Ankle Integrity: Building a Foundation from the Feet Up

Jul 15, 2019

Author: Peter Yu, SPT

When it comes to building any house it is essential to establish a stable and strong foundation. Similar to that, our ankles and feet are the foundations of our body when it comes to movement and motion. Because our feet are the first thing that comes in contact with the ground, proper motion at the ankle is essential in order to have the joints above, and ultimately the whole body, moving in an effective and efficient manner. Having a healthy ankle is crucial in allowing us to optimize our movements without any pain or discomfort! A “healthy” ankle is comprised of 3 major factors: mobility, balance, and strength. This article will provide you with ways to assess and improve your ankle performance. Start by taking the following tests.

TEST: Ankle Mobility 
(Half Kneeling Dorsiflexion Test)

To perform this test, kneel in front of a wall with about 4-5 inches of separation from your big toe to the wall. Then, push your knee forward as far as you can, trying to touch the wall with you knee.



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PASS/FAIL


PASS:

  • Knees are able touch the wall at a 5 inch distance
  • Heels don’t come off the ground
  • Knees remain in a straight line and don’t cave inwards or outwards to touch the wall
  • Hips don’t excessively sway to the side


    FAIL:
  • Knees fail to touch the wall at a 5 inch distance
  • Heel comes off of the ground
  • Knees caving inwards or outwards in order to touch the wall
  • Hips excessively sway to the side

     

     

    Failed? Click Here to Schedule an Appointment

TEST: Ankle Balance
Single Leg Stance

Stand on a stable surface with one leg without holding onto anything and maintain balance.



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PASS/FAIL


PASS:
Normative values for a healthy ankle will be able to hold balance for about 60 seconds.


FAIL:
Can't hold it for even close to 60 seconds?

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TEST: Ankle Strength
Single Leg Calf Raise

You should be able to perform 20 single leg calf raises in a full ROM while standing on a flat surface. Try not to hold onto anything while performing this test.



Click to see results

PASS/FAIL


PASS:
Able to complete 20 full ROM reps on one single leg


FAIL:


Improving Ankle Mobility, Balance, and Strength

If you have stiffness or a lack or range of motion at the ankle, it can mainly be attributed to 2 factors: joint restriction and/or muscle restriction. Joint restriction can be due to a narrowing of spacing between joints, tight joint capsules, or shortening of the ligaments. These factors can all cause a “block” or a “pinching feeling” when the talus is attempting to move over the foot. Muscle restrictions, on the other hand, happen when the muscle is unable to lengthen to the adequate length in order to get the joint in its required positions. Muscle restrictions can be caused due to muscles being too tight/stiff, too weak, or overactive.


Improving Joint Restrictions

Band distractions and self glides are one of the best ways you can improve joint mobility on your own. During ankle dorsiflexion, the talus bone moves posteriorly as the tibia and fibula moves anteriorly. So if you are feeling tightness or a pinching sensation at the front of the ankle, using a band distraction can help decrease the tight pinching feeling and allow you into more ROM. To perform a band distraction, wrap one end of the band on a stable surface and the other end of the band below the ankle malleolus around the talus bone. Make sure the band is tight and pulling backwards, push your knee forward stretching into dorsiflexion.


Improving Muscle Restrictions

If the problem of mobility lies within the muscle itself, two ways to address this problem is self myofascial release and soft tissue stretching.

Self Myofascial Release

Foam rolling the calf and tibialis anterior muscles are excellent ways to help with the restriction by altering the perception of tightness. Another technique is to use a lacrosse ball and apply pressure where you feel the “trigger points” or tight tender areas are.

Gatsroc/Soleus Myofascial Release with Lacrosse Ball

Tibialis Anterior Myogascial Release with Lacrosse Ball

Stretching

For many years, static stretching has always been the “go to” method of stretching for people. However, recent studies have shown that actively loading the muscle into a stretch can provide even greater benefits for increasing ROM. The best way to make a change is to put a demand on the body in the position of restriction. One of my favorite methods for stretching the gastric and increasing dorsiflexion ROM is by going into a kneeling position on one knee, then placing a weighted kettlebell or barbell on the knees, and pushing the knee forward. Hold for 20 seconds and actively push for 10-20 reps while keeping the heel planted on the ground as you did during the half kneel dorsiflexion test.


Improving Ankle Balance

Proprioception is the ability to understand and recognize the relative position of your body in space at all times. By training your proprioception and understanding where your body is, it can help you perform better by being able to react quickly to unpredictable movements. Working on balance is an excellent way to train your proprioception ability.

  •  

    Single Leg Stance

    working up to 60 seconds

  •  

    Single Leg Stance

    KettleBell Pass from Arm to Arm

  •  

    Mastered Those?

    Move onto an uneven surface such as a Bosu Balance Trainer and try those exercises again!


Improving Ankle Strength

With every step we take, our ankles are constantly absorbing stresses and external forces produced from the ground and other stimuli. Having strong ligaments and muscles around the ankles can help absorb these stresses and forces and more importantly prevent the joint from taking all of the impact independently.


You may be thinking “The ankle is such a small joint. Why go through all this trouble!?” Because the ankle is such a small joint, it is also the most neglected and most commonly injured part of the body. If your ankle isn’t working properly, your body will find other ways to compensate including causing other bones and muscles to overwork. This will eventually lead to other bodily dysfunctions and pathologies, so don’t ignore what seems to be a minor issue. Let’s get after it! Address the problem now and establish a strong base for your body to move more optimally, giving you a better experience throughout life.

Happy Training!

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