How many times have you heard “I can't squat because my ankle mobility doesn't allow me to?”
Limited dorsiflexion adversely affects performance in the healthy population. It can be caused by several factors such as lack of extensibility in the tissues surrounding the joint or issues with arthrokinetics (arthrokinetics is the study of the movement of the surfaces that make up the joints). Luckily, there are lots of exercises and techniques that can help improve ankle dorsiflexion.
A recent review highlighted the best exercises for improving ankle mobility. Several studies about how to improve dorsiflexion in healthy population were considered and it was found that, to date, the best techniques are:
Static stretching
Eccentric strength training
Mobilisation
Static stretching
Although different types of stretching can be performed, the results obtained with static stretching have been the most lasting over time. This type of stretching consists in lengthening the plantar flexor muscles and maintaining the position for a specific period of time. The advantage is that no particular equipment is needed and the exercise can be performed without the assistance of a professional (here I'm talking about healthy subjects, therefore without chronic conditions or injuries). According to this review, the best results in terms of increased flexibility were obtained by practicing static stretching three times a week for a total weekly time of 5 minutes.
Fig. 1: push the heel down and hold the position for at least 15-30 seconds
Eccentric strength training
This type of training consists in the active stretching of the musculotendinous unit under load conditions to help increase the flexibility. This occurs thanks to the addition of sarcomeres in series that leads to structural adaptations of the musculotendinous unit. Significant results were obtained by performing the training daily for 6 weeks regardless of whether the knee was kept flexed or extended. The same training protocol was then performed for 4 weeks obtaining very similar improvements, demonstrating that it is possible to obtain results in a shorter period of time.
Fig. 2: slowly lower the heel (the descent phase should last at least 3 seconds)
Fig. 3: push the heel up
Massage
In this case the massage is intended as self-massage. To perform this type of massage it is possible to use tools such as foam rollers, tennis or golf balls, or rounded sticks. However, the studies carried out so far about this technique are not yet sufficient to demonstrate that it has long-term effects. Research suggests that 3 sets of 30 seconds massage with a rounded stick at level 7 on the pain scale (scale ranging from 0 to 10) results in significant improvement in ankle dorsiflexion; improvement comparable to the results obtained with passive stretching. It is also interesting to note that increasing the workload by performing protocols of 2 sets of 10 repetitions does not bring more benefits.
Since the massage has no negative consequences on athletic performance, it is recommended during the warm-up phase to increase ankle mobility.
Fig. 4: use the foam roller along the entire length of the calf. Avoid the areas behind knee and ankle
Mobilisation
As per the massage, also in this case I mean self-mobilisation, therefore not carried out by third parties. Unlike the other techniques, the latter has shown improvements in ankle mobility both in the healthy population and in the population that has suffered from injuries, why? Because mobilisation not only improves the dorsiflexion range of motion, it also increases the displacement of the talus posteriorly to the tibia and fibula.
Fig. 5: the highlighted area shows the talus
Better results were obtained by applying a rope while stretching the plantar flexor muscles to facilitate the posterior displacement of the talus, thereby increasing the range of motion of the ankle dorsiflexion .
Fig. 6: if you don't have a rope, you can replace it with an elastic band
The protocol involved healthy participants who performed ankle mobilisation 5 times a week for 3 weeks. However, it would not be correct to think that only mobilisation is responsible for these improvements. Indeed, other factors must be considered, such as the modulation of the central and peripheral nervous system.
Since limited ankle mobility negatively affects the performance of daily and sporting activities, increasing the risk of injury, it is always advisable to get in touch with a professional who will evaluate whether the subject can improve the ankle range of motion through mobility and muscle strengthening exercises.
If the mobility of your ankle is limited and prevents you from performing daily activities correctly or improving your athletic performance, get in touch with me for an initial evaluation and I will explain how I can help to solve your issue.
References
Aune, A. et al. (2019) ‘Acute and chronic effects of foam rolling vs eccentric exercise on ROM and force output of the plantar flexors.'
Crowe, M. A. et al. (2019) ‘restricted unilateral ankle dorsiflexion movement increases interlimb vertical force asymmetries in bilateral bodyweight squatting.’
De Souza, A. et al. (2019) ‘Acute effect of 2 self-myofascial release protocols on hip and ankle range of motion.’
Halperin, I. et al. (2014) ‘Roller massager improves range of motion of plantar flexor muscles without subsequent decreases in force parameters.’
Howe, L. P. et al. (2017) ‘The acute effects of ankle mobilisations on lower extremity joint kinematics.’
Howe, L. P. et al. (2019) ‘Ankle dorsiflexion range of motion is associated with kinematic but not kinetic variables related to bilateral drop-landing performance at various drop heights.’
Howe, L. P. et al. (2020) ‘Strategies to increase ankle dorsiflexion range of motion.’
Mahieu, N. N. et al. (2008) ‘Effect of eccentric training on the plantar flexor muscle-tendon tissue properties.’
Marqeus, A. P. (2009) ‘Effect of frequency of static stretching on flexibility, hamstring tightness and electromyographic activity.’
Madeiros, D. M. and Martini, T. F. (2018) ‘Chronic effect of different types of stretching on ankle dorsiflexion range of motion: systematic review and meta-analysis.’
Nakamura, M. et al. (2017) ‘Changes in passive properties of the gastrocnemius muscle-tendon unit during a 4-week routine static-stretching program.’
Smith, J. C. et al. (2019) ‘Effects of static stretching and foam rolling ankle dorsiflexion range of motion.’
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