•  Poor ankle mobility sets us up for injury on the sports field.
•  Lack of ankle dorsiflexion limits landing, cutting and planting mechanics.
•  There is a large correlation between poor ankle mobility and ACL injury.
•  Manual release, self-myofascial release and ankle mobility work can be used to improve athletic performance.

We have had the opportunity to train many young athletes, many who are professional athletes. Unfortunately, most of them start training with us as part of their rehab post-injury. One of the worst injuries an athlete can endure is an anterior cruciate ligament (ACL) tear. In multi-directional sports, this seems to be one of the biggest career-ending injuries.

Disconcertingly, the occurrence of this injury amongst young football players is increasing, while even more worrying is the young age at which this serious injury seems to be prevalent. We highlight this because there is one common characteristic that these athletes all share: poor ankle mobility. We have yet to see an athlete returning after an ACL injury with a good range of motion in ankle dorsiflexion. It is one of the biggest indicators of knee injuries amongst field athletes, particularly in multi-directional sports as football, basketball, tennis, etc. These sports share movements such as landing, planting or cutting, the ankle, or any joint, absorbing force in an unstable position could easily take down an athlete when going into one of these movements.

Deficits with ankle dorsiflexion mobility can also dramatically impact functional movements such as deep squatting, lunging, and the lateral step down, all athletic movements. While it is possible to overcome the lack of ankle mobility in the gym, where most of the activities and lifts are performed in a controlled manner, the playing field is different.

To expand on the former: lifters who like to squat big but have poor ankle mobility have the option of taking up a wider stance where ankle dorsiflexion is not as important as the shins will be more vertical. Brad Longazel from EliteFTS does a great job explaining how a wider stance can be used for greater power output (1). But we digress. When you are sprinting at maximum speed and have to plant and cut at a 90-degree angle, poor ankle mobility will mean the knee will take the brunt of the force. ACL tears predominantly happen during this type of movement and often don't include any other player contact.

Ankle mobility is demonstrated by dorsiflex ability (bring the top of the foot, or dorsum, closer to the shin bone, or tibia) and plantar-flex (point the foot and toes) the foot. With the barefoot flat on the floor and the heel grounded, we should be able to move the knee forward over the toes, reducing the 90-degree angle between the tibia and foot by at least 20 degrees.

But runners and other athletes with poor ankle mobility can barely dorsiflex their foot/ankle, almost as if the shinbone and top of the foot are frozen into a right angle (2). When testing ankle dorsiflexion, we flex the ankle by bringing the same foot's knee towards a wall without the leading foot's heel leaving the floor. The distance between your toe and the wall will be your range of motion and can be measured in degrees. As a rule of thumb, 1cm equals to 3 degrees of ankle dorsiflexion. As a reference, anything under at least 15 degrees of ankle dorsiflexion in an athlete should be worrying. It should prompt the athlete to start working on some of the different methods described below to increase motion range.

Now there are several ways mobility in the ankle joint can be compromised. The first is as a result of injury. If the ankle has been sprained or broken, scar tissue or impingements can impair its ability to move freely, reducing range of motion. This is certainly true for most athletes playing multi-directional sports. Football, basketball, and tennis players are notorious for rolling their ankles regularly. If the ankle is not mobilized through manual intervention after injury, ankle sprains can lead to long-term mobility loss. Ankle mobility can also be reduced if the tissue in the back of the lower leg is tight. The structures that can become very short and tight, thereby decreasing mobility include the Achilles tendon, gastrocnemius (calf), soleus, peroneal, posterior and anterior tibialis. The insertion tendons of the malleolus are also important when considering the myofascial release of the ankle joint. It has been shown that lengthening the adductors, calves, and personal and activation of the ankle's invertors resulted in reduced knee valgus (3).

The first and most effective method of improving ankle range of motion in dorsiflexion is manual therapy; it's as simple as that. Many of the muscles and tendons described above are very small, and it is difficult to work on them using a massage ball or a foam roller, although these should be considered good alternatives. A massage stick is also very useful, particularly when working on the gastrocnemius and soleus muscles.

Exercises that we can use to increase range of motion in the ankle joint are various squats, particularly goblet squats, single-leg squats, the clock drill (video) and weighted eccentric calf raises.

It is important to include an ankle mobility protocol at the beginning of a workout consisting of planting, cutting or landing, particularly at maximum speeds, when ankle mobility has been compromised. This will ensure that athletes minimize the risk of injury and are ready for maximum performance, whether in the gym or on the field.

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(1) Brad Longazel, A Case For Wide Squats: 

http://www.elitefts.com/education/training/powerlifting/a-case-for-wide-squats

(2) Michael Dennison: What Kathy Bates Taught MeAbout Ankle Mobility:

http://deansomerset.com/what-kathy-bates-taught-me-about-ankle-mobility/#sthash.eje20CqC.dpuf

(3) Brent Brookbush: A More SophisticatedApproach to Correcting Knee Dysfunction:

http://deansomerset.com/sophisticated-approach-correcting-knee-dysfunction/

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