Recently, a client arrived for his appointment, armed with a research paper on the golf swing.1 “I want to discuss this paper before we get started,” he told me.
It’s not unusual for clients to walk in with questions regarding research or media reports on fitness topics. I am always happy to oblige with my thoughts if it’s an area I know anything about, as long as we get to moving around eventually.
I listened as he described the analysis of the golf swing. “There is a section on soleus mobility and its affect on the club swing.”
“If the soleus is tight, you will get out of your backswing early.”
He looked at me curiously. “That’s what the author concluded. How did you know that?”
The Role of Heel Anatomy
The ability of the heel to stay in contact with the ground depends on strength in the front of the shin and mobility in the back of the ankle. The gastrocnemius, or what most people think of when they refer to the calf muscle, points the foot when the knee is straight and flexes the knee. The soleus points the foot when the knee is bent; both muscles work together during physical activity to ensure efficient movement while walking, for instance.
In the front of the shin there is a muscle called the tibialis anterior that extends the foot up, otherwise known as dorsiflexing the foot. If you lack strength in the front of the shin and end range strength in the back of the ankle, your heel will leave the ground early during various activities, such as the golf swing; it may also make you more prone to tripping since your foot won’t work through a full range of motion when you are walking.
The tibilias anterior also inverts the foot at the ankle. This means it moves the sole of the foot away from the floor. There are muscles on the outside of the leg called the peroneals that move the sole of the foot towards the floor. All of these motions happen at the ankle and are different than the movements that occur when your foot flattens or arches.
Most ankle sprains that occur while playing sports are inversion sprains, meaning the outside of the foot rolls in while the foot is pointed.2 Creating balance in the strength and mobility of the ankle joint in several positions is an important component to rehabbing an ankle sprain; strengthening and mobilizing a healthy ankle can make the ankle feel less vulnerable when you do things like trail run, participate in a pick-up basketball game, or decide to play make believe games with your nephews that involve jumping on uneven surfaces to get away from imaginary crocodiles.
These movements become important when we walk and run. They are part of the process involved in propelling us forward, with the soleus and gastrocnemius acting as the main sources of propulsion, and the tibilialis anterior, hamstrings, and hip flexors functioning to accelerate the body right before the foot leaves the ground.3 The muscles that invert and evert the foot work together to prevent too much side to side motion in the ankle.
In an ideal world, everything works together, the foot can lift evenly, and you can consciously control the muscles that point, extend the foot, invert, and evert the foot in a balanced way.
The world of movement, unfortunately, is rarely ideal. Often, people lack conscious control over the ankle, are unable to move the foot evenly, or find that no matter what they do, the calf muscles remain stubbornly tight, limiting motion at the ankle.
Let’s look at a few ways to assess motion at the joint and begin exploring ways to increase range of motion and strength.
Assess Your Ankle Range of Motion
One of the most frequently used tests to check ankle range of motion in a coordinated task is the deep squat. If the ankles come off of the floor as you approach the end range of motion, you may be limited in ankle dorsiflexion. This was the test used in the paper my client brought in to determine whether the soleus could potentially be a limiting factor in the golf swing.
Here is the things with the deep squat: if you have really flexible hips, you can “cheat” the test. The ability to keep the feet on the floor isn’t just dependent on ankle dorsiflexion (though that’s certainly a contributing factor). It also depends on pelvis position, hip flexibility, and spine flexibility. I have worked with a surprising number of people who can drop into a deep squat just fine, but when asked to do other movements, struggle to maintain heel contact with the floor. If your heels come off the ground during a squat, yes, you definitely need to address your ankle range of motion, assuming a deep squat is something you want to do. If your heels stay down in the deep squat, that’s great, but assess yourself in other positions. Does your front heel want to come off of the ground when you come into a ½ kneeling position and lunge forward a little bit? What happens in your down dog position? Or if you are facing a step with one leg on top, what happens to the back heel? Or in a pistol squat, or a shrimp squat? You get the idea.
Assessing the ability of the ankle to dorsiflex extends beyond just looking at whether the heel comes off the ground. As I mentioned earlier, the ankle can move the foot in and out as well. Being able to feel the ankle doing this movement and having a little bit of strength and mobility during inversion and eversion becomes important for athletic endeavors and ankle. If you have ever sprained an ankle, working on ankle inversion and eversion can improve the loss of proprioception that often occurs during sprains.4
Proprioception is your body’s sense of where it is located in space. Your ankle joint is filled with mechanoreceptors that tell your brain where the foot is in relation to the ground, which in turn allows your brain to process the best way to land/maneuver over a rock/make it down the sandy trail without slipping. Being able to feel the center of the heel against the floor is a great way to provide an overall sense of stability to the entire neuromuscular system.
Brief note about the heel and the squat:
If you watch a room full of people deep squatting, some of them, as they approach the bottom of the motion, will unconsciously spin their heels in or collapse to the inside (or outside) of their heel. Why?
People spin their heels towards each other because it creates space in the pelvis to accommodate a deeper motion by moving the femur into external rotation. Don’t believe me? Try it.
- Stand up and arrange your feet so the tips of your toes are touching two yoga blocks placed side by side, a wall, or something else that doesn’t move. Your feet should be a little bit wider than hip distance apart. Keep your toes oriented against the blocks as you squat down and your heels against the floor. How far could you comfortably go?
- Now, allow your toes to turn out, so the heels come slightly towards each other and your heels come away from each other. Now squat down. How far can you comfortably go in this position?
Most people will be able to go further in the second scenario. There are a number of reasons for this which I will leave for the people that love biomechanics to explain, but if your toes turn out when you squat, know that it doesn’t guarantee the squatting gods are going to come down and ban you from the gates of squatting heaven. In fact, sometimes the sides are asymmetrical and one turns out more than the other.
If there is something going on in the hip, for instance, to avoid discomfort, the foot will naturally rotate outward. If you were to squat with the feet parallel, you may feel pinching or irritation in the side where the foot wants to turn out a little more. If this applies to you, thank your body for its intelligence and continue turning your foot out; however, see if you can set yourself up in the position you know you are going to end up in before you squat down, and see if you can keep the heel contact with the floor centered. Do you end up on the inside of the heel when you do this?
If so, chances are pretty good you will experience a similar shift when you balance on one foot, What I mean is the weight will shift to the inside of the heel, or the outside. It may even do one thing for the left side and another for the right side.
Think of it this way. If your version of using the center of the heel is actually the inside of the heel, your perception of where your leg is will be slightly off kilter. In addition, to maintain balance on the inside of the heel, everything that follows from the knee up will be in a slightly off balanced position. This isn’t a big deal if you don’t plan on doing any single leg balance work, but if you have goals for your lower leg program, truly being able to feel where center is can significantly impact your lower limb coordination for the better.
Hip Hinging
Let’s look at how the heel position can alter the experience of a simple pattern like hip hinging. When you set up for your deadlifting patterns, how do your feet interact with the floor? Specifically, what happens in the heel? Does the weight shift or does it stay centered?
- Start standing, with your feet about hip distance apart or maybe a little bit wider.
- Let your hips move back, coming into a hip hinge.
- Your knees can either bend or stay straight, your choice.
- Return to the starting position.
- Perform this movement three or four times, observing how it feels.
Where do you feel the weight shift? How are your feet interacting with the floor? Does the movement elicit a sensation of stretching, work, or maybe a combination of both?
Imagine the inside of the foot and the outside of the are growing long. Pay attention to how the line from the inside of your heels feel to your big toes and how the line from the outside of your heels feels to your pinkie toes.
Keep pretending like your heels are reaching away from each other. Don’t let the front of your foot pull up while your heels are reaching. What do you feel? Can you keep all of the work in your feet while you come into a hip hinge? Can you keep the work in your feet as you return to the starting position? Perform this movement three or four times.
Can you feel how the sitting bones feel like they are moving away from each other instead of towards each other? What do you feel in the front of the torso? Is your experience different than your experience a moment ago, when you weren’t paying attention to your feet?
Your ability to keep the heels in contact with the floor during closed chain activities and your perception of how they connect with the floor during movements like hip hinging can dramatically alter your experience of the exercise. If you struggle with feeling work in your hips, focusing on the feet and ensuring the ankles have adequate mobility and strength can improve the coordination of the movement you are trying to accomplish.
Final Note About Ankle Mobility
In order to be able to balance on trails without fear of spraining an ankle, jump with any sort of power, or move in a coordinated way low to the ground, ankle mobility matters. Learning how to move the foot in a variety of ways will allow you to generate more power in the hips.
Let’s think about the original inspiration for this post, the golfer with the tight soleus. What happens when he improves the mobility in his ankle?
He will have the ability to move around the foot, allowing the club to generate more speed during its downward trajectory. If he has good hip mobility to go along with his ankle mobility, there will be more power at impact when he makes contact with the ball.
Establishing good range of motion and control around the ankle joint is more than working the foot in center. If you want to be strong in the ankle for athletic endeavors other than lifting weight, challenge the joint in different positions. Give yourself access to more options during your athletic endeavors so you can so you can move powerfully and with a sense of freedom. Remember, start with understanding the basics: what does center feel like? Can I point the foot fully? I can I flex the foot fully? If you are unable to do the basics, work on those for a little while. The videos below will give you a few ideas.
Once you understand forward, back, and center, play with moving the foot different ways and understand how the inside and the outside of the heel differ from the inside and the outside of the front of the foot. Begin moving around the foot in different positions, challenging more end range strength and developing mobility at a variety of angles.
Your ankles are a source of stability and power. Treat them with the same attention you give the rest of your joints. You might be surprised what happens.
References:
1. Finn, C., (2013). Rehabilitation of low back pain in golfers. Sports Health, 5(4), 313-319.
2. Strom, M., Thorborg, K., Bandholm, T., Tang, L., Zebis, M., Nielsen, K., & Benke, J., (2016). Ankle joint control during single-legged balance using common balance training devices- implications for rehabilitation strategies. International Journal of Sports Physical Therapy, 11(3), 388-399.
3. Hamner, S.R., Seth, A., & Delp. S.L., (2011). Muscle contributions to propulsion and support during running. Journal of Biomechanics. 43(14), 2709-2716.
4. Yong, M-S., & Lee, Y-S., (2017). Effect of ankle proprioceptive exercises on standard and dynamic balance in normal adults. Journal of Physical Therapy Science, 29(2), 242-244.
