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Issue Date: May 2011 Web Features, Posted On: 5/4/2011


Functionally Fit: Ankle Dorsiflexion Mobilization
Functionally Fit
Brian Schiff

In his last column, Brian demonstrated screening tools used to asses and identify ankle asymmetries. In this column, Brian demonstrates a basic series of exercises to begin mobilizing the soleus and addressing soft tissue/ankle tightness.

See 'Related Resources' below for past Functionally Fits and other exercises and training tips.

Note: Keep in mind the movements I revealed in the previous column were screening procedures (not exact tests per se) designed to provide a gross assessment and identify any asymmetries. On average, I find most people can extend the knee between three and six inches beyond the toe in the half kneeling assessment. Do not overanalyze the screen -- just look for obvious differences.

With that in mind, you can obtain a rough percentage of difference between sides. I would not worry about differences less than 10%. For example, I had a 9-year-old soccer player who scored two inches on one side (past ankle sprain) and thee inches on his other side. He could jog fine but limped with running. In his case, this measurement equated to an approximate 33% deficit in closed chain dorsiflexion which made a significant impact on his running mechanics.

After an injury, it is common to see a loss of ankle dorsiflexion. Keep in mind the ankle prefers to be in what is known as the "loose packed" position of plantarflexion when pain or swelling is present. Immobilization is another contributing factor to loss of motion. This may lead to joint stiffness as well as soft tissue restrictions in the fascia and gastroc/soleus complex.

However, people without injuries may also display tightness in the soleus. In today's column, I will review the first basic series of exercises I use to begin mobilizing the soleus and addressing soft tissue/ankle tightness.

Sequential Mobilization Exercises

Foam Rolling: Use the foam roller to release the soleus and resolve any soft tissue and fascial tightness in the gastroc/soleus complex. Perform 30 seconds of rolling with the leg in neutral, internal rotation and external rotation. For added pressure, you may place the other leg on top of the shin of the rolling leg.

 


Bent-Knee Step Stretch: Using a low box, place the ball of one foot on the box while the rear foot is flat on the ground. Next allow the knee of the stretch leg to bend and move forward beyond the foot as you lean forward into the stretch. Hold the stretch for 30 seconds and repeat two to three times.

Standing Knee Wall Touches: Stand facing the wall and far enough away so that the kneecap can just barely tap the wall (or fall just short) as the weight transfers forward toward the wall. Avoid ankle pronation and hip internal rotation/adduction while maintaining the desired patella tracking pattern over the second toe with the heel flat on the ground. Once this becomes easy, have the client inch back again until a stretch is felt at end range again. Perform one to two sets of 15 repetitions pausing for two to three seconds at the wall each time.

 

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.


Topic: Functionally Fit

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Comments:
Wednesday, May 04, 2011 1:04:24 PM by Anonymous
Have been using the standing bent knee w/bench stretch for years with much greater success.
Still don't see this commonly taught by ortho clinics & definitel not other trainers.
Thanks (former C-ATC, Orthopaedic Nurse & ACE Certified Personal trainer)
Wednesday, May 04, 2011 6:42:57 PM by Anonymous
Brian -
Great stuff!
BUT... Mobilizations are what we as PTs do to increase the mobility of a joint. What you have shown are stretches that everyone can and should do. When I saw the title of your article, I was intrigued, but when I read it, I was disappointed.
Let's keep our descriptions accurrate!
Jeff Harband, PT
Thursday, May 05, 2011 9:48:27 PM by Brian Schiff, PT, CSCS
Jeff,

Thanks for your comment and I agree that as PT's we do peripheral joint mobilizations to restore mobility. In this series, I use this term more loosely as a phrase for mobilizing the soft tissue/soleus if you will. I think of foam rolling and the stick as soft tissue mobilization so in regard to this column that is what I am trying to convey.


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