Ankle mobility plays an important role not only in sport but in day to day life as well. If you are a regular in the gym, ankle mobility will impact your lifting abilities in many lifts and functional movement patterns. For example, if you find that your heels tend to lift up or you have poor balance when trying to perform a deep squat, you may have limited ankle mobility!
How to test your ankle mobility?
One way to check your ankle mobility is the knee-to-wall test. Stand with your toes facing the wall, then try to touch your knee against the wall without your heel lifting. Measure the distance from the wall and repeat with the other foot.
Generally, there should be less than a 2cm difference between ankles. If there is more than a 2 cm difference, the foot that can't sit as far back has limited mobility.
How ankle mobility can impact leg stiffness
Lower extremity stiffness (“leg stiffness”) describes the resistance the joints and muscles in your lower body will have to movement when your foot contacts the ground during running. Think of your leg as a spring; the more tightly coiled spring will be stiffer, the more loosely coiled will be more deformable.
A stiffer leg is associated with less joint movement (less mobility) and increased loads to bones and cartilage whereas a less stiff leg is associated with increased joint motion/mobility and relies more heavily on active muscle contraction to dissipate forces when your foot hits the ground.
Leg stiffness may be one of many variables that contribute to running related injuries. A recent study of 92 runners {Goodwin:2019bk} identified 4 variables that may allow us to more easily predict leg stiffness with clinical measures versus technical laboratory analysis.
Less mobility in the ankle joint, hip and big toe joint along with increased BMI are associated with greater leg stiffness.
What is the clinical significance of this for our Edmonton runners? For runners suffering from knee pain or stress fractures, reducing leg stiffness by improving the mobility of hip, ankle and foot may reduce joint loading.
Conversely, in runners with soft tissue injuries such as Achilles or tibialis posterior tendinopathy, increasing leg stiffness with targeted strengthening exercises to improved stability and control of the joints of the lower extremity may be an important component of rehabilitation.
Why is Ankle Mobility Important?
During weight bearing the shin, tibia, must be able to move forward over the fixed ankle and foot. Without adequate ankle flexibility and shin moved over the foot to the inside placing the knee at risk of traumatic and overuse injuries.
Conversely, patients with adequate ankle mobility and better able to keep their knee over their foot during a step down test. Granted, many of these patients may also have hip weakness, but the importance of ankle mobility should not be overlooked. New research supports the influence of ankle mobility on knee mechanics and stability.
In the Journal of Orthopedic and Sports Physical Therapy authors examined 30 healthy participants as they underwent biomechanical testing in a laboratory (Rabin et al. 2016). The participants were tested on a step down test and then underwent testing of ankle mobility.
Authors then split the group in two based on either low or high degrees of mobility. As expected, the group with the least amount of ankle mobility demonstrated less knee stability and more knee movement than the group with better ankle mobility.
Athletes and patients are encouraged to assess and treat limited ankle mobility for improvement in knee stability.
Top 3 ways to improve your ankle mobility
Here are a couple ways you can work on improving your ankle mobility:
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Self-mobilization
If the front of your ankle felt tight when performing the knee-to-wall test, you can try mobilizing your ankle with the use of a belt or strap. First, tie a belt behind you at below ankle level, then tie the other end of the belt around your ankle below the prominent bones. Then, move forward until you feel tension from the belt in your ankle. Slowly bend your ankle by bringing your knee forward as far as you can without lifting your heel. Repeat this 10-30x for and hold for 2-3sec.
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Calf Stretches
If the back of your ankle or your calves felt tight when performing the knee-to-wall test, try stretching out your calves. While there are a variety of ways to do this, one way you can do this is by first getting into a push-up position. Then, place your opposite foot on top of the ankle you are trying to stretch and allow your bottom foot to lower into the floor. You should feel a stretch in the back of your leg. Hold this stretch for 30 seconds.
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Myofascial Release
3. If your foot and calves feel tight, rolling your feet on a firm 
ball could be just what you have been looking for. Sitting or standing, place a lacrosse ball (or similar) under the inner arch of your right foot. Lean forward to put weight on your right foot — enough to feel an intense pressure from the ball. Roll the ball toward the heel slowly, then along the outer arch and across the forefoot, massaging the entire sole. Continue for 30 to 60 seconds. When you reach a tense spot, try pointing and flexing your toes to intensify the massage. Repeat with your left foot.
After performing those stretches, try the knee-to-wall test or a deep squat again, it should feel much easier! If there is pain, or no change after these exercises or if you have any questions, then come in to see one of our great physiotherapists!
