Improving Ankle Mobility without Increasing Knee Pain
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.
So there you have it: different ankle mobilization strategies for different folks! For more information on mobility progressions like this, be sure to check out Assess and Correct: Breaking Barriers to Unlock Performance.
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