"Move Better" Series: Exercises To Improve Your Dynamic Leg Strength

Yesterday’s “Move Better” post presented the Y Balance Test as a way to test your dynamic balance, strength, and stability while moving in various directions.  The Y balance test is a good functional test to assess hip and knee strength in active individuals and is often used to determine an athlete’s risk of lower extremity injury during sport activities. 

Improving your dynamic lower extremity strength and balance can improve your sport performance and decrease your injury risk.  Several studies suggest impaired dynamic balance and hip strength are risk factors for lower extremity injury during activity (1,2).  Weakness in the hip musculature may lead to dynamic lower extremity valgus (the knee moving inward) during single leg squatting, jumping, and landing.  Dynamic lower extremity valgus has been correlated with an increased risk of several knee conditions, including ACL injury and patellofemoral pain. 

Hip strength and stability are important components of many athletic activities.  Strong hips are needed to transfer force from the lower body to the upper body in sports such as basketball, soccer, volleyball, football, and throwing in track and field.  Strong hips are also required for quick and powerful changes in direction, cutting, and lateral movements.  Dynamic hip strength and stability also plays an important role in daily activities, including walking with a normal gait pattern, standing on one leg, and ascending and descending stairs.  

Exercise to improve hip strength and dynamic balance are provided in the videos below.  The video below includes exercises to improve dynamic hip strength:

The next video includes exercises to improve dynamic balance of the lower extremities:

In summary, focusing on hip strengthening and dynamic balance exercises can improve your performance with sport and daily activities and may decrease your lower extremity injury risk.

Questions?  Contact sean@salmonbaypt.com.

-Brian Collins, DPT & Sean Tyler, DPT

References

1. Khayambashi K, Ghoddosi N, Straub RK, et al. Hip muscle strength predicts noncontact anterior cruciate ligament injury in male and female athletes: a prospective study. Am J Sports Med. 2016;44(2):355-361.

2. Plisky PJ, Rauh MJ, Kaminski TW, et al. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2006;36(12):911-919

"Move Better" Series: Exercises To Improve Thoracic Mobility

Yesterday’s “Move Better” series post presented the ‌‌Tragus‌ -To-Wall‌ ‌Test‌ ‌‌‌to‌ ‌assess‌ ‌your‌ ‌neck‌ ‌and‌ ‌thoracic‌ ‌spine‌ ‌mobility.‌  This blog post will present exercises to improve thoracic mobility - more specifically the motion of thoracic extension. 

The thoracic spine is the mid-region of the spine that consists of twelve thoracic vertebrae (T1-T12) that are attached to the ribs posteriorly.  The orientations of the joints in the thoracic spine allow for motion in several planes, including flexion, extension, and sidebending.  

Sufficient thoracic extension is important to allow full scapular and shoulder range of motion with overhead activities during daily and sport activities.  A lack of thoracic extension mobility may impact someone’s strength with overhead activities and may increase someone’s risk of neck, shoulder, and low back pain.  Thoracic extension may be limited in people who spend a lot of time in positions of slouched or forward flexed postures, including office workers and landscapers.  

The video below includes exercises to improve thoracic extension mobility passively with the use of a chair, foam roller, or other substitute, like a rolled up yoga mat or large towel. 

Other common exercises that may improve thoracic extension mobility include stretching for the pec and lat muscles, which will be included in another upcoming “Move Better” post.  A future “Move Better” post will also cover ways to assess and improve thoracic rotation, another important motion that occurs in the thoracic spine.  

Stay tuned!

-Brian Collins, DPT & Sean Tyler, DPT

"Move Better" Series: 5 Times Sit-To-Stand

This week’s “Move Better” series includes a simple test to assess your balance and fall risk. If you feel like your balance and mobility is not what it used to be, try this test to see if you may be at an increased risk of falling.

Stay tuned for simple strength and balance exercises you can perform at home to improve your mobility and balance.

Be well!

-Brian Collins, DPT & Sean Tyler, DPT

"Move Better" Series: The Importance of Ankle Dorsiflexion Mobility

WHAT IS ANKLE DORSIFLEXION?

Dorsiflexion is a motion that occurs at the ankle and involves the movement of the top part of the foot toward the tibia (shin) bone.  The same movement occurs when your feet are planted on the ground and you bring your tibia forward over the foot, like when you squat or crouch.  

WHY IS ANKLE DORSIFLEXION IMPORTANT? 

Restricted ankle dorsiflexion has been found to  impact many functional movement patterns including the squat, single-leg squat, step down, and landing from a jump.  This may impact a person’s ability to perform sport specific movements as well as normal daily activities.  Someone with impairments in ankle dorsiflexion mobility may have difficulty going down stairs, squatting to lift an object off of the ground, standing up from a low chair, or walking on inclines and uneven surfaces.  

Limitations in ankle dorsiflexion during squatting, lunging, and jumping activities is also correlated with an increase in dynamic knee valgus during these movements.  Dynamic knee valgus is when the knee moves or collapses inward while under load.  This increase in dynamic knee valgus may increase someone’s risk for knee injury and knee pain with sports and movement.  

Adequate dorsiflexion range of motion is also important for running and sprinting.  During running and sprinting, ankle dorsiflexion range of motion can affect the swing speed of the forward moving leg and alter the foot position and amount of pronation during impact with the ground.  

HOW CAN I ASSESS MY ANKLE DORSIFLEXION MOBILITY?

See our previous blog post titled “MOVE BETTER" SERIES: KNEE-TO-WALL TEST to watch a video on how to perform a simple dorsiflexion mobility assessment at home. 

WHAT CAUSES POOR ANKLE DORSIFLEXION MOBILITY?

Ankle dorsiflexion mobility can be impaired due to tight calf musculature or a prior ankle injury or surgery.  These injuries and surgeries may include ankle fractures, tendon and ligament repairs, and ankle sprains.  These injuries often result in periods of immobility and possible tissue scarring that can impair ankle dorsiflexion mobility.  They may also alter the alignment and biomechanics of the ankle joint.  Both significant and minor ankle injuries may affect ankle mobility, however in most cases the ankle joint can regain full range of motion and function over time.      

HOW MUCH ANKLE DORSIFLEXION IS NORMAL? 

Normal ankle dorsiflexion range of motion is 20 degrees according to most research and orthopedic organizations, however there is some variability in the research literature.  Studies have found that walking requires 10-20 degrees of ankle dorsiflexion, while studies examining squatting have found that more than 20 degrees may be necessary to get into deep squatting positions.     

To measure your ankle dorsiflexion, see our previous blog post titled “MOVE BETTER” SERIES: KNEE-TO-WALL TEST.

HOW CAN I IMPROVE MY ANKLE DORSIFLEXION?

In most cases, ankle mobility can be improved with consistent stretching and joint mobility exercises.  See our recent blog post “MOVE BETTER” SERIES: EXERCISES TO IMPROVE ANKLE DORSIFLEXION MOBILITY for exercise examples.

-Sean Tyler, DPT

"Move Better" Series: Exercises To Improve Ankle Mobility

Following up from yesterday's “Move Better” series post on how to self-assess your ankle dorsiflexion mobility, today we will provide exercises to improve ankle dorsiflexion mobility in three ways: self-myofascial release, stretching, and ankle joint mobilization. 

Self-Myofascial Release: Foam Rolling 

Foam rolling the calf is an easy way to perform self-myofascial release of the calf musculature at home. Roll up and down the entire length of the muscle for about 1 minute each side.  If you hit a trigger point you can focus on that area for 10 seconds.

Stretching the Gastroc and Soleus Muscles 

Studies have found that static ankle dorsiflexion stretching can improve ankle dorsiflexion range of motion significantly.  A stretch should be performed for both major muscles of the calf, the gastroc and soleus muscles, by performing a calf stretch with the knee straight and with the knee bent.  Hold each stretch for 30 seconds and repeat 3 times each side.

Other Ankle Mobility Exercises 

• Lunge Ankle Dorsiflexion Stretch 

  • This is a simple stretch that can be performed as a dynamic warm-up before an activity to help improve ankle range of motion.  Get into a half kneeling position and slowly lunge forward, pushing your knee past your toes and keeping your heel on the ground.  Hold position for 5 seconds and repeat 10 times.

• Squatting Ankle Dorsiflexion Stretch

  • The squatting ankle dorsiflexion stretch is a good way to improve ankle dorsiflexion for squatting activities.  For this exercise, squat near an object that you can hold on to for balance, like a door jamb or squat rack.   Perform a deep squat, keeping an upright torso and pushing the knees forward past the toes.  Hold the deep squat position for 2-3 seconds and perform 10 repetitions.  

• Lunge Dorsiflexion Mobilization

  • The lunge dorsiflexion mobilization may be helpful if you feel a pinching or stiffness in the front of the ankle when performing the dorsiflexion mobility test.  This exercise uses a strap or lanyard to help glide the talus bone posteriorly during the stretch, which can improve address restrictions due to joint stiffness.  To perform this mobilization, position an anchored strap below your ankle bones and slowly lunge forward, pushing your knee past your toes and keeping your heel on the ground.  Hold position for 5 seconds and repeat 10 times.   

• Eccentric Heel Raises on Step

  • Eccentric exercises for the calf have been shown to improve muscular flexibility and improve strength of muscles and tendon structures.  Begin by standing on a step with knees straight, rise onto balls of your feet, and slowly lower your heel down into a deep stretch in your calf and ankle.  Complete 10-15 repetitions for 3 sets.  

The exercises above can help improve your ankle dorsiflexion mobility if performed correctly and consistently. There are several other great exercises out there for improving ankle dorsiflexion in addition to those selected above.

Questions? Contact Sean Tyler, DPT at sean@salmonbaypt.com.

Keep moving!