the Ankle complex
Over the summer, I walked past an informal summer league team practice on a nearby field and noticed that an amazingly high number of the players wore at least one ankle brace. As Dr. Nuwer reminds us in her injurytimeout.org article on ankle, ankle sprains are one of the most common injuries in Ultimate, but in general many folks interested in getting stronger, faster, or even just want to get out of knee / ankle / foot pain don’t think twice about their ankle complex when they plan out their training program.
In this blog post, we’ll cover a few ways to think about how you (re-)train your ankle/foot complex. We’re not going to cover acute care or serious ankle dysfunction here, go see your medical and fitness professionals to take care of that first. But, if you’ve already been to the doctor and gotten an opinion or two from a physical therapist or personal trainer, here are a few points to ponder.
Earlier here on UltiTraining.com, we briefly touched upon the joint-by-joint paradigm of looking at the body, looking at when, where, and how the average athlete may need more mobility and/or stability. Zooming in on the ankle complex, Gray Cook and many other fitness professionals today would agree that many typical athletes may need more mobility in the foot and ankle, whereas many also need to learn how to stabilize under load at the knee (for example avoiding valgus collapse–caving in as you squat).
But let’s simplify things further a little bit, and just look at how well an average athlete moves her feet or ankle. Or perhaps more accurately, doesn’t move them. She might wear stiff sneakers all the time, which means that the 33 joints, 26 bones, and 20 muscles in the foot alone aren’t getting much work. In other words, her feet are getting weaker and dumber. With an elevated heel, she might have extremely limited dorsiflexion–difficult bringing the toes back up towards the knee–and a tendency to heel strike as she runs, which some research suggests may increase eccentric load on her knees.
We’re not going to cover barefoot training in detail in this blog post, but suffice it to say for now that warming up once in a while in bare feet on grass just might be a useful tool, *if* you currently are not in any ankle/heel/foot pain and already have good hip mobility and knee stability.
Earlier we talked about feet getting “dumber” and by that we mean to remind ourselves that the joints of the foot are supposed to be mobile and move, from your toes on up, and not only that but the mechanoreceptors in your foot/ankle joints and muscles are constantly sending back information back up your spinal cord about what’s going on down there. Think of it this way, if you threw a disc with mittens all the time, would you expect to have a really good sense of where your fingers are when you catch and throw? Why do the same for your feet and ankle joints?
The ankle joint itself is a hinge joint, and as we talked about earlier, many modern humans now have restricted and/or asymmetric dorsiflexion, which basically means you can’t hinge your ankle up very much. This doesn’t sound that bad, until you remember that the body tends to act as a function biokinematic unit, and with every single-leg footstrike, you can put up to 8-10x your bodyweight on each foot if you’re sprinting hard for that deep cut. A joint-by-joint perspective may suggest that the load gets shunted higher up the kinetic chain, and suddenly your knee joints are working way harder than they need to.
I could go on but I’ll just lob out three high-level suggestions.
First, keep symmetry in mind as you think about your ankles. If you sit down and dorsiflex (“pull up”) your ankle, is it the same on one side compared to the other? Can you deep squat staying on your heels?
Second, remember that your body as a biomechanical unit needs a good sense of proprioception to move well and manage injury risks. Research on ACL injuries in soccer suggest that proprioception training can be an important tool in injury prevention. Don’t have an Airex pad? Try standing on a pillow and doing bodyweight single-leg movements such as a squat or deadlift. Single leg balance work? Your ankle is gonna like it.
Finally, try to balance soft tissue work (self-myofascial release, perhaps a lacrosse ball for your plantar fascia/aponeurosis or a Tiger Tail on your calves) with mindful joint mobility, whether it’s a wall ankle mobilization and ankle circles, a simple rolling motion and alphabet tracing, or a targeted Z-Health R-phase lateral or medial ankle tilt before you do those calf raises.
If you’d like to learn more, Gray Gray’s institute page is a great place to dive in. Ankle’s away!