Ankle range of motion and injuries - correct footwear fitting

The ankle joint is made up of the three articulating bones of the lower leg, including the tibia, fibula and talus. These bones connect the lower leg and the foot, and allow for movement to predominately occur in the sagittal plane of motion, as ankle dorsiflexion and ankle plantar flexion – seen in the illustration.

(Dugan et al., 2005)

The function of the ankle in running

This function of the ankle is essential in running both at the initial contact with the ground and to propel the weight of the body forwards by pushing off the ground. As the foot is a complex structure consisting of 26 bones and 33 articulating joints, movements can occur in several ways simultaneously. For example, ankle dorsiflexion is a part of pronation (ankles roll inwards) and plantar flexion a part of supination (ankles roll outwards) when the foot is weight bearing (Dungan et al., 2005).

Pronation and supination movements are essential for shock absorption, and propulsion of the foot off the ground at the end of stance phase. In pronation, the joints in the foot decouple and the ankle splays out medially (internally). During supination, the arch lifts and the foot becomes a rigid lever in preparation for propulsion. With this, both movements are essential for  correct function during gait.

Most of the muscle work in running involves eccentric contractions to shock absorb and stabilise during the pronation/dorsiflexion phase. During supination/plantar flexion, muscles work concentrically in propulsion to move the body forwards.

If the ankle joint motion is restricted, soft tissues around the joint and neighbouring joints consequently have to work harder to attenuate impact shock and create stability about the lower leg joints. Consequently, this can increase the risk of injuries.

The most common running injuries to occur in the soft tissues around the knee, foot and ankle region as reported by Taunton et al., (2002):

In women, patella-femoral pain syndrome (knee pain) and iliotibial band friction syndrome (ITBS) (outer hip pain) were the most common running injuries.

In men, plantar fasciitis (under foot/heel pain) and patella-femoral pain syndrome (knee pain)  were the most common running injuries.

Although ankle mobility is not proven to have a direct link to such injuries, limited dorsiflexion can potentially have a knock-on effect on other joints (Pope et al., 1998) and increase the tissue stress on surrounding muscles and ligaments due to less efficient shock absorption at foot level (Dugan et al., 2005).

Profeet’s experience

From our fitting experiences in Profeet, limited ankle dorsiflexion is generally seen to link with many common running-related injuries such as anterior knee pain, medial tibial stressplantar fasciitis and Achilles problems. If the velocity of the foot is high when contacting with the ground, this can potentially cause the impact shock waves to travel along the kinetic chain and shock attenuation will pass on to tendons of the ankle, the knee and hip joints. With that said, individual people differ in their shock attenuation capabilities throughout the body, and it is important to note that dorsiflexion is not the only factor that comes to play with soft tissue injuries.

Making sure that you are wearing the correct footwear and introducing some strength and mobility exercises alongside your running is essential to stay injury free. Watch our video for some ankle specific strengthening exercises.

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