"Move Better" Series: Exercises To Improve Balance and Transfers

As we age, loss of lower extremity strength and balance may decrease our ability to perform once routine tasks. It may have become more difficult to stand up from our favorite living room chair, rise from a low toilet seat, or get in and out of the car. Impaired strength and balance may also increase our risk of falls and subsequently increase the likelihood of sustaining an injury from a fall. 

Although some changes in functional strength are expected with age, we can help combat these changes by participating in regular lower extremity strengthening and balance exercises. This blog post presents some lower extremity strengthening and balance exercises that can be performed to improve your transfers and balance.

SIT-TO-STAND STRENGTHENING EXERCISES

Sit-to-stand and squatting exercises can improve your ability to squat, stand from various surfaces, and perform stairs. The following video shows a progression of sit-to-stand exercises. Perform 2-3 sets of 10-15 repetitions:

BRIDGING STRENGTHENING EXERCISES

Bridging exercises are a great way to improve the strength in your hip extensors, including the gluteal muscles, and improve your trunk stability.  Perform 2-3 sets of a bridge progression that challenges you while maintaining proper form. 

STATIC & DYNAMIC BALANCE EXERCISES

Static balance exercises  are a great way to start improving your balance, so long as they can be performed safely. It is always a good idea to have a countertop, chair, or other stable surface nearby for upper extremity support for safety while performing balance exercises. You may also want to consider only performing balance exercises when someone else is present if you feel your fall risk is high.

Dynamic balance exercises focus on improving balance and stability while your body is moving or switching positions. In general, dynamic balance exercises are more challenging than static balance exercises, and should also be performed with upper extremity support within reach.

The following video show a progression of both static and dynamic balance exercises (Note: the first four exercises are static balance exercises, the last two are dynamic balance exercises):

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

"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!

"Move Better" Series: Knee-To-Wall Test

Welcome to our new "Move Better” series, a progression of simple strength, mobility, and balance tests you can perform at home to assess your movement abilities, with corrective exercises to follow.

WEEK 1 - ANKLE DORSIFLEXION MOBILITY:  KNEE TO WALL TEST

Ankle range of motion is important for many daily and sport tasks, from walking and stairs, to running and powerlifting. Despite the importance of ankle range of motion, many people find that their ankles are stiff and lack mobility. Watch the video below to see how you can assess your ankle mobility quickly and easily at home:

Noticing any stiffness, tightness, or movement restrictions? Look out for tomorrow’s blog post that will include exercises and information on how to address these range of motion limitations. And stay tuned for more “Move Better” content in the weeks to come. These weekly tests will target movement limitations in people of different age groups and activity levels.

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

Keep moving!