All right, well welcome everyone to the next episode of the Redefining Physical Therapy Podcast.
I’m your host, Doctor Scott Gray and today we’re actually going to hop into more of a clinical take and some mistakes that I commonly see amongst other physios, manual therapists, orthopedic therapists, and sports therapists that are trying to improve ankle dorsiflexion
Ankle dorsiflexion, obviously, is very important to function, right?
Whether you’re an athlete or a 70-year-old grandma that needs to walk on the beach.
Not having adequate ankle dorsiflexion can cause, compensations of the substantial joint and mid-foot.
It can cause excessive motion at the knee but it also can even cause things such as back pain all the way up to the chain. It just depends on the task at hand but, nevertheless, ankle dorsiflexion is important.
So one thing that I commonly see is to say you’ve checked the joint mobility, the posterior glide, you’ve checked the joint play of the tib fib, you’ve worked the extensibility of the soft tissues but, you’re just not seeming to get that motion at the ankle joint whether it be in a squat pattern or when walking.
Here are a few things you may be missing, I guess not so much a squat pattern but more walking, why you’re not seeing that dorsiflexion.
And so keep in mind, when we walk, right, when I get the most ankle dorsiflexion in terminal stance in hip extension and so what do we know about the majority of our clients and patients, right?
A lot of times they lack hip extension you’re going to want to make sure that you work your way back up to the hip and realize, investigate do they have, adequate length of the hip flexors?
Do they have enough joint motion at the hip to go into functional hip extension?
Now the next thing you want to do is you want to check the rear foot. Can they supinate as well, right?
So, at that terminal stance, we’re also looking to get ankle dorsiflexion but also rear-foot inversion or supination and if you don’t typically have that, you might then see that foot stay into pronation as compensation, because they’re not getting the supination and they’re not going to get the ankle dorsiflexion.
In response, the subtalar joint is causing the midtarsal to unlock and what we know from the midtarsal joint, it has two axes, right.
So one of them allows dorsiflexion so, it gives you that false sense of dorsiflexion but, in reality, you really didn’t get it at the talocrural joint, you got it at the midtarsal joint.
In a nutshell, if you’re not getting the dorsiflexion that you want, I would, in regards to walking, I would go back and check the hip for hip extension, okay?
Then I would also check to make sure that that rear foot can invert those motions and that the hip is coupled with the rear foot and then into the ankle into dorsiflexion.
Give that a try and, if that helps with the patient, please comment below on the podcast and, or, if you have a question as well, chime in in the podcast, and my team and I will gladly answer it.