Strength and Conditioning Approach to Ankle Rehabilitation
In strength and conditioning, it’s common to have people from various backgrounds agree on a problem that is affecting a large scale of people. An example of this is how people lose their ability to perform a body weight squat while displaying a full range of motion as they age. Where we often find disagreement amongst coaches is the remedy or approach for fixing the dilemma. I recently found myself down a rabbit hole looking for a research-based answer to a common problem. The problem is how to improve ankle dorsi-flexion. Dorsi flexion is the backward bending and contracting of your hand or foot. Dorsiflexion of the ankle is executed by drawing your foot towards your shin.
Intervention through Dorsi-Flexion Stretches
The reason why I may want to improve someone’s ankle dorsi-flexion is because we have been able to determine that impaired dorsi-flexion will negatively affect someone’s ability to squat and lunge. Both movements are primary exercises and heavily programmed in the workouts we use at the training studio. The generally accepted range of dorsiflexion for the ankle is considered 0- 20 degrees. Not having the ability to demonstrate that much range of motion around one’s ankle not only will put limitations on your ability to perform certain exercises, but we are learning that you are also more susceptible to future injuries due to this restriction. The discussion in many strength and conditioning circles has been to what extent can you improve ankle mobility? This morphed from the discussion of barefoot training. That question is do you train in bare feet to develop the muscles of the feet or wear a corrective orthotic in your shoe? Regarding ankle mobility, the discussion became do you continually work on ankle mobility or use a heel lift in certain exercises.
Ankle Injuries
Common Issues and Ankle Pain
The sources of poor ankle mobility have been linked to most commonly past ankle sprains which created a tight ankle. Tight calves and flat feet have also proven to be linked to poor range of motion in the ankle. It is possible for hereditary reasons to be linked to poor dorsiflexion, but it is more likely linked to a past injury.
To add fuel to the fire, I have also started learning how to scrutinize a study. A good friend and professor by trade, recommended a book that is a great resource when trying to determine if a study provides a good analysis on what they are investigating. The book, Studying a Study & Testing a Test, by Richard Riegelamn and Benjamin Nelson, provides valuable insight on how to read evidence-based health research.
More from the Ankle Mobility Experts
Armed with search on my computer, I found a study that investigated a magnitude of interventions for improving the ankle dorsiflexion. The methods used included stretching, manual therapy, ultrasound therapy, ice, cryotherapy, electric stimulation, wobble boards, proprioceptive neuromuscular facilitation stretching, compression, ultraviolet therapy, continuous passive stretching, lower-level laser, magnets, and medication. All the above provided some type of measurable improvement. The degree of the deficit was not the same in every participant. Trying to identify people with the same lack of ankle of mobility is unrealistic. Another concern was trying to determine the source of why the person displayed the poor range of motion.
What they were able to determine was that static stretching held for 10- 15 seconds for 2-3 reps performed continuously over time proved to be the best approach. I have a couple of video examples below of stretching the calf while engaging the muscles of the feet and usage of SUPERBAND for joint distraction. Another method that is growing in popularity (by Dr. Andreo Spina of Functional Range Anatomy) is the practice of re-establishing and improving joint health by consistently working the joint through its range of motion.
https://www.instagram.com/p/Ci0h0kzPJOR/?utm_source=ig_web_copy_link
The J & D Fitness Approach
In closing, our approach at J & D Fitness Personal Training is to initially use a heel lift, if needed, along with the practice of stretching the calf. The goal being to eventually eliminate the heel lift. As with all cases the length of time and usage of the heel lift depends on the person and the severity of the past ankle sprain and/or lack of range.
I hope you found this helpful. If you did, please leave me a comment below, and I hope to see you at the studio.
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