Maximizing joint mobility is critical especially in our athletes who are pushing themselves as far as their bodies will let them. All of our joints must have a certain amount of mobility to have proper stability, and also to allow the joints above and below to work effectively. For any athlete who has to run, jump, swing, or pedal, it all starts with the foot and ankle.
Most of you can relate to this athlete: has 20+ degrees of dorsiflexion in a standing calf stretch position (knee straight). Problem is the athlete maximally pronates to get that. When taken to subtalar neutral, he or she loses 6-8 degrees easy. Now when asked to bend the knee 20 degrees, still maintaining neutral, they cannot do it without backing off another 10 degrees.
Just imagine how this athlete lands from a jump or attempts to make a cut. They must be maximally pronated to get the 20-30 degrees of DF needed for the activity. The result is landing with a lot of force on a flexed and internally rotated lower extremity, it’s no wonder we see so many ACL injuries.
Chronically speaking, poor ankle mobility can lead to a slew of issues with the remainder of the lower extremity and even up into the spine (I’m sure we could trace it even higher but that is beyond the scope of this article). You only need to look as far as the NBA. Patellar tendinitis is rampant because of years of taping ankles and taking away any hope of normal lower extremity mechanics. Take away dorsiflexion at the ankle but motion still has to come from somewhere. Last I knew they still all have 30-40 inch verticals. 99.9% of them have a history of multiple ankle sprains that certainly won’t help the mobility cause either.
Dynamic ankle mobility drills are meant to improve ROM, dorsiflexion in particular, simultaneously working on flexibility and/or strength depending on the drill. These exercises go beyond the mobilizations and stretching we all learned in school. Those things are still necessary but dynamic drills are the logical next step for a full recovery and to meet the demands of sport.
Ankle DF with Supination – a great ankle mobility exercise from Gray Cook and Lee Burton. Pressing down through the stick engages the core while maintaining a supinated position.
Tri-Stretch Mobility – keep the foot pointing straight ahead throughout, many athletes will gradually toe out as they go through the stretch. Be sure to do this with the knee straight and bent to shift the emphasis from gastroc to soleus.
Clock Drill – the athlete reaches for 12′ and 6′; 3′ and 9′; and 11′ and 5′ (standing on the L leg) and 1′ and 7′ (standing on the R leg). The knee is what drives the ankle so the athlete must bend the knee and reach as far as possible.
Squat Stretch – start by going down into a hamstring stretch, the athlete may bend the knees enough to get the hands just under the arches. Stretch briefly to relax the low back and hamstrings, then drop into the squat bringing the head and chest up. The goal is to break parallel keeping the feet pointing straight ahead, elbows between the knees to keep the ankle in neutral. Working the squat movement pattern is critical for sports requiring jumping and cutting.
Incorporating these drills into the athlete’s warm-up facilitates improved ankle mechanics and stability, while also improving mechanics up the chain. Make them see and feel their limitations as they go from pronation to supination. Increased tightness in the calf or the pain of anterior ankle impingement will indicate they’ve got work to do. I make it very clear that they will never be as fast or jump as high as they potentially could until the mechanics are improved. This usually grabs their attention. Younger athletes rarely give a second thought to prevention unless they can that there are performance benefits to be gained.
Joe Heiler PT, CSCS
Joe Heiler MSPT is the owner and content manager of SportsRehabExpert.com, a website dedicated to advancing the education of rehab and performance professionals. The site focuses on orthopedic and sports physical therapy topics through webinars, audio interviews, articles, manual therapy and exercise videos, and more.
Joe is also the owner of Elite Physical Therapy and Sports Performance in Traverse City, MI specializing in orthopedics and sports medicine, as well as athletic performance training. He is Graston Technique (GT) Certified as well as a GT Instructor, SFMA and FMS trained, and is passionate about a number of soft tissue and manual techniques including Trigger Point Dry Needling and manipulation.