Tulsa Spine and Rehab

Ankle dorsiflexion is a fancy term that essentially means moving your foot so that your toes get closer to your knee. (Ankle plantar flexion is essentially the opposite, where you point your toes downward and away from your knee.)

The Kinetic Chain

The kinetic chain is a philosophy in which the body has an alternating pattern of mobility and stability. Starting from the bottom up, the foot should be stable, the ankle should be mobile, the knee should be stable, and the hip should be mobile. If you cannot perform ankle dorsiflexion comfortably, that will be the culprit for other problems upstream. It could result in knee, hip, and low back problems, for example.

Think about what happens when we remain seated for extended periods. It’s easy for us to forget to pay attention to our ankles. Ankle dorsiflexion may eventually become limited. The body will have to compensate by increasing movement in an area that shouldn’t be moving, i.e., the low back.

In my last blog post, I talked about chasing the pain. That’s when someone is merely trying to treat the symptoms instead of looking deeper into the actual areas of dysfunction. Inadequate ankle dorsiflexion has disrupted the kinetic chain. In turn, the patient will have a doctor that’s completely zoned in on the area that’s experiencing pain. They’ll be looking into prescribing medications to manage the low back inflammation. A week or two later, the patient will be feeling much better.

Unfortunately, the problem is likely going to come back eventually. Why? Because the area of dysfunction was the ankle’s lack of dorsiflexion.

Altered Gait

Think about what’s taking place in your body through the simple act of walking. You strike your heel on the ground and there’s dorsiflexion throughout your ankle. There are frequent occasions where patient screening will indicate a limitation or tightness in this area of the body. As a result, their gait is clearly altered. This is a big deal, especially if the patient has ever gone through foot surgery.y

Any changes to the way you walk will result in compensation in other areas of the body. It’s typically going to have an effect on your hips or low back. We have to identify the areas of compensation and then reestablish proper motion throughout the ankle. Hopefully, in turn, we’ll be able to limit the possibility of problems further up the body.

Overloaded Achilles Tendon

Lack of dorsiflexion in the ankle will also potentially result in overloading of the achilles tendon. The achilles is the big tendon down by the heel that works itself into the gastrocnemius and soleus (two big muscles in the calf). Overloaded achilles tendon can result in inflammation and even tendonitis.

Improving Ankle Dorsiflexion

There are a few simple exercises you can do on your own to reestablish motion in the ankle. I’m a big fan of any method that patients can use to feel better on their own. (I’ve spoken about self-mobilization in past posts.)

Calf stretches involve getting into a 90/90 position (kneeling) with one knee down and one knee up. Work on bringing your knee over your toe while keeping your heel on the ground. Another common stretching exercise is where you put your leg on a curb (or any slightly elevated surface) and lean your knee forward, past your toes. You’ll feel a good stretch up your achilles and the back of your calf.

You can also get a golf club, foam roller, lacrosse ball, or anything to get on the tissue and break it up. Roll it around your upper and lower calf. (Of course, stay off of the achilles tendon by the heel.)

Stretching and manual therapy are both effective ways to improve flexion. The goal is to avoid injuries from occurring in the knee, hip, and low back. It’ll also end up improving your gait.

To learn more about ankle dorsiflexion and make sure that you don’t end up chasing the pain, contact us online or give us a call at (918) 743-3737.

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