Why stiff ankles after an injury matter



Ankle fractures and ankle sprains can have a large impact on the way we move if not treated and rehabilitated properly. A key component of treating this injury is to restore range of dorsiflexion which is the motion of pulling the foot upwards.


What is dorsiflexion ?


Dorsiflexion of foot is the movement at the ankle joint (talocrural joint) where the foot upwards towards the shin and reducing the angle between the dorsum of the foot and the leg.


You should be able to achieve have at least 15 degrees of dorsiflexion to be within normal limits.


Heres a video showing the movements at the foot and ankle:





Why is dorsiflexion important ?


The ability to dorsiflex the ankle is important in allowing the following actions:


  • Stops us tripping over by allowing for the foot to clear the ground when walking.

  • Gives us enough range of motion to go downstairs and walk uphill.

  • Good dorsiflexion is essential in the ability to suddenly cut and change direction in sport.

  • Strong relationship with dynamic and static balance and as a result prevention of falling.

  • Ability to squat efficently which affects everything from getting out of a chair to weightlifting.

  • Jumping and landing techniques are also affected by stiff dorsiflexion.

Lack of Dorsiflexion is thought to contribute to other injuries


Reduced ankle dorsiflexion is also a risk factor for a myriad of other injuries.

These include:

  • Plantar fasciitis (Riddle et al., 2003)

  • Ankle sprains in the unaffected or affected limb.

  • Patellar tendon injury (Malliaris, Cook & Kent, 2006)

  • ACL injury (Fong et al., 2011)

  • Patello-femoral pain syndrome (Halabchi, Mazaheri & Seif-Barghi, 2013)


Reduced dorsiflexion is also associated with muscle strength at the ankle and foot.


Intrestingly limited range of motion with dorsiflexion is also associated with a reduction in the strength of the muscles that help pull the foot up:

Tibilais anterior


Also the muscles that bend the big toe and the smaller intrinsic muscles of the feet are often affected.


Ankle and foot muscle strength is important for both young and young at heart.


Easiest way to think about thios is look at the muscles that dorsiflex the foot and also the small muscles in the sole of your foot, the intrinsics.


The dorsiflexors:


Dorsiflexors of the ankle

When walking and running the dorsiflexors allow us to pull the front of the foot up towards the shin when we are swinging the leg through.

This is also an important quality when we need to change direction suddenly such as cutting left or right in football or court sports.


Intrinisc foot muscles.

These muscles also tend to be weaker in this with reduced ankle range of motion. These muscles are very important in helping push the body forwards when walking, providing a stable platform to stand on. They are as also integral in our single leg static and dynamic balance, thuis essential in the prevention of falling.


How do i know if my ankle dorsiflexion is stiff ?


The simplest test that we use in the clinic is the knee to wall test, its also very easy to do at home so you can keep track of youir progress.


Ideally we want the left and right ankle to be equal and greater than 8-9 cm.


See the video below on how to easily perform this at home



Top tips to get the ankle moving again:


Here are our top exercises to improve your dorsiflexion range.


1) SELF MOBISATION TECHNIQUES


2) Banded mobilisation


Calf raise over step



That's our top three easy exercises to self mobilize those stiff ankles.


Any issues with ankle pain or balance feel free to give us a call


Cheers

Dave

#anklesprain #anklefracture #anklemobility #sportsrehab

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