jessephysio

This is going to be a quick video blog demonstrating one manual therapy technique and one corresponding exercise to restore talocrural joint dorsiflexion. In my experience, many medial and anterior knee pain clients tend to have restricted ankle dorsiflexion. This limitation causes a compensation to occur at the subtalor joint creating “over-pronation” to create more range into dorsiflexion. The tibia will follow the ankle leading to tibial and then femoral internal rotation…which we all know is a factor in patellofemoral pain syndrome (PFPS).

More generally, clients complaining of a pinching sensation at the front of the ankle with such things as squats can also benefit from the mobilization and exercise I’m demonstrating in the videos. Post inversion ankle sprain clients often also become restricted with dorsiflexion and just treating the ligaments with ultrasound and stim just won’t cut it….ever! You need to get your hands on the ankle!

A great ‘buy-in’ test to see the pre and post treatment results is the knee to wall measurement. Clients are often amazed at how much more mobility they get with only a few sets of this mobilization. The effects maybe neurologically driven, mechanically driven or a combination of both…who knows. It just works and that’s what’s important to me (and my patients).

Not shown in the videos is the importance of stretching and mobilizaing both the gastroc and solues muscles to aid in any myofascial restrictions contributing to the dorsiflexion restriction. I hope these videos help your clinical outcomes!

Talocrural mobilization with movement:

Home exercise for dorsiflexion:

References:

The initial effects of a Mulligan’s mobilization with movement technique on dorsiflexion and pain in subacute ankle sprains
Natalie Collins, Pamela Teys, Bill Vicenzino\
Department of Physiotherapy, The University of Queensland, St. Lucia, Brisbane, QLD 4072, Australia
http://www.sciencedirect.com/science/article/pii/S1356689X03001012