An ankle strengthening exercise device is disclosed. The device is intuitive and simple to use by a patient even without professional medical supervision since the device indicates a specific movement of a foot by pivoting an ankle of the patient. In particular, the device may have an extension member that can be positioned on a frame of the device. The foot of the patient may engage the device. An elastic member may be secured to the extension member and the foot. The direction of the elastic member indicates the direction the foot of the patient should move by pivoting his or her ankle to specifically work or strengthen and exercise a particular ankle muscle of the patient.