You can only view 3 videos without an account. Become a Member to access all videos on the website.
Self-administered Ankle Mobilization
Self-administered Ankle Mobilization is a method of stretching, relaxing and strengthening the muscles surrounding the ankle joint. This technique can be used to restore natural ankle range of motion, reduce swelling and improve balance. It is completed through a variety of guided stretching and strengthening exercises, which can be done at home or in a physical therapy session. Additionally, mobility can be improved through the use of foam rollers or massage balls. This type of mobilization can help reduce pain, speed recovery from
Transcript
00:00:0500:00:09
This is Brent and in this video we're
00:00:0500:00:09
going over ankle mobilization. I'm very
00:00:0900:00:12
excited about this video as well as the next several videos in this series,
00:00:1200:00:17
because as you guys have probably started to realize, movement impairment, postural
00:00:1700:00:21
dysfunction, improving the quality of human movement takes more than just
00:00:2100:00:25
looking at muscles. There's joints involved, there are arthro-
00:00:2500:00:30
kinematic motion as well as arthrokinematic dysfunction to think about. Now
00:00:3000:00:34
self-administered joint mobilizations have always been a gap in our exercise
00:00:3400:00:39
selection. It's been very hard to find techniques that were effective as well
00:00:3900:00:45
as easy to teach and safe. Now luckily we've had some very creative individuals,
00:00:4500:00:49
we've had some very innovative techniques all of a sudden come in. We
00:00:4900:00:53
have guys like Kelly Starrett who's using these monster bands to create all
00:00:5300:00:58
sorts of changes in arthrokinematic motion. Now his techniques are a little
00:00:5800:01:02
extreme for my taste it might just be the populations that we work with, but
00:01:0200:01:06
then after talking to my friends Pete Schultz and Aaron Swanson over at dynamic
00:01:0600:01:10
sports physical therapy, I realized there was some ways to regress this stuff. I
00:01:1000:01:14
got a chance to work with it a little bit myself and add my little twists
00:01:1400:01:20
based on my thinking of dysfunction, and all of a sudden we have a set of very
00:01:2000:01:26
easy, very safe, very practical techniques that my personal trainers can use with
00:01:2600:01:33
their clients, as well as my ATC's PT's and DC's can now add to home exercise
00:01:3300:01:37
program so all of that mobility you've been working for in joints, is kept from
00:01:3700:01:40
session to session. I'm going to have my friend Melissa come out, she's going to
00:01:4000:01:45
help me demonstrate. Now before we even start thinking about what we should do
00:01:4500:01:48
to the ankle we have to think about what is happening at the ankle in dysfunction,
00:01:4800:01:54
which is we have the the calcaneus, the heel bone, the tail is stacked on top of
00:01:5400:02:00
it and then the tibia on top of that. Now in lower leg dysfunction dysfunction in
00:02:0000:02:06
this area, the talus has a tendency to switch anteriorly, try to get stuck
00:02:0600:02:11
anteriorly which then blocks the tibia and the calcaneus from being able to tip
00:02:1100:02:16
into dorsiflexion. It's like a mechanical block. Some of you guys have probably
00:02:1600:02:20
felt that when you go and do a calf stretch and you actually feel it more of
00:02:2000:02:24
like a pinching or pressure in the front of your ankle. The other thing that
00:02:2400:02:27
happens to talus is it starts shifting medially,
00:02:2700:02:32
which creates that foot flat thing we see in so many individuals. So we have to
00:02:3200:02:37
do for our mobilization let's find a way to work on dorsiflexion which is that
00:02:3700:02:44
range of motion that's commonly lost, while trying to shift the talus that
00:02:4400:02:50
way. Right it's stuck this way we want an anterior to posterior pull. Now my
00:02:5000:02:54
problem with some of the mobilizations I've seen in the past is in order to get
00:02:5400:03:00
room for the talus to shift, you kind of need to create some distraction in
00:03:0000:03:04
the ankle. Now we might not be able to do that all that well with
00:03:0400:03:09
self-administered techniques, but previously I've seen a lot of people try
00:03:0900:03:13
to stand on this leg, they put pressure through the tibia through the talus,
00:03:1300:03:17
through the calcaneus, and compress the talus and then they try to do the
00:03:1700:03:20
mobilization, and it just doesn't work because there's no room. Like I said this
00:03:2000:03:24
is where I went to dynamic sports physical therapy and Aaron Swanson was
00:03:2400:03:29
all of a sudden doing this technique raised up on a step, and I kind of
00:03:2900:03:34
realized the genius that was happening here. Now Melissa has to put the weight
00:03:3400:03:39
on her back leg, this is unweighted. So at the very least I have no more
00:03:3900:03:44
compression and when she drives into dorsiflexion, I'm hoping that this big
00:03:4400:03:51
monster band will give me enough force to keep the talus in place just like
00:03:5100:03:55
if I had put my hand here over the neck of the talus. So getting back into
00:03:5500:04:02
setup now, she's put this nice thick band just below her lateral and medial
00:04:0200:04:09
malleolus. Alright so just below those so the band kind of ends up on the angle
00:04:0900:04:13
right here of the ankle which is on the neck of the talus, she's going to
00:04:1300:04:20
shift her foot forward and get some good some good pull. I'm going to go ahead and
00:04:2000:04:25
give her a dowel or a foam roll or something, so that she can maintain her
00:04:2500:04:30
balance. She's going to try to keep her back leg underneath her body. Remember I
00:04:3000:04:35
want this leg taking on all the weight, if that leg gets way back behind her
00:04:3500:04:37
she's going to have to switch weight on this leg and then we have
00:04:3700:04:43
the compression problem again. Now we can get really fancy here not only use this
00:04:4300:04:49
dowel for balance, but put it between the second and third toe, put it a few inches
00:04:4900:04:54
maybe four or five inches in front of her knee, and now not only does she have
00:04:5400:05:00
something nice to balance with, but if I tell her to drive forward with her left
00:05:0000:05:04
glute, so I'm working on a right ankle, her left glutes going to actually be
00:05:0400:05:10
doing the work, I can have her work on dorsiflexion trying to get to that stick
00:05:1000:05:15
which is not so easy. Alright let's try 15 to 20 reps of that, it's usually the
00:05:1500:05:21
rep range I've been working on lately. 15 to 20 reps making sure she keeps her
00:05:2100:05:25
heel down, if she doesn't keep her heel down we're not working on dorsiflexion
00:05:2500:05:32
anymore. I keep that heel down and she's got this huge posterior pull.
00:05:3200:05:38
Now you can start applying I know my PT's out there, my ATC's out there, my DC's
00:05:3800:05:41
out there, we're all taught our mobilizations our grade ones, grade 2's,
00:05:4100:05:45
grade 3's, grade 4's, it would be a little too much for me to say that we could
00:05:4500:05:52
replicate that here. But you guys could go from these larger amplitude movements
00:05:5200:05:57
to like let's say she has no pain she's just really stiff, maybe I can get her
00:05:5700:06:02
into end range and then just have her oscillate, right like we were taught to
00:06:0200:06:09
and our mobilizations in school just one to two oscillations per second for
00:06:0900:06:14
30 seconds, and maybe that's how I'm going to do this technique. So now you
00:06:1400:06:19
guys got two options; we can go through a full range of motion and she can use the
00:06:1900:06:24
stick as the goal, or we can take her to her end range and just try to oscillate
00:06:2400:06:29
a little bit. If she was somebody who was having pain I do want to warn you guys
00:06:2900:06:34
with this, let's say she has ankle impingement, we only want to touch that
00:06:3400:06:38
pain. We don't want to go into that painful range. Just touch it, because the
00:06:3800:06:45
last thing I want to do is take a nice inflamed ankle and make the inflammation
00:06:4500:06:47
and the pain worse. We definitely don't want to do that because it's going to
00:06:4700:06:49
change your gait, it's not going to help her move better,
00:06:4900:06:55
I would still use this technique, I would just say let's say she starts feeling a
00:06:5500:06:59
pinch right here, well good, I would have her set that stick back, I just want you
00:06:5900:07:03
to touch the pain, don't go into it, don't make it worse,
00:07:0300:07:07
and then she's going to back off it. Alright so we're still getting work on
00:07:0700:07:12
that anterior to posterior mobilization, but through a range of motion that's
00:07:1200:07:16
pain free. Alright guys so I want you to work with that, let me have you go ahead
00:07:1600:07:19
and switch sides so they can see that you're putting all of the weight on the
00:07:1900:07:27
other leg. Just want to see you guys see both sides of this set up, and then we'll
00:07:2700:07:35
show you the medial to lateral pull on the talus because it's the same thing.
00:07:3500:07:39
What I want you guys to notice is she set up nice and tall, good kinetic chain
00:07:3900:07:43
checkpoints, her shoulders are over her hips, her foots beneath her, and
00:07:4300:07:47
then I'm going to have her squeeze this glute and really think about squeezing
00:07:4700:07:53
this glute so that she does not start loading this leg, which is going to add
00:07:5300:07:58
the compression and make that mobilization a little harder. Once again
00:07:5800:08:03
we can do those larger amplitude movements, we can do the smaller
00:08:0300:08:06
oscillations at end range. Or if she had a little pain in her ankle we could go
00:08:0600:08:11
just up to the painful area and back, trying to help with ankle mobility
00:08:1100:08:16
without exacerbating that pain. Alright the next technique I'm also really
00:08:1600:08:22
excited about which is a medial to lateral mobilization. So we got to switch
00:08:2200:08:26
around here make sure they don't trip over the band,
00:08:2800:08:35
thank you. No other way, so you can, there we go,
00:08:3900:08:45
good. Now I know what you guys are thinking
00:08:4500:08:48
that we probably go mediolateral and start rocking back and forth this way, but that
00:08:4800:08:52
actually does not work out very well. You guys are going to get a medial to
00:08:5200:08:55
lateral force just like you see. I'm going to have her step out just a little
00:08:5500:09:01
bit that way, put the stick in this hand between our second and third toe. I
00:09:0100:09:07
actually kind of like a little bit of abduction here so that the tibia is
00:09:0700:09:12
slightly internally rotated, and then they're working on keeping their first
00:09:1200:09:18
MTP, that ball just behind their big toe down on the floor. Alright this seems
00:09:1800:09:23
to keep inversion. What I don't want to see is them all of a sudden flop into
00:09:2300:09:27
eversion because just like compression won't let the talus move this way, if
00:09:2700:09:32
all of the sudden i evert, all of the sudden now the talus can't move back into
00:09:3200:09:39
position laterally. So I needed to stay inverted but with first MTP on the
00:09:3900:09:43
ground, and then she's going to do the same thing, she's just going to do a
00:09:4300:09:51
little dorsiflexion and work on talar mechanics but now in the frontal plane.
00:09:5100:09:56
How does that feel, all the same stuff applies. Most of the weight is on this
00:09:5600:10:00
leg, she can do larger amplitude movements, she can do the smaller
00:10:0000:10:04
amplitude movements at the end of a range. Like I said if she had some pain
00:10:0400:10:09
we would go just up to the point of pain working on good ankle mobility, without
00:10:0900:10:13
exacerbating that dysfunction. Melissa thank you very much. I hope you guys
00:10:1300:10:17
enjoy these techniques. Go out and grab some of these monster bands they're
00:10:1700:10:22
really not that expensive. I know you guys can find steps in your club, a dowel,
00:10:2200:10:26
few pieces of cheap equipment, and all of a sudden we fill a huge gap in our
00:10:2600:10:30
postural dysfunction and self-administered technique model. I'll
00:10:3000:10:33
talk with you soon.
Related Videos
Self-administered Ankle Mobilization
Open Books - Self-administered Spine Rotational Mobilizations
Self-administered Hip Mobilization: Anterior to Posterior with Flexion
Self-administered Hip Mobilization (Lateral Distraction)
Knee Mobilization
Quadruped Crawl Sled Pull
Talocalcaneal Manipulation
Talonavicular and Cuneonavicular Joint Manipulations
Proximal Tibiofibular Joint Manipulation
Sacroiliac Joint Chicago Technique
Thoracic Pistol Manipulation
Upper Cervical Manipulation
Radial Head Manipulation
Shotgun (Pubic Symphysis) Manipulation
Elbow Mobilization (Self-administered)
Crucifixion Stretch (Static Pec Stretch, Sub-occipital Release & Gentle Thoracic Mobilization)
Thoracic Spine Self Administered Mobilization