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Ankle dorsiflexion clinical significant & anterior knee pain

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  • Ankle dorsiflexion clinical significant & anterior knee pain

    Hi P&R team,

    In school, I've been exposed to a lot of emphasis placed on ankle dorsiflexion ROM and needing a certain "range" to walk, run, perform certain movements etc. I'm of the understanding that our bodies tend to adapt and figure it out i.e. through compensation elsewhere, and this isn't necessarily going to lead us to injury.. However, a lot of importance is seemingly being placed on restricted ankle dorsiflexion as something that needs fixing or that the patient/individual must achieve normative data (10-12cm is what i've been seeing)... or else excessive load can result in increased foot pronation, knee valgus, hip IR, and trunk forward lean.. and this is.. bad?

    My "knee to wall" or "weight-bearing lunge" test is 5cm each side, and I can squat to depth just fine. I'm experiencing some anterior knee pain (likely tendon related and loading based, trending upwards through modification's), though people have suggested a correlation to my "bad" ankle ROM and knee pain, hence why I am questioning its importance.

    I'm also curious as to its applications for different populations (i.e., runners, team sports athletes, ankle injury), and if it holds any weight? I apologise If I misrepresent Derek's view, but I heard remember him briefly mentioning the knee to wall test in one of the P&R BBM podcasts, suggesting it's not really that useful.

    I appreciate this is a lengthly post, so thank you for your time. Any help around clarifying these narratives would be fantastic, as i've had limited experience with this. Below is one of the key papers i was looking at.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829001

  • #2
    Originally posted by alexb View Post
    Hi P&R team,

    In school, I've been exposed to a lot of emphasis placed on ankle dorsiflexion ROM and needing a certain "range" to walk, run, perform certain movements etc. I'm of the understanding that our bodies tend to adapt and figure it out i.e. through compensation elsewhere, and this isn't necessarily going to lead us to injury.. However, a lot of importance is seemingly being placed on restricted ankle dorsiflexion as something that needs fixing or that the patient/individual must achieve normative data (10-12cm is what i've been seeing)... or else excessive load can result in increased foot pronation, knee valgus, hip IR, and trunk forward lean.. and this is.. bad?

    My "knee to wall" or "weight-bearing lunge" test is 5cm each side, and I can squat to depth just fine. I'm experiencing some anterior knee pain (likely tendon related and loading based, trending upwards through modification's), though people have suggested a correlation to my "bad" ankle ROM and knee pain, hence why I am questioning its importance.

    I'm also curious as to its applications for different populations (i.e., runners, team sports athletes, ankle injury), and if it holds any weight? I apologise If I misrepresent Derek's view, but I heard remember him briefly mentioning the knee to wall test in one of the P&R BBM podcasts, suggesting it's not really that useful.

    I appreciate this is a lengthly post, so thank you for your time. Any help around clarifying these narratives would be fantastic, as i've had limited experience with this. Below is one of the key papers i was looking at.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829001
    Hey - thanks for the questions. Generally speaking, this isn't something I would worry about or go around screening for. We did a podcast a number of years ago on voodoo flossing which was specifically trying to use the knee to wall test, nothing special and I don't put much stock in the test. https://www.youtube.com/watch?v=IA134VTK2uI

    The usual time in which I check ankle range of motion is post-trauma / post surgical and looking to restore some semblance of prior individual normative range of motion from side to side.

    In regards to tendon related pain and disability - I'd check out our guide to tendinopathy HERE.

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    • #3
      Thanks for the clarification. Listened to the podcast/youtube video you linked, gave me some very useful insight. Cheers!

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