Knee Injuries

Ankle Dorsiflexion:

If you take a moment to review our information on how poor dorsiflexion affects the body, you’ll understand how a dorsiflexion restriction can play havoc on the entire kinetic chain. It can make squatting and lunging difficult and can decrease glute firing, which are all very important for performance and health. But, the affect it has on the knee joint, is probably the most important factor to consider. Knee injuries affect hundreds of thousands of athletes yearly and cost millions of dollars to treat. Neither of those stats take into account the affect of competitive time lost on athletes and their teams.

How it occurs

As the body attempts to lower itself into a lowered position to squat, lunge, decelerate, change direction or some other athletic movement, the body will search for the easiest and most efficient path to get there.

As the knee bends, it will have to move anteriorly (forward) to maintain balance and keep the center of gravity over the foot. This anterior movement will force the ankle into dorsiflexion. If they are restricted, the body will search for an easier, less restrictive path to gain the motion that it needs.

Typically, the easiest path around the dorsiflexion restriction begins at the foot. By pronating and flattening the foot, it will allow the athlete to get around the restriction. Unfortunately, this is not a desirable position to be in because of it’s affect on the rest of the lower extremity.

With pronation comes Tibial rotation. As the Tibia rotates inward, the knee will then be more likely to collapse inward into a valgus position. This is where things go very bad.

Common Injuries

The position of pronation, internal rotation, and valgus exposes an athlete a variety of lower extremity injuries. As it pertains to the knee, there are 2 main injuries that occur in this position:

Anterior Cruciate Ligament Tear – The ACL tear is likely the most feared of all injuries by athletes. It will force an athlete to have major reconstructive surgery, rehab, and months on the sideline. The most common mechanism for an ACL tear is pronation, internal rotation and valgus.

Patella Femoral Knee Pain – This is likely the most common knee pain experienced by athletes. As the knee goes into valgus, the patella (knee cap) will ride on the lateral (outside) portion of the femur (thighbone), causing pain. While it is not usually debilitating in nature, it can be extremely painful and irritating, especially for the high level athlete.

If an athlete is allowed to train in the position of pronation, rotation, and valgus, the neurological feedback loop used by the body learns that this is a normal position and strengthening in that position only cements the problem.

Many professionals will spend hours strengthening the glutes to control the knee or fit the athlete with expensive custom orthotics, but forget about the ankle. Glute strength is extremely important, and orthotics are incredibly useful tools, but much of that work can be avoided by finding and fixing the actual restriction.

To learn more about increasing ankle dorsiflexion, click here…