how demanding running is on the body.
Add dysfunction or poor technique to that and there is no wonder why so many people experience issues within the first 4-6 weeks once they commence or re-commence running after a lay off. Whether that be running on its own or through sport or any other activity. When looking at upright running mechanics (when into a normal running rhythm), the most common mistake people make, in my experience, is over striding which often results in a subsequent “heel strike” at ground contact. Not only is this inefficient but it can also lead to many preventable injuries.
Over-striding is when your foot contacts the ground in front of your centre of mass (in front of your hips as opposed to directly underneath) with each step. This results in a braking force which ultimately slows you down and puts more stress on joints, ligaments, and tendons.
Many runners, coaches and trainers still utilise and advocate a heel strike at ground contact. However, when you understand the function of the structures that occur at the sole of the foot and posterior (back) aspect of the lower leg (calf/ankle), it makes sense to utilise a midfoot ground contact.
Without getting overly technical, the Achilles tendon acts as a shock absorber, it recycles stored energy like a spring to protect joints up the chain and enhances running efficiency by allowing forward propulsion. In conjunction with this, the intrinsic muscles at the sole of your foot, stabilize the foot and ankle with each impact and assists in the absorption and transmission of force.
Optimal foot stability cannot be achieved with heel strikes, instead, large amounts of force are shocked into the foot and up the leg with minimal absorption as its pretty much results in bone hitting the ground.
In my opinion the most effective running technique is called the “pose method”. It involves landing on the mid-foot and underneath the same side hip at ground contact, and then using the hamstrings through a cyclic like action of the leg to propel the runner forward.
The pose method includes:
•A constant, slight forward body lean
•A mid-foot ground contact underneath the centre of mass (hip)
•A cyclic like action of the leg coming off the ground (swing phase) – pulling the leg through quickly and maintaining a bent knee throughout.
•Minimal ground contact time and increased cadence as opposed to longer strides. This allows for ground contact and reduces breaking forces, putting less strain on joints, ligaments and tendons.
Watch the video below for explanations of how to implement this type of action.
Training The Core Via The Slings
This last part is where you can pull everything together and strengthen all the muscles you need to simulatenously. The beauty of these exercises is that they have a massive impact on improving the gait cycle, also known as walking or running.
The gait cycle is divided into two phases.
1.The stance phase
2.The swing phase
Each cycle begins with the initial contact of the heel strike of the leading leg with a stance phase, into the swing phase, and ending again with the stance phase. The stance phase is broken into three parts being:
1.Heel strike
2.Mid stance
3.Propulsion
There are so many muscles firing within milliseconds of each other during this cycle in order to make this movement efficient and effortless. The different phases are designed to decelerate the forward momentum of the body while at the same time absorb shock as the body moves over the lower leg ground reaction forces. This is where you will often see problems arise in the calf or Achilles.
Every muscle from the trunk down has one function the minute your foot hits the ground. All the muscles of the lower limb (glutes, quads, hamstrings etc) act together to stop the ankle, knee, and hip from bending to prevent you falling to the ground. All the muscles have the same function which is to apply the brakes and slow you down and then almost reverse this process and instantly switch into propulsion mode.
The best way to improve this is to use exercises that strengthen the MYOFASCIAL SLINGS.
These exercises assist glute activation and core engagement, in movements that mimic walking and running. I think most people are very aware of the importance for adequate glute and core strength and this is something I have discussed at great lengths many times. What I don’t think is understood quite as clearly is the need to move fast.
Any exercise that requires the gait cycle always looks very smooth and athletic when performed well and extremely awkward and robotic if performed poorly.
While all these slings are vitally important the two that stand out with relation to the gait cycle are the anterior and posterior sling.
The anterior sling combines the serratus anterior, rhomboids, obliques on one side of the body to work with contra-lateral adductors and quadratus lumborum on the other side of the body to help decelerate the body and create efficient movement with actions like throwing a ball and gait. Most of the exercises using this sling are pushing movements and with regars to the calf they are concerned with propulsion or the “toe off” phase.
The video below gives you a great visual of this.
The posterior sling is where the glute max of one hip works with the latissimus dorsi of the opposing side to create tension in the lower back region called the thoracolumbar fascia. The action of these muscles along with the fascial system is to prevent rotation of the pelvis when we walk and enable you to store energy to create more efficient movement. Most of the exercises that use this sling are pulling movements and with regards to the calf it is concerned with the landing phase of the foot.
Where the anterior sling provides deceleration this sling provides propulsion with gait it is the opposite with throwing actions.
Each sling has a corresponding partner on the opposing side and as they both cross the mid-line they help to connect the upper body with the lower body to either accelerate or decelerate movement. Also it must be stated that this criss-cross connection enhances the stability of the trunk and spine and is why exercises that use these slings are referred to as core strengthening exercises.
Below is a great example of the posterior sling.
You can read more about the slings in this article – How to improve core strength using the 4 slings
Do You Need More Help?
If you currently suffer with hip, knee, or back problems you will find our online programs are a great resource that take you through all of the assessments and corrective exercises to get you back to full strength and out of pain. All of these programs are downloadable videos that come with PDF instructions manuals.
Go to the ONLINE SHOP to find out more and get a copy.
Summary
There is a lot more to preventing and correcting a stiff ankle or an Achilles injury than some calf stretches and calf raises.
Like most chronic injuries there is not one single factor that creates the injury but a multitude of little ones combined together to create the perfect storm. This is why it can be very difficult to pinpoint what to do and what is really at fault for you may make incorrect conclusions based on poor results. It is only when all the factors are addressed at once that you can narrow down where the energy leak or dysfunction is coming from.
I hope this article has given you some great ideas of where to look and enables you to avoid this horrible injury.
About The Author
Nick Jack is owner of No Regrets Personal Training and has over 20 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specializes in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.
References
•Movement – By Gray Cook
•Corrective Exercise Solutions – by Evan Osar
•Athletes Acceleration Speed Training & Game Like Speed – by Lee Taft
•Knee Injuries In Athletes – by Sports Injury Bulletin
•The ACL Solution – by Robert G Marx
•Understanding & Preventing Non-Contact ACL Injuries – American Orthopaedic Society For Sports Medicine
•Anatomy Trains – by Thomas Meyers
•Motor Learning and Performance – By Richard A Schmidt and Timothy D Lee
•Assessment & Treatment Of Muscle Imbalance – By Vladimir Janda
•Twist Conditioning Sports Strength – By Peter Twist
•Twist Conditioning Sports Movement – By Peter Twist
•Twist Conditioning Sports Balance – By Peter Twist