Become a Better Mover- Part One: Ankle Dorsiflexion

In our “Become a Better Mover” series we will be going through different areas of the body to identify movement dysfunctions and restrictions and how to fix them. For the first edition of our “become a better mover” series, we will be starting from the ground up. We will be going over ankle dorsiflexion, why it’s important, and what you can do to improve it.  All the screens, tests, and exercises come from our movement classes at Precision Movement and Therapies which we run virtually over zoom. If you wish to know more about our movement classes email us or book a class online. You’re welcome to try the first 2 weeks of classes as a free trial to see if the class works for you!

What is ankle dorsiflexion?  

Ankle dorsiflexion refers to the motion of bending your ankle joint to bring your foot closer to your shin. In activities such as walking, squatting, lunging, and running, it refers to the ability of the shin to move forward in relation to a fixed foot. It is important for the ankle to have good mobility into dorsiflexion to position the foot, knee, and hip for optimal force production and load distribution to perform your best and avoid injury.

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Limited ankle dorsiflexion

Limited ankle dorsiflexion can increase ground reaction forces through our joints when walking, running, or landing from a jump. This can also have effects on other movements such as the squat. If the ability of the shin to move forward on the foot is limited this results in a more vertical shin position at the bottom of the squat which forces the hips to shift back which then limits the ability to maintain an upright torso, placing additional demands on the lower back to complete the movement. You can see the difference in the pictures below.

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Dorsiflexion can be limited for many reasons two of the biggest factors being tightness in the calf muscles and stiffness in the joint itself. Our calf muscles attach to the back of our heel bone and produce the opposite movement from dorsiflexion at the ankle, plantar flexion (pointing your toes down), so tightness in these muscles can limit our ability to dorsiflex. Joint stiffness can result from lack of movement, so forcing the joint into movements that it is limited in can help to restore that mobility. Now that we know the importance of this movement we will go through ways to screen and measure ankle dorsiflexion as well as some exercises to help improve it.

Take- Home Message:

• Ankle dorsiflexion refers to the ability to move our toes/foot towards our shin or the ability of the shin to move forward on a fixed foot
• Limited ankle dorsiflexion can increase stress on our joints and can make movements more challenging
• Tight calf muscles and joint stiffness can limit ankle dorsiflexion

Measuring Ankle Dorsiflexion 

Inline lunge screen

The inline lunge is a simple screen to check to see if you have an adequate amount of dorsi flexion. To perform this test follow these steps:

• Line up your feet heel to toe, you will be testing the ankle that is behind the other foot -bend both knees making sure to keep the back heel on the ground
• Try to line up your back knee with medial malleolus (big ankle bone on the inside of your leg) of the front foot
• This is a general screen, you either pass or fail, if you are unable to get your knee lined up to the ankle bone, this means that you have some work to do on your ankle mobility
• You may feel a tightness in your calf or pinching at the front of the joint, taking note of what is limiting your movement as this can give you clues on what to focus on when trying to increase ankle dorsiflexion

Check both sides to see if there is a difference, if you notice a large difference side to side you  will want to measure your dorsiflexion using the knee to wall test.

Knee to Wall

For this test you are going to need a ruler and a wall. To set up for this test place the ruler on  the ground against to the wall:

• Start with your big toe about 1 inch away from the wall and drive your knee forward until it touches the wall while keeping your heel on the ground
• If successful, move your foot back and try again until you are no longer able to reach your knee to the wall and record the distance from your big toe to the wall
• Test the other side, you should be able to complete the test with your big toe 3-4 inches away to wall and measurements should be similar (within 1/4”) for both ankles
• This test is good if you want to track your progress over time to see if you are making improvements

How to improve ankle dorsiflexion

Calf Tissue Mobilization

If you felt some tightness in your calf muscles during the tests you may find benefit from mobilizing the tissues in this area as these muscles can limit dorsiflexion. To work on these tissues  you can use a lacrosse ball or foam roller and follow these steps:

• Place the ball or the roller underneath your calf and let the weight of your leg push the ball/roller into the tissues
• These muscles may be sensitive at first, go gently and over time once your body gets used to the sensations it will be easier to apply more pressure.
• Start rolling the ball/roller with long, slow rolls over all areas of the calf 
• if you feel any tight or sore spots you can stop the ball in the spot and apply pressure until you feel a release
• You can also try rolling the ball/roller with more pressure while using shorter passes in all directions over an area until you feel it start to get better
• Or you can apply pressure to an area and move your foot around to slide the tissues underneath the ball/roller which can also help to release them

If your ankles are really tight you won’t fix the problem with rolling alone and for sure not in one session, to avoid overworking the areas spend no more than 2 minutes on each leg.

Ankle PAILs RAILs and CARs

For sake of simplicity, we will not dive into the definitions of PAILs and RAILs and CARs, however, the execution of these exercises is simpler than the terminology used to describe them.  To execute the PAILs and RAILs contraction you will start by stretching the ankle joint to its end range and then contract the muscles that produce plantar flexion and dorsiflexion from this position. By increasing the strength of these muscles in the end range position, we can improve control into these ranges and increase range of motion.

PAILs and RAILs:

• Start off in a lunge/half-kneeling position with one knee on the ground 
• Drive your front knee over your toes while keeping your heel on the ground, you will feel a stretch your calf at this point, if you want to increase the stretch you can place your hands or your torso over your knee.
• Hold this stretch for 1-2 minutes
• Begin your PAILs contraction by driving your toes/foot into the ground lightly at first, gradually increasing the contraction over a period of 10-15 seconds until you are pushing into the ground as hard as you can.
• Quickly switch to trying to bring your toes/foot up off the ground into dorsiflexion by contracting the muscles on the front of your shin, squeezing them as hard as you can for 10-15s.
• After you’ve completed both contractions try and push further into the stretch (more often than not you can) and repeat 2-3 times.

After opening up your ankle with PAILs and RAILs contractions you will want to follow that up  with an exercise to lock in the new mobility you created. A good exercise for accomplishing  this are controlled articular rotations or CARs. 

CARs:

• Start either seated on the ground or in a chair, from here you will want to grab your     shin with your hands to prevent any motion from above the ankle joint
• Point your toes down as far as you can go and then start making a big circle with your  ankle in a clockwise/counterclockwise direction
• Make the circles as big as you possibly can while controlling the movement, if some areas feel jerky or hard to control, slow down and explore the limits of the motion that you can control, do not rush through the movement
• Repeat 5 times then switch directions for both ankles.

Knees over Toes lunge

This exercise is great for improving ankle dorsiflexion in a functional way as it trains the ability of the shin to move forward over a fixed foot like it does with many of our everyday movements.

• Set up in a split/lunge stance, with the option to have the front foot elevated on a stool if needed
• Lunge forward, driving your knees over your toes as far as you can and then stand back up to the starting position.
• If you want you can also place a band from behind over the ankle joint to help mobilize  the ankle even further as you complete this exercise.
• Try performing 8-10 repetitions for 2-3 sets on each foot

Squat sit

Similar to the knees over toes squat this exercise reinforces the ability of the shin to move forward over a fixed foot. 

• Start with your hips shoulder-width apart and squat down as far as you’re able -shift your weight to the side and lean forward into one of your knees, driving your knees over your toes, forcing your shin over your foot.
• Hold this position for 1-2 seconds then switch sides
• Repeat 8-10 times per side for 2-3 sets
• You can add weight to this exercise to help increase the stretch

If ankle dorsiflexion is something you have struggled with, give these exercises a try and be sure to use the inline lunge and knee to wall test to see if you are making progress. Be sure to follow our “Become a Better Mover” series for more ways to screen, test, and improve movement for different areas of the body. If you want to learn more about how to troubleshoot and improve flexibility, mobility, strength and movement feel free to try our movement class at Precision, try it out for 2 weeks to see if the class works for you, you can book online using the link below!

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Interested in learning how to do other movement properly? Check out our blog post on the hip hinge squat and split squats!