Ankle Dorsiflexion: Test & Treat

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What do you think is the most important joint in the body? Low back? Pelvis? Shoulder or hip? While all of those are great answers and have merit, I will assume very few will mention the ankle joint. However, an argument can easily be made that this joint is the most important, especially when it comes to ankle dorsiflexion. We’ll get to the reasons why, but let’s first talk about anatomy.

Ankle Anatomy

The ankle joint (or talocrural joint) is formed by three bones. These bones are the tibia, fibula and the talus. If you feel the bony bump on the outside of your ankle, that’s part of the fibula. The bump on the inside is part of the tibia. The talus is a bone that sits right on top of the foot and connects to these other bones.

The Importance of Ankle Dorsiflexion

Lift your foot up and move it around. As you can see and feel, it can move in several different directions. If you point your toes like a ballerina, that is called ankle plantarflexion. If you pull your toes and foot towards your knee, that is ankle dorsiflexion.

Ankle dorsiflexion is vital for many activities. Here is the amount needed for various activities:

Walking: 10 degrees
Biking: 22 degrees
Running: 30 degrees
Squatting: 35-43 degrees

So let’s pretend you don’t have the proper range of motion in the ankle. What happens then? Well, that means other joints and tissues have to take unnecessary stress. Let’s take two examples: running and squatting.

If you don’t have enough ankle mobility for running, that means the Achilles tendon and plantar fascia are going to be under constant stress. Or, you can “cheat” dorsiflexion by running with your foot rotated outwards. While this gives you a bit more dorsiflexion, it creates overpronation. This overpronation can then lead to several issues including knee pain, hip pain and increased risk of ankle sprains.

Squatting requires even more dorsiflexion. And if it’s lacking, it creates more problems. If ankle dorsiflexion isn’t there during a squat, the body only has two ways to deal with it. One option is to lift the heels off the ground. This strategy places a large amount of stress on the knees and hips. The other option is to keep the heel on the ground and stay balanced by rounding the back and bringing the chest down. As you can imagine, this places a lot of stress on the low back. With either of these compensations, the stress is magnified anytime we add any external weight (like a barbell or toddler).

Hopefully, you realize how important proper ankle dorsiflexion can be and how it can lead to problems not only in the ankle but in the knee, hips and low back as well.

Testing and Treating Ankle Dorsiflexion

Hopefully, you read one of our recent blogs on testing and treating your hip flexors, so now it’s time to move down to the ankle.

For testing ankle dorsiflexion, all you need is a ruler and wall. Watch the video below for testing procedures.

If you’re lacking proper motion, perform the mobilizations several times per day. Re-test weekly as needed. Watch as your ankles become awesome.

So that’s it for ankle dorsiflexion, but let us know if there’s a muscle or joint you want us to cover in an upcoming blog.

Jeff Remsburg, DC, MS, Cert. MDT, DACRB

References:
J Hum Kinet. 2015 Mar 29; 45: 59–69.
J Phys Ther Sci. 2013 Aug; 25(8): 993–995.
J Orthop Sports Phys Ther. 1988;9(8):273-8.