Ankle dorsiflexion restrictions can hinder performance and lead to dysfunctional movement patterns and pain across the spectrum of human performance from elite athletes to older adults.
Dorsiflexion is a critical component to how our legs interact with the environment around us in everyday life as well as sports performance settings. In a closed chain environment, it is the ability of the tibia to translate over the foot; in an open chain environment it is the ability to bring the top part of the foot closer to the tibia. We need dorsiflexion for normal activities across the spectrum of performance like walking, running, squatting, and going from sit to stand.
In performance, we emphasize open chain dorsiflexion in sprinting in order to shorten the lever of the leg from the knee to the toes as it swings through in order to increase swing speed. This same open chain dorsiflexion also loads the spring of the posterior tissues prior to foot strike and effectively acts as a pre-stretch to improve force production off of the ground.
Closed chain dorsiflexion is equally important, since a lack of dorsiflexion can cause problems in other parts of the kinetic chain. Take walking for instance: as we transition through stance phase of the gait cycle, the tibia is supposed to continue to translate over the tibia into dorsiflexion. If the ankle is immobile, the body will try to accomplish the same task in other ways. Down the kinetic chain, this could result in over pronation of the foot. Up the kinetic chain, this could result in a valgus moment on the knee. Both scenarios can lead to pain and dysfunction; therefore, assessment of dorsiflexion is key to preventing injury.
Lack of dorsiflexion in a closed chain position could present itself in a squat or even simply going from sit to stand. In our video series featured on social media, we demonstrated how to assess dorsiflexion quickly and easily with the knee to wall test, and how to quantify dorsiflexion using the level app that is on most cell phones. For more information on how to assess mobility and functionality of other regions of the body, see Running Injury Explained: The Diagnosis is Not the Problem.
A dorsiflexion limitation is often not the primary problem we, as clinicians, are addressing. It may present itself as knee or hip pain or dysfunction, so it is likely that there are other related issues that will need to be treated. However, dorsiflexion can be a critical component to assess, especially with injuries of the lower extremity.
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