How to Improve Ankle Mobility/ Stability with Active Mobilization and Fascial Tensioning. As demonstrated on American Ninja Warrior Meghan Beatty.
Meghan Beaty Ankle Blog from Brad Cox on Vimeo.
The Pattern:
The ability to properly active the big toe and arch of the foot, while at the same time having full internal rotation and flexion of the lower leg are essential components of proper running, jumping, squat, hinge and lunge mechanics.
If you have poor lower leg rotation and lack of big toe activation then it shows up a few different ways depending on the movement pattern we are talking about.
-During Squatting/ Jumping/ Hinge and LungeThere are 4 main ways that this problem will present.
1) As you go deeper into your squat/lunge you roll onto the outer part of the foot and loose big toe connection
2) At around 90 degrees of depth one or both feet will have to turn out and the arch will collapse.
3) Can’t squat to depth without having the heels come up.
4) At depth you will have to shift and rotate weight onto the other hip causing a visible hip shift.
During Running and Walking:
1) Can’t toe off with the big toe and rolls to the outer part of the foot
2) The foot kicks out to the side as it leaves the ground.
Every single one of these presentations affects stability throughout the entire chain and when loaded can cause havoc on the ankle, knee and hip joints.
Common Causes:For ankle and big toe dysfunction the common causes are a history of sprained ankles, a lower leg that is stuck in external rotation, and restrictive footwear/ arch support that compresses the toes together and prevent normal range of motion. Whenever we are assessing an athlete the first two places we start are the core and then the feet because any problem with the feet will immediately affect rooting and stability all the way up the chain.
Assessments:
We walk Meghan through two very simple self-assessments to give us a starting place.
We are big fans of quick assessments because very often you can determine the source of a problem and clean it up quickly to maximize your performance. Clearly there are numerous other factors that could be affecting her ankle mechanics, and in the clinic we would put her through a full evaluation to analyze all of her mobility/ stability/ and pattern problems. But a quick self-assessment can go a long way towards getting you on the right track, if you know what to look for.
Assessment 1: Lower Leg rotation and Big Toe activation test:
Step 1: Sit at the edge of a chair and square your hips straight. Bring your knee slightly forward over the toes. Rotate your foot roughly 45 degrees in and try to press your big toe into the ground to activate the arch.
Step 2: While maintaining that big toe activation try to rotate your knee out so that it is in line with your hips.
Picture to the left shows good internal rotation of the lower leg and she is raising her small toes to emphasize the big toe activation on the ground.
Failures: There are 3 common failures that you see in this assessment:
1: Cannot press the big toe into the ground and activate the arch
2: Cannot maintain big toe activation as you rotate the knee back to neutral
3: Maintain big toe activation but can visibly see the pressure roll to the outer part of the ankle as you rotate the knee out with an exaggerated arch.
4: The heel comes off the ground as you rotate the knee.
All of these failures indicate a problem with the arch mechanics of the foot and a loss of internal rotation of the lower leg.
Assessment 2: Hip external rotation test: This test we do primarily to see if there are any obvious restrictions in the External hip rotators, because very often when you see an impairment in internal rotation of the lower leg you will also see a restriction in TFL/ Glute Med and Glute min on the same side.
Step 1: Lay down on your back and raise one leg up creating a 90 degree angle from the hip to knee and 90 degree at the knee.
Step 2: Actively rotate your lower leg inward ( you should be able to actively clear your foot past the leg that is still on the ground.
Step 3: With one hand pull your ankle towards your torso as the other hand presses against the knee to maintain 90 degree angle. (you should be able to roughly get to 90 Degrees of rotation)
Note:There are wide variations in Femur length and hip socket structure that can also affect this, and so what you are really looking for with this assessment is asymmetries. If one side you have great external rotation and the other you don’t, then it is safe to assume that the lack of rotation on the one side is going to cause dysfunction. This is also very often due to the inherent lack of core stability on that side as well. One of the ways you can tell if it is structural vs. muscular is if it responds to active mobilization. When trigger point release with active mobilization is done to an area of the body it should show progressive improvement in ROM. If you keep having to work the same area without improvement then assume there is something else that is the causative factor.
Corrections:
Here we show an in-depth corrective strategy to improve lower leg rotation, big toe activation and Glute engagement to improve both mobility and stability. In the beginning you will want to go through every one of the below steps, but once you have regained initial mobility then you can cut down on reps and focus mostly on using the Eclipse Rollerto maintain tissue mobility and then the Active Figue 4 stretch and Fascial tension getup and lunge drills at the end to prep for activity. After the initial week or two of work you should be able to maintain your progress with roughly 5-10 min of work only 2-3 times a week before training.
- There are 3 main steps to help address the lack of rotation of the lower leg and improve big toe activation and hip mobility.
- Address trigger points in the Calf/ Tib Anterior and the foot using our Active Mobilization approach
- Release TFL/ Glute Medius
- Active Stretching and Fascial Tensioning floor to standing sequence to integrate and re-pattern the newfound mobility.
Correction 1:
Soleus/ Tib Posterior Trigger Point release: This helps to improve mobility and also enhance activation through the arch and big toe.
Step 1: Sit on a bench and cross one leg over the other.
Step 2: Roll off the edge of the bone on the inside of the calf and find a tender area along the Soleus muscle (begin at the top of the calf). Use the base edge of the Acumobility ball(for this we often recommend the Level 2 ball because it is firmer) and press into the side of the calf applying pressure in and at a slight upward angle underneath the bone.
Step 3: Work back and forth with the edge of the ball as you bring your foot through flexion and extension.
Step 4: Spend roughly 10 seconds per spot working the ankle through range of motion 4 reps each spot and then move down towards the ankle hunting around for different restricted spots. Repeat on 4 different Trigger points.
Correction 2:
Tib Anterior Trigger Point Release: This helps to improve flexion/ extension/ and rotation of the lower leg and also improves propulsion and drive. This is an often neglected muscle, that plays a critical roll in both stability and power of all leg dominant movements.
Step 1: Place the Acumobility Ballon a yoga block or bench.
Step 2: Find a Trigger Point at the top of the muscle just off of the bone and drive pressure into the ball
Step 3: Create stability with the upper body by gripping the floor or bench and firing your lats. At the same time pack the breath and create tension in the core
Step 4: Put the foot through flexion and extension as you drive pressure into the trigger point. Repeat 5-7 reps. Find 3-4 Trigger Points as you work towards the ankle.
Correction 3:
Trigger point release of the back and side of the calf: This helps to improve rotation of the lower leg and is generally very restricted on people who have poor Tibial Rotation and ankle flexion. We are specifically targeting the Peroneus Longus, Flexor Hullucis longus and Peroneus Brevis.
Step 1: Find a Trigger point along the outer part of your calf near the ankle and using the Eclipse Roller place this area on the middle direct pressure strip.
Step 2: Lift your body off the ground into a side plank position with your other leg driving pressure down on top of the bottom leg.
Step 3: Roll back and forth in small 1-2 inch rolls targeting the different Trigger points in the side and back of the calf. (The Eclipse Roller is perfect for this, because with just small changes in angle you can lean into the different pressure strips and really target very specific areas)
Step 4: When you are on a specific trigger point bring the ankle through flexion and extension to work through active ranges of motion.
Note: You can also do an advanced version of this technique with the Acumobility ball. For a vid of this go here:
Correction 4:
Fascial Twist Release to the Calf.
This helps to improve rotation through the lower leg and improve the neuromuscular signaling through the fascia.
Step 1: Come into a lunge with the restricted foot forward
Step 2: Active press the big toe into the ground and work to fire your arch
Step 3. Using your hands, wrap around the calf and front of the lower leg and then create a wringing motion in which you grip and rotate the muscles of the lower leg both ways, to improve glide and roation.
Correction 5:
Trigger point release for the Glutes. This helps to improve the mobility in the hips. You want to target the Glute Medius/ Glute Minimus and TFL muscles.
Step 1: Lay on your side with your elbow on the ground and one foot firmly planted on the ground.
Step 2: Place the Acumobility Ball under your bottom hip on a restricted Trigger Point in the upper glutes.
Step 3: Brace through your core and engage the big toe and glute of the planted leg as you drive pressure into the ball.
Step 4: Lift your bottom leg up in a clamshell motion putting the external hip rotators through their active range of motion while releasing the specific trigger point. Repeat 5 reps and find 2-3 restricted spots.
Correction 6:
Active Figure 4 Stretch:
This helps to both improve hip mobility and activation of the external hip rotators.
Step 1: Lay on your back and bring one leg into the figure four position
Step 2: Reach through with your hands and pull your knee closer to your chest
Step 3: Actively Contract your stretched glute muscle and hold for 6 seconds, then release and sink deeper into the stretch. (Repeat this 3-4 cycles)
Correction 7:
Shin Box Getup with Fascial Tensioning:
This drill both improves mobility and also works to improve sequencing and stability through the chain.
Step1: Sit upright with one hip in internal rotation and one hip in external rotation. ( If you can’t get into this position then lean onto your hand and massage the internally rotated hip with the Ball as you slowly try to work yourself upright)
Step 2: Take 2 Acumobility Balls and crush them in your hands while activating your diaphragm, abs and lats to create tension through the torso.
Step 3: Drive your hips up and forward locking out at full neutral (make sure the glute is fired and that you stay upright)
Step 4: Swing the internally rotated leg in front of the body into a lunge.
Step 5: Actively contract the glutes and stand up
Correction 8:
Side step Lunge with Fascial Tensioning:
This drill helps to tie together Big toe/ Arch activation plus dynamic rotation of the lower leg. Once you have successful worked through the mobility problems in the lower leg, this is a great drill to keep in your routine as prep work for any single leg lifts or running workouts.
Step 1: Place one foot firmly rooted to the ground. Actively press the big toe into the ground and fire the arch.
Step 2: With the back leg step out at a 30 degree angle into a lunge.
Step 3: Stand back up, firing your glute as you go.
Step 4: Step out 3 more times, every time moving your foot further and further towards a 90 degree angle to the planted foot. This progressively challenges rotation of the lower leg while also encouraging proper activation of the foot.
You can see here how with just one time going through this protocol Meghan was able to immediately improve both her big toe activation and ankle mobility. With a few more times she should be able to get continually improvement and then transition to maintenance work.
Following the above protocol will give you a good starting strategy for improving your ankle mobility and stability. If you want to learn more sign up for our newsletter and follow us on Facebookand Instagram @acumobility.
-Brad Cox (Co-CEO/ Founder Acumobility)
