Tag Archives: ankle therapy

Ankle Mobility Drills for Runners

This is the last in our series of dynamic warm-up drills for runners that we use here at Elite Physical Therapy and Sports Performance.  In this video Scott McKeel demonstrates some of our favorite ankle mobility drills to get those ankles moving which will help with a number of common injuries like plantarfascitis, Achilles tendinopathy, IT band syndrome, knee pain, and low back pain.

 

We do small group, and even individual, training sessions for runners which includes the Functional Movement Screen plus other critical tests to find the weak links in mobility and flexibility, strength, and running technique.  If you’re interested contact us:  joe@elitepttc.com

Barefoot or not Barefoot… That is the Question

Originally posted on SportsRehabExpert.com

Andy Barker PT

Barefoot training has taken off in recent years. Whether in the gym or out on a track or field, the number of people training barefoot has increased. But why? This post will look at the benefits of barefoot training and in addition the importance of foot position when training.

Barefoot training

As the name suggests barefoot training involves wearing no footwear. This could be to lift weights in the gym or indeed used for running training. There has been many a discussion in the training community as to the advantages and disadvantages of such training, although there isn’t much decent clinical evidence on whether this type of training is beneficial or not.

Why use barefoot training?

Having bare feet ultimately is going to give you and your body a heightened level of body awareness due to increased contact with the floor. This can be
advantageous in many ways especially in drills involving foot and ankle mobility
and stability. A great example would be the use of an ankle mobilisation. I would always conduct such exercises involving the foot and ankle in a barefoot state.

Stick Ankle Mobilization

I like conducting such drills like this as you can feel the movement better in this position and in addition, if I was teaching such a movement I can actual see and feel what is happening which might not be as apparent in a training shoe.

I also at times like athletes and clients to lift, i.e. squat and deadlift variations in barefeet. In addition to the reasons mentioned above, for some, being in a barefoot position enables the foot to generate more torque and have a greater influence on knee and hip position during lower limb movement.

For example, in a barefoot stance an athlete is more easily able to generate a
lateral directed force from the foot into the ground prior to a squat. This can be cued by asking the athlete to try turn the feet outwards without the feet actually moving. That torque created enables stiffness through the foot and ankle creating a stable platform to lift and in addition pull the foot out of a position of pronation. This cue has been particularly useful for those athletes that excessively pronate. Getting out of excessive pronation also benefits the knee and hip by preventing possible knee valgus and hip internal rotation stress respectively which are detrimental to knee and hip health and movement quality.

Tripod stance

Regardless of what lift or activity that is being produced, be it a squat, deadlift or running the aim is generally to gain a neutral foot position. Having equal amounts of weight distribution between to foot is key to being able to create a stable foot position or ‘tripod stance.’

A successful tripod stance position would involve equal distribution of weight
between the three points of;

  • Base 5th metatarsal
  • Calcaneus
  • Base 1st metatarsal

If weight can be distributed evenly between these three points then the foot is
likely to favour a neutral foot position and in addition will provide a stable
platform for movement.

Tripod Foot Position

Therefore in my opinion the reason for opting to go barefoot or not isn’t the
main issue. The question is with what footwear type or barefoot style
stance will enable you to get into a neutral foot position or tripod stance. This will differ between individuals.

Getting that tripod stance is the key. As a result it doesn’t really matter what’s on your feet if anything as long as we maximise and make use of a good solid foot and ankle position for movement.

Examples

The type of activity the person is partaking will be a major determinant of
what to use in addition to the ability to gain a stable foot and ankle position to carry out such an activity.

To use myself as an example of three different activities in with I will alter what I wear on my feet. The activities include:

1. Squatting in the gym</br>
2. General wear (at work, walking, and general daily activities)</br>
3. Road running

#1

Regarding squatting in the gym I lift barefoot. The reason for doing this is that I feel that I can use the floor and my foot position to gain a strong stable base of support prior to lifting. I am able to feel the floor and use it to my advantage. By almost screwing my feet into external rotation, without actually moving my feet, I can generate torque through the floor, bringing my feet out of a position of relative pronation and thus at the same time preventing knee valgus and hip internal rotation. In addition, I feel I can sit through my hips better and in doing so I am in a stronger position and as a result can shift more weight.

#2

Conversely, I tend to wear barefoot training shoes for general activites throughout the day. I have a pathological right ankle which needs regular rehab predominately through ankle mobility drills. I have found that wearing a barefoot training shoe has enabled me to maintain my ankle range of movement in comparison to before I started wearing barefoot style shoes. This is ultimately because I am using/maximising the range at my ankles even during everyday activites and thus complements my ankle mobility rehab.

#3

Finally, for road running, I feel more comfortable in a neutral training/running shoe as opposed to a barefoot shoe. I feel as though the additional support and cushioning of the shoe provides a better and more comfortable run and therefore I use such a shoe to run. In theory a barefoot shoe might seem more advantageous given my ankle pathology however this has not proved to be in case in my example.

Conclusion

To bring it all together, using I as an example, it is clear that different
activities require different footwear types. As athletes, weekend warriors or
practitioners we should be aware of the fact that differing activities require
different provisions and going one way or the other, being anti-barefoot or pro-barefoot, is maybe not the way to do it. Maybe being aware that different
circumstances require different training equipment is the way to go and adapting
our approach in that way.

Hope this has been of interest. Any questions just post them in the discussion forum.

Thanks for reading

BIO

Andy is the current head physiotherapist for the Leeds Rhinos first team squad and has been involved with the club for the past six seasons.

He graduated in Physiotherapy from the University of Bradford with a first class honours degree which followed on from a previous Bachelor of Science degree from Leeds Metropolitan University in Sports Performance Coaching.

Andy currently works privately in addition to his sporting work and has also previous experience within National League basketball and professional golf.

Andy has a keen interest in injury prevention and the biomechanics of movement in which he is continuing his studies with the start of a MSc degree later this year in Sports and Exercise Biomechanics.

Andy is also the creator and author of rehabroom.co.uk. RehabRoom is a free    online rehab resource site aimed at but not exclusive to physiotherapists, strength and conditioning coaches and personal trainers. To visit the site please click the link:  http://www.rehabroom.co.uk

Taping for Plantarfascitis/Foot Pain

In this blog post I wanted to discuss the benefits of taping, specifically a technique known as ‘low dye’ taping, for relieving foot and heel pain while allowing the soft tissues of the foot time to heal. This is a technique we commonly use here at Elite Physical Therapy.

Plantarfascitis is the common term for the pain in the arch of the foot or even in the heel.  It’s usually worse during walking or running – activities that really stretch that tissue on the bottom of the foot.

Our treatment model for plantarfascitis includes:

  • soft tissue work using Graston Technique to the plantarfascia, as well as to the muscles of the foot and calf to promote healing and greater extensibility of the tissues.
  • low dye taping to support the foot in weight bearing and to allow for tissue healing.
  • therapeutic exercise to increase mobility through the foot, ankle, and calf, as well as strengthening for the musculature of the lower leg.
  • corrective exercise to address movement dysfunction or lack of stability further up the chain including the hips and trunk.  The underlying reason for your foot pain is often found here!

Orthotics can be an important piece to the puzzle here as well, but they are quite expensive and not always a slam dunk to work.  A successful trial of low dye taping along with physical therapy is either going to eliminate the patient’s pain to the point that orthotics are not really necessary, or it’s going to relieve the symptoms enough that I feel more confident recommending orthotics as a more permanent solution.

Check out the video below to see how we do it here at Elite Physical Therapy.  If you have experienced these types of symptoms and they just won’t resolve, feel free to contact me to see if physical therapy would be an appropriate intervention.

I also shot a video demonstration of using Graston Technique to treat the foot a few weeks back.  You can find that video here:  http://www.elitepttc.com/blog/?p=415

 

Ankle Rehab Update

So last week I posted this message on Facebook:  “Limited ankle mobility is a very common reason for nagging foot, knee, hip, and back pain in runners. Unfortunately not too many PTs or doctors are looking there. Maybe it’s time to call us and rid yourself of that pain for good!”

In the past week I have been asked 3 separate times about what is the best way to check your own ankle mobility and then how to improve it.  So to bring you up to speed on why it is so important to have great ankle mobility I refer you to a previous blog post title “Movement Proficiency and the Ankle” which you can find here:  http://www.elitepttc.com/blog/?p=20

Now for the measuring and correcting!

The first video below shows how I measure ankle mobility in the clinic with the foot on the floor and controlling the ankle to prevent pronation (arch flattening out):

To measure your own ankle mobility, simply assume the kneeling position shown in the video.  Rock your knee over the foot to touch the wall measuring how far your big toe is from the wall with a simple tape measure.  The heel must stay down and arch not allowed to collapse.  The goal is 4 inches!

The next video demonstrates how you can quickly address the soft tissue component of the limitation.  Be sure to measure again as we did in the video as this is the only way you are going to know if it is effective or not.  Always follow the rolling with stretching.

If this does not result in an immediate improvement in ankle mobility, you may have a joint restriction that will not be resolved with rolling or stretching.  Another sure sign of joint restriction is pain or pinching in the front or side of the ankle during the testing.  This can often be resolved quickly with ankle joint manipulation and/or mobilization and certain taping techniques that I employ here at Elite Physical Therapy (in other words it’s time to call the professional).

If you have any further questions feel free to contact me:  joe@elitepttc.com