Ankles - they're important!

About ten years ago I took a weekend-long class called "When the foot hits the ground, everything changes" ... and it was *awesome*.  Of course the content was useful, but what really stuck with me was the title; it has influenced countless conversations with my clients over the years.  In this blog we will discuss the ankle - how to mobilize it, and how to stabilize it.   Having a mobile yet stable ankle is crucial for safety during landing from skills in acro (not to mention - being able to move your feet comes in handy when basing).

Osteokinematics :: (because big words are sexy)

Dorsiflexion is the osteokinematic term used to describe an actively flexed foot or ankle - specifically the term refers to the range of motion available in that direction.  We've all been told to "point" our toes in acro ... dorsiflexion is the opposite of pointing (aka plantarflexion).

There is a lot of evidence to suggest that having sufficient dorsiflexion decreases the risk of various lower extremity injuries ... but before I lose your attention, let's dive right into self-care tips for the ankle.  If you have been reading our blogs - hopefully you have an idea of what is to follow ... tissue prep and stability training.

Tissue prep:  

You can use a foam roller, two lacrosse balls in a sock (as shown), or a peanut (which is essentially two lacrosse balls joined together).  Roll your calf up/down the balls or rollers; when you find a sore spot hang out there and move the foot up and down a few times until the sore spot lessens its grip on your sanity.  Work on all sides of the calf and shin.

Plantarflexion over lacrosse balls

Dorsiflexion over lacrosse balls

working the peroneals on lateral calf

rolling over the anterior tib - can also move foot around

** Ideally you will take the time to do this before you train - for flyers ankle mobility and stability are wicked important during standing acrobatics (think of landing from those skills over and over and over).  For bases - these factors are also important during standing (think squatting to get under your flyer, or taking a knee to help your flyer safely to the ground after nailing that skill).  Bases also need a lot of dorsiflexion for L-basing.

Stability training:

Once you prep the tissue - you need to train for stability.  While stability is a *very* big topic and undoubtedly deserves its own post (if not several), I'll give you a couple of exercises to start with.

Balance training on an unstable surface:  this can be done on a pillow, a half foam roller (as shown), or a slackline (fun video showcasing the original YogaSlackers).   Start simply - with timed intervals, eyes open.

note:  knee is not locked in extension

Slacklining is *amazing* stability training

Progression:  If keeping your eyes open is super easy, try standing with your eyes closed.  Note:  when you close your eyes, you will likely lose your balance - so be smart about it!  Start by standing on the ground with your eyes closed; then practice standing on the ground with your eyes closed and turning your head from R<>L or moving your limbs around like you are some strange creature (because let's face it - you are, indeed, a strange creature).  If all of this goes well, then you can try standing on an unstable surface with your eyes closed.

Strength training:  

A lot of our ankle stability starts with the core ... if you can control how much your body moves around by creating a stable core, then there will be less demand on the smaller muscles surrounding your ankles.  There are a bazillion exercises for the core (and besides - what *is* the core anyways?!?).  For now - let's start with training your lateral hip rotators with a few basic exercises.

Band walks:  place a band around your lower legs, just above the ankles, keep the tension and walk from R<>L with minimal wobbling.  Keep your knees straight-ish (meaning don't lock them in extension - stay active in your quads while allowing a slight bend in the knees).

Clamshells:  they're boring, but effective!  Try doing 30 in each of 3 positions (2 shown; the 3rd is like the 1st but with feet on the ground ... and if you are able to follow these instructions you win the prize of more boring ways to train your glute med!!  yay for you!!).

starting position

ending position

start as per above, finish in this position

Note:  when doing these exercises: keep the spine in a neutral position (you will need to lift your waist from the floor) and keep your lower belly muscles engaged (transversus abdominus).  You can also gently engage your pelvic floor - but no clenching!!  The pelvic floor needs to be trained but it also needs to function all day long - overdoing it is a real risk.  

For the feet:  

Working on the strength of the intrinsic muscles of the foot will help control your medial arch - this plays into the notion that when the foot hits the ground - everything changes.  If you create stability within the foot itself, you will have a better chance of avoiding injuries in your legs when you are dealing with landing on your feet (or tossing people around on your feet as the base case may be).  

Basic exercises include:  tissue prep by rolling the foot over a ball in various directions and strengthening via:  towel scrunches (pull the towel towards you by flexing your toes for about 30 seconds per foot) and toe alternations (lift big toe while keeping other toes flat, then reverse).  

starting position for towel scrunch

final position for towel scrunch

four toes up, big toe down

big toe up, 4 toes down

roll it out, yo

Mobility test:  

So how much dorsiflexion do you need?  There is a pretty basic test to determine if you have sufficient dorsiflexion.  Start in a half kneeling position, 5 inches from a wall.  Shift your weight forward over your front foot, without letting the knee fall inwards.  If your knee touches the wall - you have sufficient dorsiflexion.  If your knee does NOT touch the wall - you probably don't.    Watch this video by Dave Tilley for step by step instruction. 

Note:  If you "fail" this simple test, try the above mobility exercises, add in daily stretches for 4-6 weeks, then re-take the test.  If you still fail - go get yourself checked out by a trained physical therapist (or other sports med pro) who can help discern if you have a soft tissue or bony deficit.  Research varies as to whether or not you can actually change your dorsiflexion ... because as with most things body related ... it depends!  

Note on the note:  If you fail this test, and you want to be proactive - consider getting yourself checked out sooner rather than later.  These blogs are never meant to replace the advice and treatment from skilled medical practitioners.  

Practical relevance of ankle mobility: (only the nerdy, or the interested need read on at this point - even amongst you brave readers, this may be a bit dry)

As mentioned briefly above, the amount of available dorsiflexion has been linked to various lower extremity injuries (ankle sprains, ACL tears, patellar tendinitis, to name a few).  The basic mechanism is as follows:  decreased dorsiflexion changes the degree of knee flexion during landing, which increases the likelihood of excessive valgus angle at the knees, while also increasing the torque on the hips and low back.  If your ankle doesn't sufficiently dorsiflex you have to compensate somewhere for that lack of movement - the knees won't bend as much due to angle of the tibia and resultant/altered displacement of your body weight to avoid falling over backwards --- so either you throw your chest forward (which increases hip flexion thereby increasing torque on your hips and potentially strains your lower back), or your knees fall inward quickly (which puts excessive strain on the medial compartment of the knee joint itself, and the tendons of the IT band, lateral quad and lateral HS, not to mention the ACL and both menisci).  Neither of these scenarios bode well for the long term health and longevity of your lower extremities, or back.  While there are many things to consider regarding stability during landing, starting with the ankle seems like a relatively easy way to pick the proverbial low bearing fruit.

For a well written blog with lots of research to back up these thoughts on the various potential risks of decreased dorsiflexion follow this link. 

There's so much to say, and so little time - stay tuned for next month's blog where we start exploring the core.

Thanks for reading!  Keep training, keep it safe, and enjoy ...

Upcoming events with Precision Acrobatics:
Handstand Workshop with Ariel:  August 16th, Zaccho Dance Theater, SF
Strength Training for Acrobats with Ariel:  August 23rd, 5 Stones, SF
Hand to Hand Series:  September 6th, 13th, 20th, Zaccho Dance Theater, SF
Intermediate Daylong Intensive:  Sassy September:  September 10th, Zaccho Dance Theater, SF
Handstand Workshop with Ariel:  October 4th, Zaccho Dance Theater, SF
Divine Play Festival:  October 7th-9th, Portland, OR
Dance Acro Series:  November 8th, 15th, 29th, Zaccho Dance Theater, SF
Intermediate Daylong Intensive:  Noteworthy November:  November 12th, Zaccho Dance Theater, SF

If you live in the SF bay area and would like to work with me (Liz) as your PT, you can find me here:
Oakland:  http://synapsemassageandbodywork.com/services/physical-therapy/
San Francisco:  http://eastwestsf.com/