An ankle that doesn’t dorsiflex and stabilize well can cause problems locally or ‘up the chain’ at the knee, hip, and lower back. Understanding what’s moving, how it moves, and what type of training helps may lead to a healthier season for the players under your care.
The muscles primarily responsible for dorsiflexion are the extensor digitorum longus, tibialis anterior, and extensor hallicus longus. Remember, the foot is rarely strictly dorsiflexed, because of the axes of rotation about the talocrural joint (tibia, fibula, talus) and subtalar joint (talus, calcaneus). The talocrural joint and subtalar joint together contribute frontal, sagittal, and transverse plane freedom to ‘pull up.’ This pulling up through dorsiflexion, abduction, and eversion is pronation.
Dorsiflexors act as antagonists to the plantarflexors and play an important role in the gait cycle. Their primary actions are:
Activation at ground contact to help control plantarflexion on heel strike (walking)
As the heel hits, dorsiflexor group contracts eccentrically to allow the foot to be set down smoothly.
Weak dorsiflexors create the ‘foot slap’ when the foot falls quickly as it hits the ground.
Activation as the foot is picked up and swung forward in preparation for the next stride (swing phase)
Dorsiflexion ensures the toes don’t drag. Dorsiflexion weakness can create toe catching or ‘foot drag.’
When strengthening the dorsiflexors, you may be stricter in your movement and attempt to only dorsiflex. Or, consider other muscles (e.g. fibularis brevis and longus in eversion) and movement patterns in gait, training, or play to allow more freedom of movement when an athlete ‘pulls their toes to the ceiling.’
Active contraction: while seated, flex the ankle up and control the downstroke, trying to squeeze the muscles on the front of the shin.
Isometric Hold: with a band secured around both feet and one hip in flexion (at or above 90 degrees), maintain this position.
Dynamic Isometric: walking heel marches (walking with the foot held in dorsiflexion).
Band-Resisted Dorsiflexion: with a band secured around both feet and one hip held in flexion (at or above 90 degrees), move the ankle through concentric and eccentric dorsiflexor contractions
(post from Rehascience Instagram on December 9, 2018, titled ‘Ankle Dorsiflexors’)
Sport-specific notes: Hockey players tend to have poor ankle dorsiflexion. These strengthening exercises can follow post-skate mobility work, activation, or prehab. The banded isometric or band-resisted dorsiflexion engages the hip flexors at or above 90o and could be a useful pre-skate activation or prehab exercise.
Following the joint-by-joint approach outlined by Cook and Boyle, the ankle is a mobile joint and will more often require training to be stable or strong (e.g. resist outside forces). That doesn’t mean to avoid mobility work entirely, though. If your players have a hard game day, history of ankle injury that’s created a temporary loss to dorsiflexion, or tough week of training, it doesn’t hurt to check mobility and ensure athletes are ‘coming as mobile as they’re going.’ A useful tool to that end is the Knee-to-Wall Ankle Dorsiflexion Assessment. You’re looking for close to 20 degrees of dorsiflexion with a less than 10% difference left-to-right. The PrehabGuys put together a video to demonstrate the test (https://library.theprehabguys.com/vimeo-video/knee-to-wall-ankle-dorsiflexion-assessment/). This exercise can become a personal check-in prior to training, then easily parlay into a mobility exercise, if it’s an appropriate fit.
Major muscles supporting the ankle often benefit most from strengthening, unless there’s a loss of mobility from lifestyle, sport, or injury. To support dorsiflexion, you have your choice in strengthening modalities. but periodically check-in to ensure movement is still fluid and full. 5-minutes regularly invested pre-workout or between major lifts can save a player 5 weeks in the rehab room.