 Brian turns his focus to ankle tightness in the first of a three-part series. This column offers two exercises to detect differences in the ankles.
See 'Related Resources' below for past Functionally Fits and other exercises and training tips.
In squatting and lunging the soleus is a major player as the
knee and ankle flex more and more. A tight soleus leads to increased pronation
often setting off an undesirable chain reaction with bad lower extremity
mechanics.
In this three-part series, I will address how to screen your
clients for limitations and review the exercises I use to facilitate normal
dorsiflexion range of motion in the closed chain to optimize squatting, lunging
and running mechanics.
The first step is assessing any differences or asymmetries
in ankle mobility. I prefer to assess this in the closed chain as that is where
you will see the dysfunction manifested throughout the kinetic chain. I use the
following method to assess passive mobility/range of motion:
Execution:
Half-kneeling ankle
dorsiflexion
Half kneel with the back knee directly under the trailing
hip and the front leg bent at 90 degrees (foot facing forward). Placing both
hands on a dowel and keeping the body upright, slowly lean forward allowing the
front knee and ankle to bend maximally while the front heel stays flat and the
knee tracks over the second toe. Be sure to keep the trunk upright.
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Once you cannot move further without compensation, measure
the distance obtained by dropping from a straight line down from the mid
patella to the floor and away from the toes. Repeat on the other side.
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To assess active or dynamic mobility, I prefer to use a
single-leg reaching activity. To better facilitate keeping the heel down, I
have the client reach with the foot as opposed to the upper extremity as
follows:
Standing lower
extremity anterior reach
Standing on the left leg (foot and heel flat),
slowly reach the right heel as far forward as you can keeping the left heel
down and knee tracking in line with the second toe. Once you obtain your
maximum reach, lightly touch the right heel down to the floor and return to the
start position.
Repeat this for three trials on each side and take the best
of the three trials. Repeat the same procedure on the other side.
Note:
These are screening tools designed to help you
observe asymmetry side-to-side. Tightness in the soleus or ankle joint complex
will dramatically affect closed chain kinematics and the forces imposed on the
knee and hip. Additionally, it will promote faulty neuromuscular squatting,
lunging, running and landing mechanics which thereby increase the risk of
traumatic and overuse injuries.
Ideally, you want to see clients achieve a minimum of 15-20
degrees of dorsiflexion to help ensure optimal movement. Most clients that are
able to achieve a full squat with good form will have closer to 25-30 degrees.
If the ankle joint is limited by scar tissue or joint
tightness related to an injury, the client may need to see a rehab specialist
for appropriate joint mobilization/manual therapy. However, in many cases you
can improve motion with appropriate self mobilization, stretching and
exercises.
In the next column, I will review some basic mobilization
and stretching exercises for unlocking the ankle.
Brian Schiff, PT, CSCS, is a licensed physical therapist,
respected author and fitness professional. Currently, he serves as the
supervisor at the Athletic Performance Center in Raleigh, NC. Brian presents
nationally at several professional conferences and seminars on injury
prevention, rehab and sport-specific training. For more cutting edge training
information, subscribe to his monthly Training & Sports Medicine Update at www.BrianSchiff.com.
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