Fifty-eight patients with hemophilic ankle arthropathy were randomized to self-myofascial release with a foam roller (n=29) or no intervention (n=29). The primary outcome was safety (frequency of ankle hemarthrosis via weekly follow-up). Secondary outcomes were pain (VAS), ankle ROM (goniometer), functional capacity (2-Minute Walk Test), and muscle strength (hand-held dynamometer). Outcomes were measured at baseline, 8 weeks (end of intervention), and ~10 weeks (follow-up). Overall, the results showed zero hemarthroses during the intervention in the myofascial-release group and significant time*group effects favoring the intervention for dorsiflexion, functional capacity, and gastrocnemius strength. In short, a brief daily foam-rolling program appeared safe and produced clinically relevant gains in ankle dorsiflexion, walking capacity, and calf strength.