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Whether you're an avid runner, an athlete, or simply someone looking to improve their overall mobility, having flexible and strong ankles is crucial. Ankle range of motion plays a pivotal role in various activities, from walking and running to more specialized movements in sports. If you find your ankles feeling tight or limited in motion, fear not – there are targeted exercises which we prescribe quite regularly at Gold Coast Physiotherapy, that can help you increase the flexibility and function of your ankle joints. In this blog post, we explore these exercises and discuss the importance of healthy ankle range for movement and function.
Testing Ankle Range of Motion
Ever feel like you’re going to fall backwards when you squat deep? Very commonly our ankle range of motion can limit our ability to move well in everyday life. In fact, there are many research papers which have looked at ankle range of motion and its impact on our ability achieve healthy movement. The most common assessment used in physiotherapy for assessing ankle range of motion is the Knee to Wall Test (KTW).
The "knee to wall" test is a functional movement assessment commonly used amongst health professionals to evaluate ankle range of motion known as dorsiflexion. This test is often used in sports medicine, physiotherapy, and fitness settings to identify limitations in ankle mobility.
Try this test at home:
1. Stand facing a wall with your feet hip-width apart.
2. Place one foot's toes approximately 10cm away from the wall, toes pointing straight ahead. The other foot is not important in this test and should be behind you.
3. Keeping the heel of the front foot on the ground, attempt to touch your knee to the wall by moving your knee forward over your toes. Ensure that the heel remains in contact with the ground throughout the movement.
4. Measure the distance between the toes of the front foot and the wall. Ideally, the knee should be able to touch the wall without lifting the heel off the ground. A lack of dorsiflexion may result in the inability to touch the knee to the wall, indicating limited ankle mobility.
5. Perform the test on both legs, as there may be differences in mobility between the left and right ankles.
Normative Values on the Knee To Wall Test:
Research indicates that every 1 cm away from the wall is equivalent to approximately 3.6° of ankle/subtalar dorsiflexion (Bennell et al., 1998). Normal values are approximately 10-15cm on the knee to wall test (Gohil & Tilaye 2022). To have a good quality squat where you can maintain an upright trunk 16cm+ is required on the knee to wall test. Please see our blog post on “Mastering your Squat” to learn more.
The following sections will focus on exercises designed to optimise mechanics and range of motion at the ankle and are all proven exercises that help increase our ankle range of motion.
Exercises for Foot Mobility & Arch Activity
The ankle needs a solid base from which to function from. Having sound foot mobility and arch muscle activity sets the foundations to allow for good ankle function and inevitably ankle range of motion. Often, we will see clients in physiotherapy who have foot dysfunction which inevitably leads to ankle issues. A common presentation is the client who has weak foot muscles which results in a compensation strategy of overactive calf muscles which are trying to make up for the poorly functioning foot. The following exercises are great for improving foot mobility and arch activity.
1. Ball Under Foot
Recommended Prescription:
5-10 minutes
2 - 3 days / week
The ball-under-foot rolling exercise involves using a small, firm ball, such as a golf or a massage ball, to roll beneath the sole of the foot. To perform this exercise, place the ball on the ground and then gently roll it back and forth beneath your foot by applying pressure with your body weight. This helps massage the plantar fascia, the connective tissue on the bottom of the foot, and can be beneficial for relieving tension, improving flexibility, and promoting overall foot health. The exercise is commonly used as a self-care technique for foot discomfort, especially after prolonged periods of standing or physical activity.
2. Extensor Stretch
Recommended Prescription:
12 reps x 3 sets
2 - 3 days / week
The foot extensor stretch is an exercise designed to stretch and improve the flexibility of the muscles on the top of the foot and toes. To perform this stretch, flex your toes by actively curling them towards the sole. Whilst keeping your toes curled, point your foot to take your toes as far away from your shins as possible. Use a hand / or the ground to over press this stretch if you like and this will create a stronger stretch along the front part of your foot.
3. Arch Activations
Recommended Prescription:
10 x 10 second holds
2 - 3 days / week
The foot arch activation exercise strengthens the arches muscles of the feet. To create strong arches in our foot, we need solid contact with the ground in 3 places. These are the heel, the base of the 1st toe, and the base of the 5th toe. Our feet are just like a camera tripods, they most stable when all 3 points of contact are firmly grounded and spread wide apart. To perform this exercise, sit or stand with your feet flat on the ground and toes spread out. Then aiming to "shorten your foot with long toes” by closing the distance between your heel and toes you will activate the arch muscles of the foot. Again, try to keep your toes spread apart and long when doing this exercise.
4. Pick Ups
Recommended Prescription:
5-10 minutes
2 - 3 days / week
Using different materials / objects such as marbles, monopoly set pieces and socks to activate and hold the contractions. Play games like get as many marbles into a bucket as you can in 1 minute etc. Also picks ups + holds whilst doing foot circles and pointing and flexing your foot up and down are great for maintaining arch control with movement.
Exercise for Ankle Joint Mobilisation
It is the articulation between the tibia, fibular and talus bones (see image below) which allows for flexion (dorsiflexion) and extension (plantar flexion) at the ankle. This joint is called the talocrural joint. For normal physiological movement to occur into ankle dorsiflexion, the talus needs to slide backward underneath the tibia and fibular. The following exercise helps promote the sliding of the joint through the use of a heavy resistance band (power band).
5. Banded Dorsiflexion Stretch
Recommended Prescription:
8-12 reps x 3 sets
2 - 3 days / week
This one is a Gold Coast Physiotherapy favourite as it mobilises the joint whilst stretching the calf at the same time. With a Thick resistance band anchor approximately 1m behind you. Wrap the other end around the front of the foot just below the shin bone. Place your foot on an elevated surface approximately knee height. Begin moving the knees over the toes as far as possible then return to beginning to complete a repetition. Look to explore the full range of motion at the ankle when moving forwards, add a little pause at the end of its range to enhance the stretch. Provide additional pressure to the thigh with your hands/lean over with elbows to gain additional stretch.
Exercise for Calf Muscle Flexibility & Strength
Like all areas of the body when we are trying in increase range of motion, stretching is imperative and the ankle is no different. Tight calf muscles can significantly restrict ankle mobility. From the multitude of exercises there are to choose from when stretching the calf muscles, the standing calf stretch has proven to be the best over the years to address tight calf muscles which are restricting ankle range of motion.
6. Calf Stretches
Recommended Prescription:
3 sets of 45 second holds
2 - 3 days / week
Begin by standing facing a wall, with your hands placed on it for support. Take a step back with one foot, keeping it straight, and bend the front knee while keeping the back heel on the ground. Hold the stretch for 30-45 seconds and repeat on the other side. Performing this stretch twice on 3 days of the week has been shown to improve ankle range of motion (Young et al. 2013).
7. Seated Heal Raises
Recommended Prescription:
12 reps x 3 sets
2 - 3 days / week
Sitting with the ball of your fore foot on the edge of a step with your heels hanging over the edge. With your feet hip-width apart, a weight (approx 30% of your body weight to start) resting on your knees, slowly rise onto your toes, lifting your heels up. Hold for a moment, then lower your heels down below the step height slowly (3 seconds) until end range then stretch for 3 seconds. *like all the other weight bearing exercises, keep reinforcing toes spread, weight bear more under big toe and long toes.
Exercise to Address the Fascia
Fascia is a connective tissue that surrounds muscles, bones, nerves, and organs in the body. It forms a continuous, three-dimensional web throughout the entire body, providing support, structure, and a framework for various tissues. The fascial system is composed of collagen fibres, elastin, and a gel-like substance called ground substance. It contains many sensory receptors for feedback, and its flexibility is crucial for optimal range of motion. Well-hydrated and flexible fascia allows for smoother movement, while tight fascia can restrict mobility and lead to discomfort. Regular activity such ankle pulses and hopping helps to engage and mobilise the fascia.
8. Ankle Pulses & Mini Hops
Recommended Prescription:
3 sets of 45 seconds
2 - 3 days / week
Standing on both feet, with heels raised a little off the ground, toes spread apart and weight bearing a little more on balls of the feet. Push through the forefoot to bounce up and down without allowing your heels to touch the ground. Keep within a very small-moderate range of ankle movement (pulse in rhythm). Hold onto something for support if you are unsteady on your feet. Upgrade this to hopping once you are confident and sturdy on your feet. Again, implementing wide foot, arches on and long toes.
Exercise to Address Nerve Mobility
Nerve flossing, also known as nerve gliding or neural gliding, is a therapeutic technique aimed at improving the mobility and flexibility of our nerves. This method involves gently mobilizing and stretching a nerve through its natural course to reduce tension and enhance its function. The concept is similar to flossing a string through the eye of a needle. If done well nerve flossing can help to reduce nerve tension and improve range of motion at our joints.
9. Straight Leg Ankle Floss
Recommended Prescription:
20 reps x 3 sets
2 - 3 days / week
Laying on your back with your one leg straight out and flat on the floor and the other leg straight and up against a wall. A doorway is perfect for this. Choose an angle for your leg where you feel a stretch of approx. 3/10. Now bend and extend at your ankle by bringing your toes towards your shin, followed immediately by pointing your toes away from your shins. Complete this cycle repetitively, rhythmically, slow and controlled. You will feel the stretch increase in intensity at different foot and hip angles. This is the sensation of sliding/flossing your nerve
There you have it. Our 9 favourite ankle mobility exercises. Over our years of experience working with people from all walks of life, from professional athletes to weekend warriors, we have found that incorporating these specific physiotherapy exercises into your routine will help you to increase your ankle range of motion. By increasing your ankles flexibility you will increase your bodies efficiency to achieve tasks like bending and lifting, walking, running and weight training like squatting. Remember to start slowly, listen to your body, and be consistent with your efforts. Please be advised that this is no substitute for professional advice. If you experience persistent pain, discomfort or inability to improve with your ankle range of motion we advise you to consult with a physiotherapist who can provide personalized guidance and address any underlying issues. Investing time and effort into improving your ankle mobility will pay off big time, especially when it comes to bending and lifting things off the floor, playing with children and many more general tasks of daily living. By putting the time and effort into improving your ankle range your body will thank you, big time. Most importantly, always enjoy the journey of improvement.
References
Gohil R, & Tilaye P. (2022). Normative data for calf muscle flexibility tested by weight bearing lunge test in age group of 20-30 years- pilot study. Int J Health Sci Res. 12(2): 71-75.
DOI: https://doi.org/10.52403 /ijhsr.20220209
Bennell K, Talbot R, Wajswelner H, Techovanich W, Kelly D, Hall A. Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Australian Journal of Physiotherapy 1998;44(3):175e80.
Young, R., Nix, S., Wholohan, A. et al. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. J Foot Ankle Res 6, 46 (2013). https://doi.org/10.1186/1757-1146-6-46
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