Ankle Dorsiflexion For Performance

I had a client the other day that wanted to improve her squat by working on her stiff ankle dorsiflexion. Initially, I wanted to offer some of the stuff I learned when I was an athlete and student teacher in pilates training, but I wanted to make sure I was current with my recommendations. I decided to double check the current science on ankle stiffness and write up an evidence-based plan for her. I want to share with you a bit of what I collected...

Anatomy And Mechanics of the Ankle Joint

Ankle Movement 

Ankle dorsiflexion is one of the various ways the ankle moves.  To be inclusive, the ankle is a multi-axis joint that moves through the following directions.  

• Plantar flexion (foot moves away from chest)

• Dorsiflexion (foot moves towards chest)

• Eversion (away from the midline)

• Inversion (towards the midline).  

The combination of these directions, allows the ankle to adapt to different surfaces and locomotion.  For the purpose of why I collected the research, I am going to focus on ankle dorsiflexion.  

Ankle dorsiflexion is important because it allows the human body to run, jump, walk, squat, and for swimmers - frog kick. Limited range of motion can make it tough to do deep squats, limit jumping height, and more.  The maximum range of motion, also called ‘range of motion’ (ROM) in science, is impacted by age, gender, daily activities, cultural habits, trauma, knee position, degenerative conditions, and maybe push force generation in women.  

Ankle dorsiflexion includes primarily two joints, the subtalar and tibiotalar. Dorsiflexor muscles entails the tibialis anterior, extensor hallucinating longus, extensor digitorum longus, and peroneus tertius.  The agonist (the prime mover) to dorsiflexion is the tibialis anterior.  The antagonist muscles (the prime inhibitor) to dorsiflexion includes the soleus and gastrocnemius.  

Conditions Associated with Limited Dorsiflexion

Tight plantar flexor muscles, like the gastrocnemius, are associated with limited dorsiflexion. For those unfamiliar with the gastrocnemius, it is the posterior part of the calf muscle and what makes that belly bump in the lower back leg; running above the knee to the ankle.  As mentioned earlier, daily activities, trauma, degenerative conditions (ex. rheumatoid arthritis), and even fibromyalgia can impact, as well as limit the ROM of dorsiflexion (DF).    

DF stiffness compensations may include the overemphasis of hip flexion, inhibited knee flexion, and feet rising from the floor during a squat.  In addition, lower back pain, SI joint pain, hammertoes, and the inability to do a deep squat is associated with limited dorsiflexion.

Limited dorsiflexion, like in the dorsiflexion lunge test, can predict higher risk for future injury in cricket and soccer.    

Measuring Limited Dorsiflexion  

Less than 9 cm  to 10 cm is considered restricted DF in the dorsiflexion lunge test.  And the angle of tibial-shaft-to-wall is restricted if it is less than 35 - 38 degrees.

Weight bearing measures are preferred for figuring out the programming of a stiff DF.  

Three Tips On Improving Your Ankle Dorsiflexion Mobility

With increasing dorsiflexion, there is a ton of work we can do on the Pilates apparatus, but for convenience here are some exercises you can do from home and with minimal props.   

Stretches

• Standing stretch with foot on floor and bent knee. If this is not enough, you can place forefoot on wall and do dynamic stretching or hold it for 10 seconds; longer if you need a better stretch. 

Half Knee Mobilization Stretch

Strengthening

Research has shown that improving ankle dorsiflexion ROM and strength in female subjects may be important for preventing injuries in deep squats. And it is why I am including two strength exercises here.

For beginners,  you may want to start with active dorsiflexion without resistance...

While sitting, place the bottom of the foot (all three points) on the floor. Flex from ankle so that just the forefoot leaves the floor. Then relax it. Repeat.  Make sure to keep the heel on the ground and to evenly lift the forefoot towards shin.  If you have hammertoes, the tendency will be to lift the extensor digitorum longus muscle as the primary muscle and not the tibialis anterior.  If this is the case or you are not sure, please see a movement-based practitioner in order to ensure you are doing it correctly.

Resisted DF With A Theraband

On Pilates equipment

Footwork - Prehensile

My oh my! Look at those prehensile feet you have there!  Retrieved from https://goo.gl/images/BsjB2p

From Nora St. John's Level 1 On The Reformer Teacher Training Manual.  (2008)

• In footwork on the reformer and other equipment, practicing prehensile (what I like to call monkey/birdie feet - like how the Gerp Mouse Lemur is standing on his branch in the above picture ) is a great movement exercise to actively practice dorsiflexion while squatting in supine position.  

• Use the maximum amount of spring you can use on a balanced body machine (from one red spring to 4 red springs or more). For classical machines, two to 4 springs. The resistance will not only depend on your strength but if you can keep your ROM in your ankle and the way the reformer is set up.  

• One cue I learned from Amy Taylor Alpers, from The Pilates Center, is to evenly wrap my foot around the bar so that both my heels and forefeet are actively reaching with the same amount of effort as I length my body away from home position and return back to home position.  

• The hardest part to remember is to keep reaching your heel under the bar as you return back to home position, especially if you lack ROM in your DF.  

• From experience, you will find that your glutes will turn on more as you are able to keep your full foot and ankle actively in full prehensile position.

Footwork - Dorsiflexion on the Cadillac

Image taken from Nora St. John's Trapreze Table for Teachers. (2008).  

• Using the push-through-bar (parakeet bar) on the Cadillac is another way to work on your dorsiflexion. For this exercise, please only use short springs. One short red to two red springs will do at the high position.  

• Lie supine on the table with head away from the bar.  

• Hook the top of the metatarsals of one foot over the parakeet bar. Depending on your length of your leg, the knee may be straight or bent.  If bending your leg is not enough, just move your hips slight away from the bar, towards to the open side.  

• Don't wear anything slippery on your feet during this exercise, including socks. If you need more cushion between the bar and the front of your foot, place a sticky pad between them by wrapping it around the parakeet bar.  

• Position the foot so that the bar covers the ‘tops of all 5 metatarsals’ and pull down with equal effort through all of the 5 metatarsals.

There are more exercises, but I am going to stop here. Feel free to play around with the repetitions, positions, and weights to find what works best for you. You can get creative too. Just be mindful of how you feel and are progressing, so that you can adjust accordingly.  

If you have more questions, please contact me. I offer privates training in San Francisco and over the phone or skype.  

References

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