Hi. I’m Dr. Eric Cobb of Z-Health Performance. Today, we’re going to be talking about ankle pain and rehabilitation.
I’m going to show you some progressions over the next few weeks of things that you can do if you’re recovering from an ankle sprain, some type of ankle injury, or your ankles just bother you after playing sports or after you take a long run.
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So I wanna talk about the ankle. Obviously, if you’ve never had a bad ankle injury, you have no idea how limiting it is. But ankle pain is a huge detractor for most of us from participating in daily activities.
So whenever we start thinking about solving an ankle issue, the first thing that we wanna do is begin restoring motion to areas of the ankle that are somewhat restricted.
The easiest way to begin with this rather than an active exercise is probably to begin with some passive mobilizations.
So I’m gonna show you some ways to work on this yourself. What you’re gonna do is you’re gonna sit and you need to be in a cross-legged position.
Now if this is difficult for you, you can use a lower table or something, but basically, the reason I’m going to have you sit in this position, if possible, is that we wanna use the leg that’s in contact with the floor as basically a table or a block. so that as we start moving the ankle ourselves, we have some resistance.
So we’re not having to use so much force with our hands.
So the first thing that we’re gonna focus on is the back part of the ankle. The rear bone here is called the calcaneus and we need the calcaneus to have some degree of mobility.
So what I’m gonna do is I’m going to grab just below my inside and outside ankle bone, my malleoli with one hand, In this case, since this is my right leg, I’m gonna use my right hand there. And then I’m gonna use my left hand and I’m gonna grab the back of my heel.
I’m gonna tuck it in and then I’m gonna have my fingers pointing toward my toes. Now, once I’m in this position, I have two different movements that I want to do.
Movement number one is a gliding motion. So this means I’m gonna be driving my heelbone down toward the floor, up toward the ceiling. Alright? So I’m just gonna be moving it up and down. And you can see I’m using my top hand to provide some counterforce.
So my hands are actually moving in opposition to one another. I’m also using the pressure against the leg to help me get some motion.
As you can see, my foot is just in a relatively neutral position as I do this. I’m not trying to pull my toes up. I’m not trying to point my toes yet. So I’m gonna begin with that lateral glide.
Now I’m going to tilt. So I want you to stay in that same position, you’re holding onto the heel, and now you’re going to imagine you’re turning a doorknob in and out. So I’m gonna be tilting the calcutaneous back and forth.
This is very much like one of our classic exercises called ankle tilts. So I’m just trying to create some motion in each of these directions.
So again, We have a down and up motion and we have a door knob type motion. Now once you’ve done that with the foot in neutral, I want you to try to repeat those same movements with the foot first or the ankle in dorsiflexion.
So you’re gonna pull your toes and foot up toward your knee. And you’re gonna repeat that lateral glide and your little doorknob motion. And then you’re gonna point your toes and you’re gonna do the same thing.
And what you’ll notice in each of these positions is that you’ll have more or less freedom of motion in the calcaneus.
Now once we’ve done that, we’re now gonna move lower in the foot.
So I’m now gonna think about the area of my arch. I’m gonna come above my arch and below my arch.
My thumbs are pointing at one another. Once I’m in this position, I’m going to do a towel wringing motion.
So I’m just gonna be wringing one direction and the other direction. We’re trying to create a rotational mobilization of all of these tarsals and metatarsals, little bones in the foot. And again, what you’re trying to find is, are there areas where things don’t feel like they’re moving very well?
If so, you’re gonna spend a few extra repetitions of just rotation. You’re gonna wanna move your foot or your hands up a little bit and your hands down a little bit and you’re gonna repeat that same wringing motion.
Once you’ve done your wringing motion, you’re then going to begin doing a gliding motion, which is what we were doing with heel where one hand is pushing down while the other hand pulls up.
So now I’m doing kind of a side-to-side gliding movement of the midfoot.
Once I’ve done those two together, I can combine them.
So I’m gonna do a little bit of a wringing movement and a little bit of a gliding movement. Opposite towel wringing motion with some gliding movement.
So we’ve worked on our heel. We’ve worked on the midfoot. We then wanna go toward our toes.
In the toes, the easiest thing to do is to think about pulling the toe off the foot, so distracting the joint, and then lifting it up into extension.
Distract the joint, lift it up into extension. And you can do this on all of your toes. You may actually feel some things popping and moving and that’s all relatively normal.
Once you’ve done some distraction with the extension. You’re gonna distract and rotate.
Distract and rotate.
So I want you to do that through all of your toes You’ve worked now through your heel, through your tarsals, metatarsals, all the way down to the phalanges.
If you put that foot back on the floor now, moving your ankle around, hopefully, you will notice that it feels more free.
In most cases, this kind of passive mobilization is going to be insufficient. to completely resolve any kind of issue in the ankle, but we found it to be really effective as a home process that you can do to just start waking the area up, reminding your brain that you have a foot, and you have an ankle that is supposed to move, and then we’ll follow that up with some active exercises next time.
So good luck with this. I hope it works well for you.