Sometimes our Problems Reside Beyond our Pain: Ankle Mobility & Hip Dysfunction


Squatting is one of the primary exercises athletes perform to improve performance, yet when working with new athletes I tend to see one common dysfunction, an excessive forward lean with heels elevated. Although an excessive forward lean can be caused by lower-crossed syndrome (tight hip flexors and hamstrings and inhibited abdominals and glutes), I began to notice a recurring trend where their heels were also leaving the ground.

After doing some research, I stumbled across a few findings that suggest a lack of ankle mobility can be more to do with an excessive forward lean while squatting, specifically a lack of dorsiflexion due to a weak anterior tibialis (front of shin) and tight Gastrocnemius (calf). This lack of mobility in the ankle limits the hips ability to fully extend while walking and running which overtime causes an anterior tilt of the pelvis. This tilt forward and down (picture pouring a bowl of cereal onto the ground in front of you from your pelvis) leads to a shorted hipflexor and an over lengthened and taut hamstring.

Although similar to lower crossed syndrome, it is different since the hamstring is lengthened and taut rather than shortened and overactive. This means the tension is not a result of the hamstring outperforming the glutes, but rather the ankle causing restricted motion and an anterior tilt of the pelvis. Tightness is a sensation, not a symptom and we tend to mistake the sensation of taut muscles as tight muscles. Our taut hamstrings are a result of tight calfs pulling and lengthening the hamstrings. Knowing this, we should not treat our hamstrings as tight shortened muscles, but rather lengthened muscles.

For this reason, it must be treated differently by first rolling your foot over a golf ball for one minute, then rolling a lacrosse ball over your peroneals (side of your lower leg), both hemispheres of your Gastrocnemious (left and right sides of your calf), rolling on a lacrosse ball on the proximal end (directly under your butt cheak) of your hamstring to reduce the taut nature of the hip and stretching your hipflexors.

Upon completing these preparatory exercises, I would recommend glute bridges and performing anterior tibialis strengthening exercises such as forward leans and prone knee drives (lie on the floor in the prone and place a mini band around your feet, then drive your knee towards your hips being aware that your foot must stay lined up with your knee) to isolated the weak muscles. Followed by forefoot elevated overhead squats with a PVC pipe where the balls of your feet are elevated on small plates, as well as posterior chain squats on a TRX to integrate all the movements at once.

Of course, there is more you can do of this situation, but I am a firm believer in providing enough to get started so it is not overwhelming, then adding more as you go. Also, remember that every situation is unique and you are best off meeting with a professional to determine what is truly happening.

Here are the exercises laid out for you as a workout.

Inhibit

  1. Roll with a golf ball; plantar fascia (1 min)

  2. Roll with a lacrosse ball; lateral and medial gastrocnemius and proximal attachment of hamstrings (3 min)

  3. Foam roll peroneals (3 min)

  4. Stretch hip flexors (1 min)

Isolate

  1. Forward Leans (1 x 15)

  2. Glute Bridge (1 x 15)

  3. Prone mini band hip flexion and ankle dorsiflexion (1 x 15)

Integrate

  1. PVC forefoot elevated overhead squat (2 x 8)

  2. Posterior chain squat TRX squats (1 x 8)

Always improve,

Chris

P.s. Please read Part II regarding shoulder dysfunctions.

#PersonalTraining #CorrectiveExercise #ExerciseTherapy #Mobility #HipPain #AnkleMobility

© 2020 by Christopher Johnson, Ed.D. No information on this site is to be taken as medical advice. Newton, Ma 02460