On this section of the series, we will now go through each of our significant joints, right from the bottom at the ankles all the way up to your neck. So be prepared to have no excuses as to why you are still restricted in them robot ankles. Luckily our first joint we look at is the ankle joint! nnnnn
The ankle joint is what's known as a synovial hinge joint. It is formed by the bones in the leg and feet. (tibia, fibula, talus, calcaneus) It allows dorsiflexion which is bringing the foot up towards the shin. It also allows plantar flexion which is where you point your feet down to go on your tiptoes.
Muscles/Tendons:
Gastrocnemius - This muscle aids in the movement of plantar-flexion of the foot, flexes the knee and one of the main driving forces allowing walking/running. High heeled shoes will cause this muscle to shorten, which in turn will affect postural integrity. The lateral head originates from the lateral condyle of the femur, whereas medial head originates from the medial condyle of the femur. Its insertion is found on the posterior surface of the calcaneus via the Achilles tendon. An excellent stretch for this muscle would be the heel drop calf stretch, where you stand on the edge of block or stairs and let gravity pull you down, I prefer 1 foot at a time as I can feel the stretch a lot better and hold the stretch for 60s.
Soleus - The soleus again helps with plantar-flexion of the foot. It helps to maintain an upright posture by continually contracting while you are standing, so you don’t fall forwards at the ankle joint. It has the same problem as the gastrocnemius, with muscles shortening due to elevated heels compromising postural integrity. This muscle has two origins, one being the posterior surface of the head and upper 1/3 of the shaft of the fibula and the middle 1/3 of the medial border of the tibia, tendinous arch between tibia and fibula. The insertion is the posterior surface of the calcaneus via the Achilles. A stretch for the soleus muscles would be to take a step forward, have your weight evenly distributed between feet and bend your knees, sinking to the ground, keeping heels on the floor and hold for 60s. Soleus is stretched with a flexed knee whereas gastrocnemius is stretched in a standing position.
Plantaris - The plantaris will plantar-flex the foot and flexes the knee. The same as the gastrocnemius as it mainly works alongside this muscle. Fun fact, this muscle is considered unimportant, and it’s estimated that it’s absent in 8-12% of the population. Its origin is from the inferior part of the lateral supracondylar ridge of the femur at a position slightly superior to the origin of the lateral head of gastrocnemius. The insertion is the posterior surface of the calcaneus via the Achilles tendon. You can stretch it the same way as the gastrocnemius or try the heel back calf stretch. Which is where you put one foot back while keeping that heel on the floor and drive yourself forward keeping a straight back leg and slightly bent front leg and hold for 60s.
Achilles Tendon - sometimes referred to as the calcaneal tendon. This is the thickest, biggest and strongest tendon in our body. It can receive a load of up to 3.9 times body weight during walking and 7.7 times body weight when running. The Achilles, like any other tendon, will attach muscle to bone, specifically the plantaris, gastrocnemius and the soleus to the calcaneus bone. When the calf muscles contract, the Achilles tendon will pull on the heel, allowing us to go on our toes when we walk, run or jump.
Testing: An easy way of testing range of motion at the ankle joint is the half-kneeling dorsiflexion test. This test requires nothing at all! Just you and a wall, that simple. Start barefoot kneeling with the tested foot in front. Have your foot 5 inches away from the wall and use this as your starting place. Then you will slowly shift your knee trying to touch the wall with your kneecap while keeping the heel flat on the floor and keeping a neutral spine. If you can reach the wall you good mobility and can move your foot further back a little to see how far you can go, just so you can keep track of progressions, stagnations or regressions. If you cannot reach the wall, then you are most definitely restricted. Try moving it a little closer to see where you can hit the wall with heels on the floor. Again now you can log this and make your progressions.
Strengthening: Strengthening the ankle joint you will need to continue to build your squats as it’s all interlinked like a chain. However, if we think about specific, isolated exercises to help strengthen this joint and help prevent injury, we should include exercise such as calf raises on a step - allowing us to go through the full range of motion. These can be performed by focusing on the isometri or eccentric phase; also we can do these single legged or both at the same time, overtime progressing and adding more resistance. Another exercise would be to have a light band just past midfoot and rotate your foot in and out. This will aid in strengthening the ligaments and supporting muscles of the calf and foot, assisting in injury prevention. You can include these in your warmups, rehab or prehab whichever suits you. However, I would stick to 3 sets with 15+reps.
Top 3 stretches:
Banded Heel Cord - Hook a band around the front of your ankle and create as much tension as you desire. Have your foot pointing straight and barefoot. Drive your knee forward while keeping knee stable and a neutral spine. I go through 10 slow, controlled repetitions with a 1-second hold at the stretch. This can be modified by placing a weight under your foot to further challenge your dorsiflexion. This can also be performed in the half kneeling position as we did with the test. I do it with the weight under my foot and in the half kneeling position.
Barbell on quads - For this position, you will want to take your feet in the position you will squat. Pick up a loaded barbell (not heavy) and place it, just above your kneecap and bottom of the quadriceps. You will sit in a squat position using the barbell to force your knees to move further and travel past the toes. The barbell will also act as, so you won't fall over. This should be performed barefoot with a neutral spine (mimicking a bottom squat position). I would hold this for 30-60 seconds and do three sets.
Classic Calf Stretch - This one is easy to do and requires a step, a ledge or something along those lines. Place one foot on the step with only the ball/frontal part on the step and the other foot will hang next to you. Let gravity pull you down, and you will feel a deep stretch in the calf muscles. Making sure you don't let your knee collapse inwards or outwards during the stretch. You can also bend and straighten the knee for a further/deeper stretch. I would hold this for 30-60 seconds for three sets.
Not a stretch but an added extra - I would add some kind of myofascial release, whether it be from a sports massage, foam roller, ball or pain pill. It will help reduce scar tissue, getting blood to the muscle, reduce tension, stiffness, pain and aid in the recovery of a muscle.
Exercise/movements effected: Ankle mobility can and will affect your lifts and potentially general life. If you have poor ankle mobility, then you will find it hard to reach a full depth squat, let alone an ass to grass squat. Don't fool yourself by doing a good morning squat or rounding the lumbar to reach depth; you're only compromising yourself and risking injury. This will not only affect your back squat but will torment your front squat, snatch, cleans, overhead squat and even jumping and running! This is due to the joint not being allowed to go through its full potential range of motion and not letting the knees past the toes.
Potential Injuries at this joint: There are many types and forms of injuries you could have, some being mild and other being severe. Sprains can range from a grade 1 (mild) to a grade 3 which would be a complete tear/rupture of a ligament. You could also fracture one of the bones included in the ankle joint. Again there are different types of fractures like a stable fracture where both broken ends still line up and aren't really out of place. Alternatively, on the other end of the scale, you could have a comminuted fracture where the bone breaks into 3 or more pieces. Your Achilles tendon could also rupture or tear completely which often you would hear it snapping. Most injuries would likely come with some degree of pain some being terrible, others just mild discomfort. Bruising and swelling would likely appear on the affected area. Your best option if receiving any of these injuries would be to head straight to the hospital. These injuries often occur running, jumping or landing awkwardly on the foot, and it was not being stable or strong enough to support you.
Dean.