Ankle Mobility

written by Dr. Jackie Ruggiero DPT

How to Screen and Improve Ankle Mobility:

Hi guys! This week we talked about how to improve ankle mobility in a deep squat. Limitations in ankle mobility and the ability for the tibia to translate over the foot during a deep squat leads to instability up the kinetic chain. In order to perform a deep squat, there needs to be an average of 38.5° of ankle dorsiflexion1. A lack of anterior tibial translation will lead to compensations such as an unstable arch/foot collapse, the tendency for the knees to cave in, or excessive mediolateral movement of the lower extremity.

How to Screen Ankle Mobility Restrictions:

The mobility screen is called the half-kneeling dorsiflexion test2, which is a simple way to assess if you have an ankle mobility restriction. To perform the test, take off your shoes, measure 5 inches from the wall to your big toe, and push your knee forward attempting to touch your knee to the wall. It is important to keep your heel down on the ground during the test. 

A failed test consists of any of the following: (1) pain noted at any point during movement, (2) unable to touch your knee to the wall, (3) heel comes off the ground, (4) or knee collapses inward in relation to the foot. A ‘failed’ test is a result of a dorsiflexion mobility restriction, which could be from either soft tissue or joint mobility issues. 

I Failed the Screen… Now What Do I Do?:

There are two possible reasons for an ankle dorsiflexion mobility restriction: (1) soft tissue tightness or (2) joint mobility dysfunction. The soft tissues that can cause problems with ankle mobility are tightness of the gastrocnemius, soleus, or posterior tibialis muscles, capsular tightness, or fascial restriction. An ankle joint mobility restriction is often indicative of a “bony block”, where the bottom portion of the tibiofibular joint is coming in contact with the top portion of the talus bone of the foot. The bony block often creates a “pinching” pain at maximum dorsiflexion during a deep squat. 

There are 4 ways to improve ankle mobility problems: 

1. Mobilize the restricted joint

2. Foam roll soft tissues 

3. Stretch tight muscles 

4. Stabilize the ankle joint

Ankle Banded Mobilizations:

Restrictions in joint mobility is always the first thing to solve because they often cannot be fixed with general stretching and soft tissue mobilization. Banded joint mobilization with movement is a great way to loosen tight joint capsules. To perform an ankle banded joint mobilization, you first need to have a tight and moderately thick TheraBand and a stool/step. The band must be anchored on a slightly lower angle than your foot, with the band positioned just below the two ankle bones. The downward angle produces a posterior and inferior pull on the talus bone when translating your knee forward, thus increasing your dorsiflexion range of motion. To perform the mobilization with the band in place, push your knee over your toes as far as possible while keeping your heel on the supporting surface. Hold this position for 30 seconds and repeat 3 times. 

Foam Rolling:

To address soft tissue tightness and fascial restrictions, foam rolling is a great tool to use before and after a workout or lift. Position the foam roller under your calf, and slowly move back and forth to mobilize myofascial tightness. You can spend more time on certain areas where you feel more restriction and add in an active release with some ankle pumps while rolling. It is recommended to perform this exercise for 2-3 minutes on each area.

Stretching:

To address muscle tightness there are a few stretches you can perform for further soft tissue release. First is the standing calf stretch off a step. While standing on a step, drop your heel off with your forefoot remaining on the supporting surface, and try to touch your heel to the ground. Hold this position for 30 seconds and repeat 3 times. Next, you can perform a weightbearing stretch using a kettlebell or plate. Start in a deep squat with the kettlebell resting on your knee, then translate your knee forward while keeping your heel on the supporting surface. Hold this position for 10 second and repeat 10 times. 

Stabilizing:

After you have mobilized and stretched the tight tissue, it is important to stabilize your ankle in the new range. The best way to stabilize and strengthen the joint is through end-range isometric stretching to activate muscles in their weakest range and improve flexibility. To perform an end-range isometric stretch, get into a half-kneeling position, translate your knee as far forward as possible while still keeping your heel on the ground. Then push down into the ground as hard as you can and hold for 10 seconds. Release the static hold, then with your heel planted on the ground try to lift your forefoot as high as you can and hold for 10 seconds. Repeat this for 3 repetitions on each side. 

Ankle mobility is a very important part of performing a full squat. I hope I was able to provide you with some tools to achieve your maximum potential and better understand the complexity of the ankle joint when lifting. Happy squatting!

Keep on moving, 

Dr. Jacqueline Ruggiero, PT, DPT

Citations:

1. Kim SH, Kwon OY, Park KN, Jeon IC, Weon JH. Lower extremity strength and the range of motion in relation to squat depth. J Hum Kinet. 2015;45:59-69. Published 2015 Apr 7. doi:10.1515/hukin-2015-0007

2. Bennell KL, Talbot RC, Wajswelner H, Techovanich W, Kelly DH, Hall AJ. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Aust J Physiother. 1998;44(3):175-180. doi:10.1016/s0004-9514(14)60377-9