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
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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.
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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.
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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.
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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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