Limited ankle dorsiflexion is a common functional deficit I find when working with my clients. Whether the result of a prior fracture, ankle sprain or soft tissue restriction, this can lead to kinetic change problems for the hip and knee. A weight bearing lunge assessment can be done to detect a loss of dorsiflexion. Normal range of motion for closed chain dorsiflexion in healthy subjects is about 30-50 degrees or 10 cm of excursion.
In the next two columns, I will review two exercises to address a loss of ankle mobility. The anterior step-down is a functional activity that will load the joint, but proper form is essential to avoid compensatory motion.
Execution: Stand on a low box/step with the left leg on the box. The right right hand should be used to support the body and ensure stability/balance during the exercise. Now, slowly reach the right heel forward as far as possible while squatting down on the left side all the while keeping the left heel down. Pause at end range of motion and return to the start position. Perform 10 repetitions on each side, and repeat for 1-3 sets.
Note that performing the exercise with a mirror and/or tactile feedback is helpful to avoid pronation at the ankle and knee valgus. As the ankle joint reaches end range of motion, those are the most common compensations seen. Performing soft tissue mobilization and even static stretching prior to doing this exercise may allow for better results.
Application: This exercise will help restore ankle mobility using body weight loading, as well as training single limb stability. Proper ankle mobility is essential for proper squat and lunge patterns. With that said, the primary aim of the activity when using upper body support is maximizing closed chain dorsiflexion.
Limited ankle mobility and asymmetry may expose athletes to increased risk for injuries including ACL tears, MCL sprains, patella subluxation, ITB syndrome, patellofemoral pain, hip bursitis and other conditions. In addition, this exercise can be used to provide eccentric loading to the Achilles tendon which may be helpful in those with chronic tendinitis/tendinosis.
Precautions: Do not force range of motion if there is any pain in the ankle, knee or hip joint. If pain is present, the client should consult a MD or physical therapist for further evaluation.