Post: #1

Due to surgery in the past, my ankle mobility is horrid. The dorsiflexion in my ankle is embarrassing and is now effecting my squats along with a majority of my other athletic endeavors.

Does anyone have a good method to increase dorsiflexion in the ankles? Possibly a quick ankle mobility workout I could do in the mornings...

I've tried a few things on Youtube and have had no success.

Post: #2

The best ankle mobilization drill in my experience is to just put your foot up against some stairs (heel on floor, midfoot on stairs) and lean in and hold. Make sure to wear shoes while doing it.

However if that doesn't work there are three more things you can do

1. Change up your footwear, if simply standing in your shoes puts you in plantarflexion you are hindering your mobility a great deal. Try some "minimalist" or "barefoot" shoes. The New Balance Minimus is a good option I've heard.

2. The Strassburg Sock, look it up, I've heard some people have had success with it.

3. Strengthen your Tibialis Anterior (shins). Some gyms have machines for "reverse calf raises". Chances are yours doesn't so you might have the improvise a bit. Just try to replicate the motion for high reps.

Post: #3

(08-10-2014 06:38 PM)thedavidgt Wrote:  The best ankle mobilization drill in my experience is to just put your foot up against some stairs (heel on floor, midfoot on stairs) and lean in and hold. Make sure to wear shoes while doing it.

However if that doesn't work there are three more things you can do

1. Change up your footwear, if simply standing in your shoes puts you in plantarflexion you are hindering your mobility a great deal. Try some "minimalist" or "barefoot" shoes. The New Balance Minimus is a good option I've heard.

2. The Strassburg Sock, look it up, I've heard some people have had success with it.

3. Strengthen your Tibialis Anterior (shins). Some gyms have machines for "reverse calf raises". Chances are yours doesn't so you might have the improvise a bit. Just try to replicate the motion for high reps.

The calf stretch isn't doing it for me. I have been thinking of trying out reverse calf raises. I have read about the benefits of doing them daily and plan on incorporating them into my warm up before each workout.

Post: #4

Edited - poorly thought out originally.

Okay, swimming is good for general ankle (and, importantly, hip) mobility but it doesn't directly help improve ankle dorsiflexion.

http://www.mikereinold.com/2013/03/ankle...exion.html

That guy seems like he has a clue.

You might try to figure out if you have any severe muscle imbalances in your lower leg. I had such a bad imbalance in my left lower leg that I couldn't run more than a half mile for quite awhile. The extension muscles would overpower the flexion muscles and I wouldn't be able get into dorsiflexion at all. That was a result of atrophy after surgery.

Post: #5

I had to regain range of motion after paralysis, and using a wedge on the floor while stretching works really well. But the best way that I discovered was to sit on the floor/lie on your bed, doesn't really matter, and put a belt around the ball of your foot. Then with both hands pulling with equal tension, pull up on your foot so that it mimics the "reverse calf raise" described above. You can really pull on the ankle and it creates a solid stretch.

Post: #6

(08-10-2014 07:54 PM)weambulance Wrote:  Just off the top of my head, try swimming. Freestyle and back stroke. It might take awhile but the low impact kicking motion should really loosen stuff up in your ankle.

I'm going to start swimming myself to increase my shoulder mobility.

Definitely do NOT do this. When you swim your foot is extended to the max ,this will only decrease your dorsiflexion. It will "loosen" your ankle, but in the opposite direction of what MasculineProfiles needs.

The amount of time I have spent fixing postural problems caused by competitive swimming is ridiculous. Overall not a great activity/sport for general athleticism.

Post: #7

(08-10-2014 08:23 PM)thedavidgt Wrote:  

(08-10-2014 07:54 PM)weambulance Wrote:  Just off the top of my head, try swimming. Freestyle and back stroke. It might take awhile but the low impact kicking motion should really loosen stuff up in your ankle.

I'm going to start swimming myself to increase my shoulder mobility.

Definitely do NOT do this. When you swim your foot is extended to the max ,this will only decrease your dorsiflexion. It will "loosen" your ankle, but in the opposite direction of what MasculineProfiles needs.

The amount of time I have spent fixing postural problems caused by competitive swimming is ridiculous. Overall not a great activity/sport for general athleticism.

You're absolutely right on the first point, which is why after thinking about it for a minute I went back and changed my advice. I had some wires crossed in my thought process. Be that as it may, breast stroke is good for maintaining ankle dorsiflexion.

As to the second... I'm not talking about competitive swimming. I'm talking about using swimming as an accessory exercise to rehab a joint. I know swimmers can get crazy problems, and I knew a number of them who had neverending ankle problems when they tried running after years of swimming. I'm not talking about four hours a day in the pool, I'm talking about doing 500 meters here and there.

Post: #8

Squat down ATG, grab onto something to support your balance if needed.

Lean your weight on one side and push down & forward on your knee in the direction over your toes. Push gently and ease into more ankle dorsiflexion. Wiggle a little bit from side to side, don't stay static. Stay on one side for at least a minute, up to several, then switch side.

Do the same thing with the Cossack stretch.

Changing your footwear to something more barefoot-like is an excellent suggestion too.

Post: #9

I wonder if freestyle swimming might also help - ankle flexibility is important for the kick.

Post: #10

I have this same issue.
Gaining mobility in the ankle is more than just static stretching the calf muscle.

One of the big things that I know I need to work on is the achilles tendon. If you stand on a step with your legs straight then you are stretching the calf. If you bend your knee and ankle you will feel the stretch in your achilles tendon and ankle.

There are videos of these probably, but I'll try and explain them as I'm not able to go and look for them right now. I got them from mobilitywod and I think they are in his book too.

1) Roll the achilles tendon.
-Get a regular olympic bar and throw some 25s on there and put in on the ground. Sit on the ground and put the back of your ankle on the bar (it will be uncomfortable) and roll it back and forth and move your ankle back and forth. Those two things serve two purposes. One rolls the tendon in the static position and the other lengthens and shortens the tendon over a point of pressure. Test your mobility before you do this and then test it after. There will be a difference.

2) Lacrosse ball on the ankle.
-This one will be difficult to explain. Kstar does this be just putting the lax ball on various points on the ankle and then smacking it. Sounds dumb, I know. Breaks up the tissue or something.

3) Band stretch
-Again, sort of difficult to explain. Choke a band, if you have access to one, around a rack and loop the free end around the top/front of your ankle. Walk away from the choked band to get pressure on the joint. Whatever physiology he explains it by, it put the ankle in the optimal position or whatever. You can just stand on the ground and lean forward or bend the knee/ankle and move it around. Or you can put a plate or something and prop your forefoot up and stretch that way.

Do these things and then do active range of motion/ mobility work.

Hope this helps, sorry if the descriptions suck. Try and find the mobilitywod videos or look at the supple leopard book.

Post: #11

(08-10-2014 09:23 PM)Doctor Wrote:  I have this same issue.
Gaining mobility in the ankle is more than just static stretching the calf muscle.

One of the big things that I know I need to work on is the achilles tendon. If you stand on a step with your legs straight then you are stretching the calf. If you bend your knee and ankle you will feel the stretch in your achilles tendon and ankle.

There are videos of these probably, but I'll try and explain them as I'm not able to go and look for them right now. I got them from mobilitywod and I think they are in his book too.

1) Roll the achilles tendon.
-Get a regular olympic bar and throw some 25s on there and put in on the ground. Sit on the ground and put the back of your ankle on the bar (it will be uncomfortable) and roll it back and forth and move your ankle back and forth. Those two things serve two purposes. One rolls the tendon in the static position and the other lengthens and shortens the tendon over a point of pressure. Test your mobility before you do this and then test it after. There will be a difference.

2) Lacrosse ball on the ankle.
-This one will be difficult to explain. Kstar does this be just putting the lax ball on various points on the ankle and then smacking it. Sounds dumb, I know. Breaks up the tissue or something.

3) Band stretch
-Again, sort of difficult to explain. Choke a band, if you have access to one, around a rack and loop the free end around the top/front of your ankle. Walk away from the choked band to get pressure on the joint. Whatever physiology he explains it by, it put the ankle in the optimal position or whatever. You can just stand on the ground and lean forward or bend the knee/ankle and move it around. Or you can put a plate or something and prop your forefoot up and stretch that way.

Do these things and then do active range of motion/ mobility work.

Hope this helps, sorry if the descriptions suck. Try and find the mobilitywod videos or look at the supple leopard book.

I just ordered a band and am going to add band stretching to my ankle mobility work. I report back here in a month or so and let everyone know what worked best.

Post: #12

Jump rope.

Not only one of the best conditioning tools, but will make your lower legs rock solid and injury proof(feet, heels, Achilles, ankles, calfs, shins) . Start with a few jumps a day, and be consistent everyday. Work up to 100's of turns per workout, then 1000's. Then work up to conditioning(high knees) and double unders.

With a little consistent work you will see your mobility come back. Earn mobility through motion, not through stretching.

I like these - http://rxjumpropes.com/

My go to authority;
http://www.rosstraining.com/jumpropeconditioning.html
http://www.rosstraining.com/articles/jumprope2.htm

Post: #13

Bumping cause I'm recovering from ORIF surgery for a Grade III ankle sprain/syndesmosis injury and the dorisflexion (DF) in my left foot is quite limited, but it has improved fairly quickly.

I had a Maisonneuve fracture on 10/20/16 and my ankle was immobilized completely from 10/20/16 to 11/15/16 (a Maisonneuve fracture is complete disruption of the ankle syndesmosis ligaments with a concomitant proximal fibula fracture). The fibula fracture healed quickly with nothing significant to report and in any case is not relevant to the ankle discussion here.

On 11/15 I was put into a walking boot and encouraged to begin range of motion (ROM) exercises on my own. That ankle was LOCKED, I could only move my toes. I did ankle pumps, circles, and the "alphabet" drill as best as I could while lying on the couch RICEing. Not much improvement from that.

On 12/15/16 I was given the go ahead to weight bear as tolerated (WBAT) and started gingerly walking on the boot using two crutches. On 12/20 I went to my first PT session and received solid advice on a home exercise program (HEP) using resistance bands. I do those exercises twice a day, in addition to the range of motion exercises described above. The PT sessions are (still going to them) pool therapy 2x a week and a gym session 1x a week.

On 12/21 I was down to one crutch and on 12/23 I shitcanned the crutches entirely, walking slowly on the boot but being sure to walk with as normal of a gait as possible and not trying to compensate for the boot. By Christmas I was going up and down stairs almost normally (bringing the trailing foot to the next step rather than putting it next to the other foot if that makes sense). DF and plantarflextion (PF) were still severely limited by the boot so it still wasn't quite a normal gait and when walking without the boot at home I had to shorten my steps to accommodate for the lack of DF/PF.

On 12/27 I began getting scar a tissue massage, and this is one of the things that I believe jump-started the flexion improvement. The day after the massage I noticed swelling was down and DF was a bit better, especially in the pool therapy session when my bodyweight was less of a load.

On 12/30 (after 2x massage, 4x pool sessions, 2x gym sessions, HEP 2x/day) I said fuck it and wanted to try using normal shoes. I taped the shit out of my ankle, put on a compression sock followed by a thick wool sock and stuck all that into a high, fairly rigid hiking boot. I had originally planned to take it easy and stay in the boot until followup on 1/12/17, but I really believe that the continued boot immobilization was contributing to the delay in regaining ROM. I walked around doing errands and stuff normally, my ankle was sore at the end of the day but not painful. I RICEd before going to bed, and did the same thing the next day.

After 72 hours of tape+socks+hiking boot+normal activity the swelling has noticeably reduced, DF/PF are waaaaaay better and I have a more positive outlook since I can go about things (almost) normally. I really believe getting the ankle back into DF/PF through walking while protecting the ankle from lateral movement via the tape and boots was instrumental in the heightened recovery. I still can't run nor jog (I haven't tried but I can tell that's a no go for right now) but my gait is becoming more normal. I have upped the icing throughout the day to keep any swelling at bay but there's no pain, just soreness.

I plan to continue PT and HEP as much as possible, there's still a lot of improvement to go. I was curious about why protected movement seemed to help recovery versus RICE to infinity and came across this study regarding aggressive syndesmosis rehab in Division I athletes. Basically the patients were kept immobilized until 1 week post-op, at which time there were put into a boot and given the go-ahead to WBAT. Return to sports was 8 weeks median time, I believe.

Now granted these were high-level athletes and followup reporting on them is limited to a median of 34 months (I think) but it makes sense to me that if a patient is athletic, not overweight, has a healthy diet/supplementation history, and isn't a smoker the body is capable of healing very fast. Not to 100% return to sports very fast, but capable of independent normal daily tasks.

If anyone else has any experience dealing with/treating Grade III ankle sprains/syndesmosis injuries I would love to hear about it. Thanks.

Post: #14

^^ I had almost the exact same injury about 4 years ago. Only difference is that I didn't get surgery and neglected physical therapy. It was very very bad.

I'd recommend progressing VERY slow with it, even if you think its ok. I thought it was ok and started running on it pretty early on, it was just tight and had a little pain. I'd advise against this. I don't think mine healed optimally.

The "return to sports 8 weeks median time" sounds good and all, but I really suggest you take it slower. In 8 weeks from injury (which is where it seems you are at) walk 3-5 miles, see if any pain the next day. I'd consider wearing the boot longer if you still have pain and can't walk that well. KEEP doing the physical therapy twice a day definitely. Incorporate this around the 8 week mark when you start easing back into high-impact stuff.
Ankle Impingement Exercise

10 weeks you should start doing some light jump rope. 12 weeks in jogging and doing much more high-impact stuff. Again progress as fast as you want, but as someone who's been there I'd recommend going SLOW. Focusing on the PT. If it takes longer for the high-impact stuff so be it. Don't run if it hurts.

Another thing with surgery is that once they go in its almost never the same. I was fortunate to have 3 radiologists and 2 orthopedic surgeons look at my scans (MRI, x-rays), and I was very close to getting surgery. 1 of the orthopedic surgeons is probably top-5 ankle surgeon on the U.S., and he recommended to not get surgery. He said it can take a really long time to fully heal, much longer than you think. But once you go in, it might not be the same (even minor arthroscopic surgery to clear scar tissue).

You're already passed that stage, but if you consider surgery in the future wait 1 year then re-assess. If it still hurts get 2-3 opinions. If they all go for it then do it, but I'd be very cautious. Be conservative in your medical treatment.

Post: #15

@Armogan,

thanks for taking the time to reply, I appreciate your input.

I hear you on taking it slow, I don't plan to run on it anytime soon; the most I'll be doing until at least 12 weeks post-op is stretching, PT, walking, and yoga.

I was using the "8 week return to sports" time as an illustration of what the study indicated these athletes had accomplished and what that could mean for someone not needing to perform at that high of a level. I'm not an elite athlete and under no illusions that I have the physical capacity of one. I also realize that collegiate/professional athletes are rushed back into the game prematurely to get the wins and rehabbing the damage can be done in the off-season.

Good idea on the light jump roping. I had originally planned to leave jogging for later as well. Honestly, I'm kind of over running (used to do marathons) so it's doubtful I'll ever do anything other than short sprints for conditioning.

It's interesting your docs had that opinion, my radiologist is a top guy in a western state resort town (skiing, mountain biking, climbing) so he's seen a lot of these things. Same for the orthopedic surgeon, he's been at the university orthopedic center for years and also works with the US Ski Team. But sometimes there are no clear answers in medicine. FWIW, I've no pain from the procedure itself nor are the screws bothering me, even in cold showers and the sub-20 degree weather we've had here lately.

I'll load the "Ankle Thingy" exercise into my routine as well. Thanks.

Post: #16

Good luck. I bring up the surgery and doctor opinions so that you really critically think through any future surgeries. Don't be the guy that gets 3 surgeries in 14 months. I'm sure your doctors made the right move in your case. But some doctors are real scam artists/or downright dangerous.

I can do everything that I used to be able to do, just have some pain afterwards depending on the activity. It may be the same for you.

Post: #17

For any guys with serious ankle injuries, I would be very careful about surgery, and would definitely get a second opinion. I had a hairline fracture and severe sprain from a car accident several years ago.

I wore the boot for several weeks, did everything the doctor said, went to physical therapy, but still did not regain much range of motion. I did the exercises every day, stretched it out, and after a few months, I could still barely move it up down and side to side.

I went back to the doctor. He seemed rushed and hurriedly said that he wanted to do surgery because the fracture hadn't healed. The whole thing felt off, so I consulted another doctor.

The second doctor said that the fracture had healed, but due to it being a high impact injury, I had arthritis. He gave me two cortisone injections over about a month long period, and my range of motion came back to about 85% of what it was before.

I still do have some issues with it. If I go for a long hike or play basketball for a few hours, it tightens up. Usually taking a couple of Ibuprofen helps alleviate any pain and tightness, but resting it does the trick, and usually a half day later I'm back to normal.

The research on ankle injuries is actually rather limited. Most doctors just go the simple route of RICE, and if that doesn't work, then they'll try surgery. I know a couple of people who have been worse off after surgery. After a couple of years, they still barely have any range of motion and struggle running on it. Some people may have different experiences, by I'm very skeptical when it comes to ankle surgeries.

Post: #18

Been doing this exercise pretty consistently and its been a big help on my ankle. Essentially, you stand 3-4 inches from a wall and bend your knee to touch the wall, while keeping your foot grounded. Do 10 reps then hold it against the wall for 10 seconds. Seen a big improvement on flexibility and ankle pain.

Post: #19

EDIT: I realize I gave the same advice here two years ago. My advice still stands.

Buy a jump rope, and start jump roping regularly. Check out this site for that - http://rosstraining.com/blog/