Training guide
Ankle weights turn leg lifts into strength exercises: straightening your knee, curling your heel back, lifting your leg out to the side or behind you. That is what they're good for. They're the load in the Otago home exercise programme, which cut falls in older adults by about a third, and in home knee programmes that eased arthritis pain.
Walking or running in them is a different story: it adds only a little effort and changes how your legs swing. This guide covers the moves to use them for, how heavy to start (the lightest you have), how to build up, why we don't suggest walking in them, who should change them, and a follow-along leg workout.
Cuff weights strapped round your ankles turn leg lifts into strength exercises: straightening the knee, curling the heel back, lifting the leg out to the side or behind. Knee programmes and falls-prevention programmes have used them for decades.
The Otago home programme, leg strengthening with ankle cuff weights plus balance work and walking, cut falls and fall injuries by 35% across 4 trials of 1,016 people aged 65 to 97. The weights are one part of it: in a review of 108 trials, balance and functional exercise was the most reliable kind.
Home thigh-strengthening with ankle cuff weights eased knee arthritis pain and improved function about as much as weight-bearing exercise in a trial of 128 people.
Learn each move with no weight until 10 slow reps are easy, then add the lightest cuff you have, about 0.5 to 1 kg, and about 0.5 kg at a time after that. Most people never need more than about 4.5 kg (10 lb).
Lift for a count of 3 and lower for a count of 5, as the Otago booklet teaches, 2 or 3 times a week, stopping with 2 or 3 reps to spare.
Walking in ankle weights adds only about 4 to 9% to the effort and changes how your legs swing, and the only trial of walking in them didn't improve chair rising or walking speed. Take them off for balance work and to walk about.
Padded cuffs with a hook-and-loop strap, holding sand, iron filings or removable bars, usually from about 0.5 kg to 5 kg each. Adjustable ones let you add weight in small steps: one knee trial used cuffs from 0.65 to 10 kg in 0.5 kg steps.
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A weight at the ankle sits at the end of a long lever, so even 1 kg makes a straight-leg lift much harder for your hip and thigh muscles (our reading of the physics). That suits moves where your foot leaves the floor: straightening the knee (quadriceps), curling the heel back (hamstrings), lifting the leg out to the side (gluteus medius) or behind you (gluteus maximus), and the straight-leg raise (quadriceps and hip flexors).
Squats, lunges and step-ups, where your feet stay on the floor, get almost nothing from an ankle weight. A weighted vest or dumbbells load those instead (our reading).
You should be able to do 10 slow, controlled reps of each move with no weight, with your trunk still and, in side-lying lifts, your waist not hitching, as our side-lying leg raise guide says.
Longer legs make the same weight harder at the hip (our reading). In women with weak side hips, heavier weights mostly made the hip hitch (see below). Older adults in falls programmes used light cuffs and progressed slowly.
The figure shows the seated knee extension without the cuff. The 3-up, 5-down count and taking the weights off for balance work are the Otago booklet's; the strap fit is our suggestion.
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The movement on the figure: Seated knee extension (chair)
No trial has compared starting weights. These steps are our editorial starting point, built from the programmes below.
10 slow, controlled reps of each move: in the bent-knee half for a sore kneecap, and with your waist still for side lifts, as our move pages and guides say.
The lightest cuff you have, about 0.5 to 1 kg, as our knee surgery guides suggest; our seniors plan adds a light ankle weight once 10 slow knee extensions or side leg lifts feel easy. A knee arthritis trial started at a weight people could lift about 10 times, at an effort of 5 to 8 out of 10.
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Add reps up to the top of the range, then about 0.5 kg. The knee trial told people to "increase the weights (0.5 kg at a time)" when the exercise felt easier: the same double progression our plans use.
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The American Academy of Orthopaedic Surgeons (AAOS) knee programme starts at 5 lb (about 2 kg) and builds "up to a 10 lb. weight" (about 4.5 kg). For side-lying lifts, our side-lying leg raise guide's ceiling is about 3 to 5% of your body weight. Beyond that, a cable or machine is easier on the strap and your ankle (our suggestion).
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2 to 3 sets of 10, slowly, stopping with 2 or 3 reps to spare: the AAOS programme uses 3 sets of 10, and the Otago booklet up to 10 reps. Do them 2 or 3 times a week as part of your strength training, or 3 times a week in a falls programme. The AAOS programme's 4 to 5 days a week is a rehabilitation dose.
Starting points, not prescriptions. Put the weight on only once the move is easy without it.
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The figures don't show the cuff. Do each move with no weight first, slowly, holding a support for the standing ones; the quad set stays unweighted, as the step before the straight-leg raise.
3D demoSeated knee extension (chair)Beginner · A bench or box + Something with weight
3D demoStanding hamstring curlBeginner · A wall
3D demoWall side leg lift (standing side kick at the wall)Beginner · A wall
3D demoStraight-leg raiseBeginner · No equipment
3D demoSide-lying leg raiseBeginner · No equipment
3D demoGlute kickback (quadruped hip extension)Beginner · No equipment
3D demoQuad set (static quads)Beginner · No equipmentTake the weights off for these: calf raises (10 to 20, holding a counter), single-leg stands (3 holds of 5 to 10 seconds each leg, building to 30 seconds) and marching on the spot (1 to 2 minutes as a warm-up), as in our seniors workout.
The Otago home programme is leg strengthening with ankle cuff weights, balance exercises and walking, 3 times a week. In its first trial, 233 women aged 80 and over had 0.87 falls a year against 1.34. In 240 people aged 75 and over, falls fell by 46%. Pooled across 4 trials of 1,016 people aged 65 to 97, falls and fall injuries both fell by 35%, with the most benefit in people aged 80 and over. Across 7 trials of 1,503 people, falls fell by 32% and deaths by 55%, though only about a third were still exercising 3 times a week after a year.
In 345 people aged 70 and over who had fallen, 12 months of Otago exercise cut further falls by 36% (236 falls against 366).
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In a Cochrane review of 108 trials with 23,407 people, exercise cut the rate of falls by 23% (high certainty). Balance and functional exercise was the most reliable kind, and the effect of strength training on its own was uncertain. Harms were few, mostly to muscles and joints.
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It gets harder by "adding more weight to the ankles, increasing the number of repetitions or reducing support". The beginners' booklet uses ankle weights for its knee and side hip strengtheners, up to 10 slow reps, and takes them off for the balance moves.
The American Academy of Orthopaedic Surgeons' knee conditioning programme uses ankle weights for straight-leg raises, hamstring curls and leg extensions (3 sets of 10, 4 to 5 days a week) and side-lying hip lifts (3 sets of 20), starting at 5 lb and building to 10 lb, and says "You should not feel pain during an exercise".
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In 128 people with knee arthritis and obesity, 12 weeks of home thigh-strengthening with ankle cuff weights, 4 times a week, eased pain and improved function as much as weight-bearing exercise. Minor aches and pains were more common with the cuff weights (39% against 23%). The dose was halved if pain or swelling lasted more than a day.
In 54 adults with knee pain, 12 weeks of home thigh-strengthening with cuff weights went with less pain and better function, though use fell from about 90% to 65% of sessions. With no control group, some of the change may have happened anyway.
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In 90 people in hospital after a hip fracture, knee straightening with ankle cuffs (3 sets of 10, the load rising from 3.6 to 6.2 kg) improved strength by 10.5% in those who kept to it, but not across everyone in the trial, with no harms from the exercise.
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Our side-lying leg raise guide's reading: In 24 women with weak side hips, ankle weights of 3% and 5% of body weight mostly raised the side waist muscle (from 49% to 82% and 92% of its maximum), so the hip hitched more and the gluteus medius did less of the work. Studies that used weights chose 3 to 5% of body weight.
Our knee pain on the leg extension guide notes that in the bent range, a cuff weight (constant resistance) loads the kneecap more than a machine: "Constant resistance gave higher kneecap stress from 60 to 90 degrees than a cam machine." The seated knee extension's page says: "Pause briefly near straight. With pain around the kneecap, stop at about halfway (the knee still bent about 45°) for the first weeks."
With 1.36 kg (3 lb) ankle weights, oxygen use walking uphill rose from 26.6 to 29.0 ml/kg/min (millilitres per kilogram of body weight a minute) in 12 young men, about 9% more; hand and wrist weights cost more. About 2 kg on each shin raised the cost of level walking by 4.2% in 14 adults.
Each kilogram on the foot raised the cost of running by 11 to 16%, but hand or ankle weights raised it by only 5 to 8% in all, and the authors of that study concluded that "commercial claims of marked increases in energy expenditure during running with hand/ankle weights are exaggerated".
The further down the leg a load sits, the more energy it takes to swing. 4 lb (about 1.8 kg) on each shin raised the peak knee-straightening moment (the turning force at the knee) by 21% in 19 young adults, while lighter loads changed little. A bigger moment isn't proof of harm.
In 36 older adults doing Nordic walking twice a week for 12 weeks, the group walking in ankle weights improved grip and muscle mass but not chair rising or walking speed. Two reports without control groups, in older adults wearing 0.5 to 1.5 kg, found small gains and "no serious accidents or incidents".
We found no trial showing that walking in ankle weights tones the legs, and no study or case report of harm to the knees or other joints. We still don't suggest it, because it adds little, and our sprint speed guide notes that vests and limb weights slow you while you wear them.
Hand-held weights while walking raised blood pressure and heart rate in older adults, and their authors suggest they may not suit people with heart disease.
Walk faster or uphill, or wear a light weighted vest or rucksack, and keep ankle weights for slow strength moves (our suggestion). Our incline walking, weighted vest and rucking guides cover how.
Our ankle weight leg workout puts the moves in order, with the weights off for balance at the end. The seniors workout already adds ankle weights to its knee extensions and side leg lifts.
A 25-minute leg strength session with ankle weights: knee straightening, hamstring curls, side and back leg lifts, then calf raises and balance, weights off.
25 minBeginner11 movesA bench or box, Something with weightA 40-minute strength and balance session for over-65s, built from the Otago home programme and NHS exercises, using a chair, a counter and a step.
40 minBeginner18 movesA bench or box, Something with weightA 20-minute seated workout for older adults who cannot stand for long: marching, leg and arm strength, posture, and sit-to-stands that lead back to standing.
20 minBeginner11 movesA bench or box, Something with weightA gentle leg strength routine with no jumping: sit-to-stands, step-ups, wall sits, bridges and calf raises.
20 minBeginner7 movesA bench or box, A stepA 25-minute glute workout with bodyweight and a mini band: bridges, clamshells, band walks, kickbacks and lunges.
25 minBeginner9 movesA wall, A bandA 25-minute session for knees that don't currently hurt: thigh and hamstring strength, single-leg control, then an optional full-range block with knees over toes.
25 minBeginner14 movesA bench or box, A wallBalance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.
10 minBeginner7 movesA wall, A bench or boxThe seniors plan is built on the Otago programme and adds a light ankle weight in weeks 3 to 6, once 10 slow knee extensions or side leg lifts feel easy.
A 12-week exercise plan for over-65s: strength and balance three times a week, short balance sessions and daily walks, based on falls-prevention trials.
3 training days40 minBeginner3 days a weekA weekly plan for women over 50: strength, bone-loading and balance on 3 days plus walking, built on UK osteoporosis consensus advice.
3 training days45 minBeginnerThe seated knee extension's page says: "Pause briefly near straight. With pain around the kneecap, stop at about halfway (the knee still bent about 45°) for the first weeks."
Keep the weight light or leave it off in that range (our suggestion), because cuff weights load the kneecap more than a machine there.
With pain on the outside of the hip, start with lying and standing holds and bridges, and leave side-lying leg raises out while it hurts at night: the trial that did best for this pain didn't use them. When they come back, lie on your good side with a pillow between your knees, keep the top leg level with your hip or slightly behind, keep the lift small, and stop if the bony point on the side of your hip gets sorer or your nights get worse.
Leave the ankle weight off until that pain has settled (our suggestion).
In 24 women with weak side hips, ankle weights of 3% and 5% of body weight mostly raised the side waist muscle (from 49% to 82% and 92% of its maximum), so the hip hitched more and the gluteus medius did less of the work. Studies that used weights chose 3 to 5% of body weight.
Follow your surgical or physiotherapy team's limits, and see our knee replacement, meniscus tear and ACL injury guides.
An ankle weight on a knee straightening is resisted work, and as our broken kneecap guide says: "Resisted straightening is added later, once your team agrees."
Always hold a support. If you've fallen and were hurt, fallen twice or more in a year, or couldn't get up, ask your GP about a falls service first, as our seniors workout advises.
Our suggestion: put the weights on sitting down, do standing moves holding a counter, and take them off before you walk about, as the Otago booklet does between its strength and balance moves.
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With numb feet from diabetes or another cause, choose low-impact options, wear well-fitting shoes, and check your feet for redness or blisters afterwards; with an open sore or ulcer, do no weight-bearing exercise until your foot team says so.
Our suggestion: a cuff shouldn't leave deep marks, pins and needles or numbness; loosen it or pad it.
The NHS says "It's not recommended to start a new vigorous activity in pregnancy, such as running." We found no study of ankle weights in pregnancy. Our suggestion: keep the weight light, hold a support for standing moves, and with pelvic girdle pain ask your midwife or a physiotherapist before side leg lifts.
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Speak to a GP first if you haven't exercised for some time, or if you have a medical condition or concerns. Get advice first, too, if you have a health problem, an injury or symptoms, have recently had a heart attack or an operation, or are pregnant or have recently given birth.
If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.
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If you get chest pain or pressure, feel faint or dizzy, are unusually breathless, or your heart races or beats irregularly during exercise, as our plans advise.
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For chest pain that comes on suddenly and doesn't go away, feels tight or like squeezing, spreads to your arms, neck, jaw, stomach or back, or comes with sweating, feeling sick, light-headedness or breathlessness; severe difficulty breathing; someone who faints while exercising; palpitations that don't go away, or come with chest pain, shortness of breath or feeling faint; or a headache that starts suddenly and is extremely painful, especially while lifting or straining, or comes with numbness or weakness, difficulty speaking or loss of vision. The NHS says a bleed on the brain may be more likely when lifting something heavy. Don't drive yourself to A&E.
Call NHS 111 (in the US, your doctor or an urgent care centre) if you're suddenly more short of breath than usual, or have chest pain with feeling sick or a heartbeat that races, skips or flutters.
Ask for an urgent GP appointment or get help from NHS 111 for a headache that's triggered or made worse by coughing, sneezing, bending down or exercising. In the US, contact your doctor or urgent care.
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Stop straight away if you feel any pain or become unwell, the NHS says, and contact 111 if your symptoms worry you or don't go away.
A dull ache in your muscles for a day or two after something new is normal. Joint pain that's sharp, gets worse during a set or lingers into the next day means switching to the easier option, and seeing a GP or physiotherapist if it carries on (our plans' rule). Our muscle soreness guide has more.
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Go to A&E (accident and emergency) if you've injured your knee and it has changed shape, it becomes very swollen very quickly, you felt a pop or snap, you can see bone sticking out, or it's bleeding heavily. Don't drive yourself: ask someone to take you, or call 999 if the pain means you can't move your leg to get there.
Get advice from NHS 111 now: you cannot move the knee or put any weight on it, or it is very painful, badly swollen or has changed shape.
You hurt your knee and cannot take 4 steps, or you are 55 or over and have injured it: get it checked the same day for a broken bone.
Get advice from NHS 111 now: the knee locks, gives way or clicks painfully. Painless clicking is normal.
See a GP: If knee pain doesn't improve within a few weeks.
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Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
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Same day (GP or NHS 111): back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly.
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Call 999 or go to A&E: leg pain with numbness around the genitals or bottom, new trouble starting or controlling peeing, not knowing when you need to poo or losing control of it, sciatica in both legs, or weakness or numbness in both legs that is severe or getting worse. These can be signs of cauda equina syndrome, which needs treating in hospital as soon as possible.
Pain, tingling or numbness spreading below the knee that isn't settling after a few weeks, is getting worse or stops your normal activities: see a GP.
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Swelling in one leg that you can't explain, or swelling that is severe, painful or came on suddenly.
Also call 999 for pain and swelling in one leg with breathlessness or chest pain: it can be a blood clot that has reached the lungs.
Same day (urgent GP appointment or NHS 111): throbbing pain in one leg (rarely both), usually the calf or thigh; swelling in one leg (rarely both); red, blue or darkened skin around the painful area, which may be harder to see on brown or black skin; or swollen veins. This can be a deep vein thrombosis (DVT). It is more likely after surgery, a hospital stay, 3 or more days in bed, a journey of over 4 hours, pregnancy or a recent birth, cancer, a previous clot, or oestrogen-containing contraception or HRT.
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Call 999 if someone has been knocked out and hasn't woken up, can't stay awake, has a fit, has new numbness or weakness, or has problems with their vision, speech, walking or balance. Get help from NHS 111 after a head injury if they're being sick, feel dizzy, or take medicine that thins the blood, as the NHS advises.
If you've fallen and were hurt, have fallen twice or more in a year, couldn't get up, or blacked out, ask your GP about a falls assessment. In some areas you can refer yourself to a falls service: ask at your GP surgery.
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A lump in the groin, or groin pain with coughing or straining (a possible hernia).
Get help from NHS 111 if you have a hernia (a lump in the groin or tummy) and pain in or around it, a bloated tummy, you feel sick or are being sick, you're vomiting blood or your vomit looks like coffee grounds, you're constipated, you have a high temperature or feel hot, cold or shivery, or you've suddenly become confused.
Call 999 or go to A&E now if you have a femoral hernia (a small lump at the top of the thigh, in the groin) and very bad tummy pain, you feel sick or are being sick, you cannot fart or poo, you have a high temperature or feel hot, cold or shivery, or you've suddenly become confused. It may be strangulated, which is an emergency. Don't drive yourself.
It adds little effort, changes how your legs swing, and has no trial behind it. Put them on for a strength session instead.
Start with no weight, then the lightest cuff you have.
Up for a count of 3, down for 5. If you have to swing, the weight is too heavy.
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To lift higher in side lifts and kickbacks. Keep the lift smaller and your trunk still, as our side-lying leg raise and glute kickback guides say.
A cuff that leaves deep marks or causes tingling needs loosening or padding.
Your feet stay on the floor, so the weight adds almost nothing. Use a vest or dumbbells.
Wait until your team allows resisted straightening.
We found no trial showing it. The extra effort is about 4 to 9%, and the one walking trial didn't improve chair rising or walking speed. Slow strength moves with the weight on, or squats and step-ups with dumbbells, load the legs far more (our reading).
In a lab study, 4 lb (about 1.8 kg) on each shin raised the peak knee-straightening moment by 21%, while lighter loads changed little, but we found no study or case report of harm. We still don't suggest it, because it adds little.
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A few per cent more while you walk, and no study of all-day wear in healthy adults.
Our sprint speed guide found that vests and limb weights slow you while you wear them, with no good evidence of a lasting benefit. Our jump guide: "Jumping with added weight gave no extra benefit, and loaded jumps did no better than unloaded ones. We found no trial of ankle weights."
They're a handy home load for hip and thigh strength at any age, and they're the load in the Otago falls-prevention programme.
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In women with weak side hips, heavier weights mostly made the hip hitch, and the knee arthritis trial added 0.5 kg at a time.
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For slow leg-strengthening moves, yes. They're the load in the Otago falls-prevention programme, which cut falls by about a third, and in home knee programmes that eased arthritis pain. They're much less useful for walking or running.
Start with the lightest you have, about 0.5 to 1 kg, once you can do 10 slow reps with no weight. Add about 0.5 kg at a time; most people never need more than about 4.5 kg (10 lb), the top of a well-known knee programme.
We don't suggest it. It adds only about 4 to 9% to the effort, changes how your legs swing and raises the forces at your knee a little, and we found no trial showing it tones your legs. Walk faster, uphill, or with a light weighted vest instead.
We found no study showing harm, and home knee programmes use them to ease arthritis pain. With a sore kneecap, work only in the bent-knee half of knee straightening, and stop for sharp pain, swelling, or a knee that locks or gives way.
Seated knee straightening, standing hamstring curls, side leg lifts standing at a wall or lying on your side, straight-leg raises and kickbacks on all fours. Our ankle weight leg workout puts them in order, with calf raises and balance work after the weights come off.
There's no evidence it helps: a few per cent more effort while you walk is all it adds. Put them on for a 15 to 20 minute strength session instead.
Yes, for strength moves done holding a counter: the Otago programme, which uses ankle cuff weights, cut falls by about a third in people over 65. Put them on sitting down, and take them off for balance practice and walking about.
They make side-lying leg raises and kickbacks harder once body weight is easy. But in women with weak side hips, heavier weights mostly made the hip hitch, and hip thrusts or step-ups with dumbbells load the glutes more.
2 to 3 sets of about 10, slowly (up for a count of 3, down for 5), 2 or 3 times a week, stopping with 2 or 3 reps to spare. Add reps first, then weight.
Both work for these moves. A band gets harder as it stretches and is easy to grade; an ankle weight gives a steady load through the lift and is easy to use sitting or lying down.
They do different jobs. Ankle weights load leg lifts, and a vest loads walking, stairs, squats and step-ups. Neither has been shown to build bone on its own.
Only when your surgical or physiotherapy team says resisted straightening can start. Until then, use the moves they give you, such as thigh tightening and straight-leg raises without weight.
Exercise education, not a personal prescription, and clinical review of these guides is pending. Check with a GP before starting hard training if you have a heart condition, chest pain, dizziness or breathlessness when active, and stop for sharp or increasing pain. Health disclaimer.
