Improving Ankle Mobility without Increasing Knee Pain
Written on June 19, 2012 at 7:19 am, by Eric Cressey
It goes without saying that ankle mobility deficits are becoming more and more common these days. It may be because:
1. Modern footwear is atrocious, with elevated heels, high tops, and rigid sides
2. We carry our center of mass too far forward thanks to postural distortions that encompass anterior pelvic tilt and forward head posture (among other ramifications).
3. We never utilize extensive dorsiflexion in our daily lives, whether it’s in a full squat or high-speed running.
Of course, it’s usually a combination of all these factors. And, while we can try out minimalist sneakers to deal with problem #1 and tinker with our exercise program to work on problem #2, problem #3 is a bit more cumbersome, as many of these folks have anterior knee pain that is exacerbated with squatting, running, and ankle mobility exercises where the knee is driven in front of the toes, creating shear stress at the knee. In other words, this ankle mobility drill might be great for someone with healthy knees, but painful for someone with a history of knee pain.
Interestingly, if you consider the functional anatomy of the plantarflexors (calf muscles) while looking at this mobility exercise, you’re really only putting the soleus on stretch. The gastrocnemius, actually crosses both the knee and ankle, working as a knee flexor and plantarflexor. So, while this drill may be “more functional” because it occurs in an upright position, it actually shortens the muscle at the knee as it lengthens it at the ankle. And, the more the knee tracks forward, the more symptoms those with knee pain will get.
To that end, if we think back to the functional anatomy lesson we just had, we can get the gastrocnemius to fully lengthen by combining knee extension with plantarflexion – which puts us in a great position that minimizes shear stress at the knee. Problem solved.
After someone has utilized this second drill for a while and minimized their symptoms, it can be progressed to a knee-break ankle mobilization, which still creates a bit of shear stress, but not nearly as much as the first video I showed. Because dorsiflexion is maxed out before knee flexion can occur, it seems – at least anecdotally – to reduce the discomfort that some folks feel.
In the first video on ankle mobility–If someone drives dorsiflexion (med and Lat) with their pelvis and trunk–I will have the try to do it with a stable pelvis and trunk also–I really want them to feel the difference and be able to drive from the hips without moving the pelvis/trunk–it all has a role
Good stuff Eric. Do you think the deficits are do primarily to shortening of the gastrocnemius/soleus or more capsular in nature. Just curious to hear your input as know this could affect specifics of exercise selection.
Can it be beneficial to dynamically stretch ankle
prontation/supination in an effort to improve mobility for someone with a history of ankle sprains? The sprains would be asymptomatic by the way.
Given that the calcaneocuboid articulation has the same motion as the talocrual joint (df and abduction/of and addiction), how are isolating motion to the ankle?
I aggree that the ankle is a difficult joint to increase mobility.
It is important to note that studies on both the plantar flexors and hamstrings have shown that stretching although increasing ROM does not decrease passive resistive torque.
This interesting studie found that eccentric training both increased ROM and decreased the passive resistive torque of the plantar flexors.
This is to my knowledge the only study who have found this, and there was no decrease of passive torque of the achilles tendon. it would be interestng to se what this protocol would do for people with ankle mobility issues in terms of squatting-pattern etc. http://www.ncbi.nlm.nih.gov/pubmed/18091014
I have the full article but have not been able to find it online.
I really like you ideas on improving the ankle mobility!!! From my experience lots of coaches underestimates the importance of ankle mobility in many sports (e.g. involving running or weight training). Although I do not fully agree to your comments concerning knee pain. Obviously It is a small line but: tissue (as we know tendons like the patella are made of a sort of tissue) need to be stressed to get stronger -of course: if you overload it to much- it won’t heal – but it won’t heal if you do not stress it at all either.
however, as you always post so terrific videos I also want to share one with you – it also strongly involves the calf muscles and improves ankle mobility (don wonder about the language – it is from a very well know dutch physiotherapist) – here we go: http://www.youtube.com/watch?v=Yh6h9ojE2Hs
looking forward to watching other great videos of yours
What about the simple toes against wall, leaning in, calf stretch. Since the athlete is straight legged, it would seem it protects the knee. Seems like a pretty good stretch. Upsides? Downsides? Thanks, Eric, and thanks to the many knowledgeable commenters.
Cheers!
-Adam
If someone feels an impingement in the front of their ankle while doing these drills, should they just try to work through it and assume it will eventually go away? If not, what’s a good way to get rid of this as it seems to create blockage and forces the knee inwards.
No! You wouldn’t want to plow that. See a qualified manual therapist to get some work done on the ankle. Kinesiotaping and Mulligan glides can be a good option, too.
“elevated heels … and rigid sides” “center of mass too far forward,” “never utilize extensive dorsiflexion in our daily lives, whether it’s in a full squat”
shit… that sounds ALOT like a weightlifting shoe, like the pendlay do wins I just got…
What do you recommend Eric? I squat somewhat wide with stance about 1.5x shoulder width with low bar. should switch to high bar narrow stance or should i use converses or something to improve ankle mobility?
June 19th, 2012 at 4:25 pm
I just love the information I can take away from your blog posts each and every time I read them. Another great post!
June 19th, 2012 at 4:44 pm
As always a pertinent topic
In the first video on ankle mobility–If someone drives dorsiflexion (med and Lat) with their pelvis and trunk–I will have the try to do it with a stable pelvis and trunk also–I really want them to feel the difference and be able to drive from the hips without moving the pelvis/trunk–it all has a role
Thanks again
June 19th, 2012 at 5:54 pm
Good stuff Eric. Do you think the deficits are do primarily to shortening of the gastrocnemius/soleus or more capsular in nature. Just curious to hear your input as know this could affect specifics of exercise selection.
June 19th, 2012 at 5:55 pm
Really glad this has been covered in the strength and conditioning realms. A simple concept but often overlooked. Great work Eric, thanks mate
June 19th, 2012 at 6:05 pm
Hi Eric
Can it be beneficial to dynamically stretch ankle
prontation/supination in an effort to improve mobility for someone with a history of ankle sprains? The sprains would be asymptomatic by the way.
-Thanks
June 19th, 2012 at 7:42 pm
Given that the calcaneocuboid articulation has the same motion as the talocrual joint (df and abduction/of and addiction), how are isolating motion to the ankle?
June 19th, 2012 at 10:42 pm
Thanks Eric, this is great. I see the exact same thing all day long. Wish more trainers would read your stuff so they can become educated!
June 20th, 2012 at 1:09 am
I aggree that the ankle is a difficult joint to increase mobility.
It is important to note that studies on both the plantar flexors and hamstrings have shown that stretching although increasing ROM does not decrease passive resistive torque.
This interesting studie found that eccentric training both increased ROM and decreased the passive resistive torque of the plantar flexors.
This is to my knowledge the only study who have found this, and there was no decrease of passive torque of the achilles tendon. it would be interestng to se what this protocol would do for people with ankle mobility issues in terms of squatting-pattern etc. http://www.ncbi.nlm.nih.gov/pubmed/18091014
I have the full article but have not been able to find it online.
June 20th, 2012 at 1:30 am
what if we just do full range standing calf raisers or donkey calf raisers ?
June 20th, 2012 at 2:43 am
Hi Eric
I really like you ideas on improving the ankle mobility!!! From my experience lots of coaches underestimates the importance of ankle mobility in many sports (e.g. involving running or weight training). Although I do not fully agree to your comments concerning knee pain. Obviously It is a small line but: tissue (as we know tendons like the patella are made of a sort of tissue) need to be stressed to get stronger -of course: if you overload it to much- it won’t heal – but it won’t heal if you do not stress it at all either.
however, as you always post so terrific videos I also want to share one with you – it also strongly involves the calf muscles and improves ankle mobility (don wonder about the language – it is from a very well know dutch physiotherapist) – here we go:
http://www.youtube.com/watch?v=Yh6h9ojE2Hs
looking forward to watching other great videos of yours
all the best
philipp
June 20th, 2012 at 6:38 am
Thanks for that, Eric. The first exercise does seem to bother my knees sometimes. I’ll try the rocking ankle mobilization today!
June 20th, 2012 at 8:27 am
Is it possible to have too much ankle mobility? If so, do you recommend stopping these mobility exercises for a while?
June 21st, 2012 at 3:02 am
Hi Eric,
Another great informative post!
Everyday’s a school day!
Ian
June 23rd, 2012 at 11:56 am
What about the simple toes against wall, leaning in, calf stretch. Since the athlete is straight legged, it would seem it protects the knee. Seems like a pretty good stretch. Upsides? Downsides? Thanks, Eric, and thanks to the many knowledgeable commenters.
Cheers!
-Adam
June 23rd, 2012 at 2:47 pm
Adlock,
Certainly won’t hurt!
August 9th, 2012 at 1:51 am
Hi Eric,
i don’t understand the “AssessandCorrect.com: Rocking Ankle Mobilization” yet. isn’t it just a kind of calf raise exercise?
greets
flex
August 9th, 2012 at 8:21 pm
Flex,
It’s a stretch/mobilization, not a calf raise. The goal is to lengthen these tissues, not strengthen them.
November 3rd, 2012 at 10:07 pm
Hi Eric,
If someone feels an impingement in the front of their ankle while doing these drills, should they just try to work through it and assume it will eventually go away? If not, what’s a good way to get rid of this as it seems to create blockage and forces the knee inwards.
Thanks,
David
November 4th, 2012 at 8:58 am
David,
No! You wouldn’t want to plow that. See a qualified manual therapist to get some work done on the ankle. Kinesiotaping and Mulligan glides can be a good option, too.
June 27th, 2013 at 5:35 am
“elevated heels … and rigid sides” “center of mass too far forward,” “never utilize extensive dorsiflexion in our daily lives, whether it’s in a full squat”
shit… that sounds ALOT like a weightlifting shoe, like the pendlay do wins I just got…
What do you recommend Eric? I squat somewhat wide with stance about 1.5x shoulder width with low bar. should switch to high bar narrow stance or should i use converses or something to improve ankle mobility?