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How to Screen Ankle Mobility

Welcome back to Squat University. Last week we talked about our feet. We discussed how creating a “tripod” foot ensures proper stability for our squat from the bottom up. If you recall the ‘Joint-By-Joint Concept’ lecture, the stable foot sets the foundation for our mobile ankle. This is our topic of discussion for today.

Despite the occasional ankle sprain, our ankle is naturally a fairly stable joint. It is prone to become stiff and immobile. For this reason, the role of the ankle is movement or mobility. When our ankle loses its ability to move, it affects the rest of the body. The foot below becomes unstable and therefore the natural arch of the foot collapses. The knee above also becomes unstable. When we squat, an unstable knee will often wobble and fall inwards. These are only the immediate affects of an immobile ankle. Eventually, a stiff ankle could negatively impact the rest of the body. Entire movement patterns can be thrown out of whack due to stiff ankles.

In order to perform a full depth squat, our bodies require a certain amount of ankle mobility. Unless you are performing a low-bar back squat, the knee must be able to move forward over our toes. This forward knee movement comes from the ankle and is called dorsiflexion. You can measure dorsiflexion by drawing a line with the shin and another line with the outside of the foot. The smaller or more closed the angle is, the more ankle dorsiflexion the athlete has. A restriction in this motion is where most athletes run into trouble.

Stiff ankles are often a culprit behind our squat problems. Do your feet point outwards when you squat even when you try your hardest to keep the toes forward? Can you remain upright in the bottom of your snatch or clean? Do your knees constantly fall inward when you perform a pistol squat? All of these movement problems can be related to poor ankle mobility.

How To Screen

Today I want to introduce a simple way to assess our ankles. This screen will tell us if we have full mobility or if our movement problems are a result of a problem somewhere else in the body.

This test is called the half-kneeling dorsiflexion test. This specific test has been used numerous times in research to assess ankle mobility (1). Physical Therapist Dr. Mike Reinold recommended this screen for its ability to provide reliable results without the need for a trained specialist (2).

Find a wall and kneel close to it with your shoes off. Use a tape measure and place your big toe 5 inches from the wall. From this position, push your knee forward attempting to touch the wall with your knee. Your heel must stay in contact with the ground.

What did you see?

Movement Checklist:

PASS FAIL
  Knee can touch the wall at 5 or more inch distance   Knee Unable to touch wall at 5 inch distance
  Heels remain firmly planted   Heels pull off from ground
  Knees Aligned with Feet   Knees collapsed inwards (Valgus collapse) in order to touch wall
  No Pain noted   Pain noted

Did you have checkmarks in the ‘pass’ column? If you could touch your knee to the wall at a distance of 5 inches while keeping your knee in line with your foot, you show adequate mobility in the ankle (1).

However if you had any checks in the ‘fail’ column for this screen, you have a dorsiflexion mobility restriction. This restriction could be either a soft tissue restriction or a joint mobility problem, or both! We will discuss in our next lecture how to decipher between a soft tissue issue or a joint mobility issue. In addition, we can talk about a few ways to improve ankle mobility.

With the ‘Joint-By-Joint Concept’ we can learn to assess the body in a different fashion than we have in the past. Always assess movement first. If you found a problem in your single or double leg squat, we can then use different tools (like the half-kneeling dorsiflexion screen) to find out the cause of the breakdown. By addressing ankle mobility issues, we can improve the overall quality of our movements.

Until next time,

Dr. Aaron Horschig, PT, DPT, CSCS, USAW

With

Dr. Kevin Sonthana, PT, DPT, CSCS

References

  1. Bennell K, Talbot R, Wajswelner H, Techovanich W, Kelly D. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Australian Journal of Physiotherapy. 1998; 44(3):175-180.
  2. Reinold M. (2013) Ankle mobility exercises to improve dorsiflexion. Retrieved from MikeReinold.com.
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