A fix for stiff ankles – your knees will thank you!

Originally published in: The Raider Patch: Magazine of the U.S. Marine Raider Association

  • Do you wear boots for work?
  • Have you been a member of the military?
  • Have you rolled or sprained an ankle in the past?
  • Have you rolled one ankle more than once, or rolled both ankles?
  • Can you stand on each leg for 10 seconds with eyes closed and without falling over? 

If you answered Yes to even one of these questions, Congratulations! You’re likely the winner of some knee pain, compliments of stiff ankles.

Everyday activities such as squatting, going up or downstairs, and running require full motion at the ankle to avoid compensation by other joints in the body. When the ankle doesn’t move as it should, other joints up the chain (e.g., knee, hip, and low back) have to create that motion to get you where you need to go. The knee seems to be the most vocal of the areas impacted by injured or stiff ankles. Increased demands may also be placed on joints down the chain, such as the big toe, to propel the body forward.

When you live a physically-demanding lifestyle and wear footwear designed for protection, your risk of ankle problems is significantly increased. For example, military personnel sustain up to five times as many ankle sprains as the general population. In addition to the binding effect of military and work boots, incomplete recovery after ankle sprains can create excessive scar tissue and a loss of ankle mobility.

You can prevent several types of knee pain by keeping your ankles healthy. Read on to learn how to measure your ankle mobility and what your score means. Then learn how you can improve your score to reduce the stress on your knees.  

Ankle dorsiflexion range of motion in a kneeling position should produce a shin angle of about 40 degrees, allowing for little difference between left and right ankles. You can use your hand and a wall to approximate this measurement if you don’t have an inclinometer or a smartphone handy. Your knee should clear your toes by 4 inches or about the width of your palm (Figure 1), and the difference between left and right should not be more than one finger-width.

Figure 1

If you scored a 2 or 1 (Figure 2), try the Kneeling Ankle Mobility drill (Figure 3). Perform 30 repetitions daily, twice a day for extra credit if you feel like it’s helping. While a normal ankle doesn’t require stretching, even 10 reps a day can help to maintain what you’ve got. 

Figure 2
Figure 3

Retest your ankle mobility every week for four weeks. If your numbers fail to improve, you may need a different solution.  Ankle dorsiflexion stretches like this one are usually effective. However, other structures in the foot, calf, or knee can be involved in limited ankle mobility. They could need different exercises or hands-on treatment. 

Mobile ankles may not solve all of your knee pain problems, but they will relieve unnecessary stress on the knees, hips, and lower back. If you scored 0 on either side, it’s best to get an assessment of your knees and ankles by a physical therapist, athletic trainer, or other sports medicine professional. Take care of your joints (all of them), and they’ll take care of you!

References:

  1. 1. Teyhen DS, Shaffer SW, Butler RJ, et al. What risk factors are associated with musculoskeletal injury in US Army Rangers? A prospective prognostic study. Clin Orthop Relat Res 2015;473:2948-58.
  2. de Noronha M, Refshauge KM, Herbert Rd, Kilbreath SL, Hertel J. Do voluntary strength, proprioception, range of motion or postural sway predict occurrence of lateral ankle sprain? Br J Sports Med. 2006;40(10):824-828.
  3. Cook G. Fit to Serve. 2013. Available at: graycook.com

Related Articles 

If stiff ankles (or aching knees) are making it difficult to lift weights, here are some ways to modify your lower body routine:

Which Deadlift is Best for You?

Dealing with ankle pain or a sprain injury? These articles might help: 

How to Brace a Sprained Ankle

Selection Injuries: The Good, Bad and Ugly, Part 3 (Shin and Ankle)


Dealing with persistent ankle or knee problems? If you have any questions, reach out to us at team@alphapnr.com. We answer every question.

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