The Importance of Dorsiflexion

The Importance of Dorsiflexion

The Importance of Dorsiflexion for Lower Extremity Functioning I have spent the last year working on research projects around the need for proper dorsiflexion range of motion for optimal lower extremity function during functional tasks such as a squat, step down, and jump landing.

Dorsiflexion is often limited by tightness in the gastrocnemius and/or soleus muscles (AKA the calves). There have been several recent studies examining the effects of limited dorsiflexion.  The first study involved healthy subjects and simulated restricted dorsiflexion by having subjects stand on a wedge while performing a squat.  They found that decreasing the amount of available dorsiflexion altered both movement patterns (participants exhibited excessive medial knee displacement) and muscle activation patterns (Macrum, 2012).  In the other study, participants displaying excessive medial knee displacement during an overhead squat task were measured to have decreased dorsiflexion range of motion (Bell et al., 2012).  This was also seen by Robin & Kozol in participants performing a lateral step-down test (2012).

Excessive Medial Knee Displacement

 

This excessive medial knee displacement can be because decreased sagittal plane motion at the ankle can lead to compensatory increases in frontal plane motion throughout the rest of the lower extremity (Bell et al., 2012).  These compensations of excessive dynamic knee valgus can lead to an increased injury risk including ACL tear, pes anserine strains, and patellofemoral pain syndrome (Hewett et al., 2005; Messier et al., 1991; Nicholas & Hershman, 1995; Powers, 2003). Part of my research in this was a case study of a recreational soccer player with a long history of sports injuries to her lower extremities.  Dorsiflexion was very limited bilaterally and patient was complaining of pain in both knees with soccer and with stairs.  After evaluation the patient stretched her calves daily.  She performed no other exercises to address her knee pain and after only two weeks of stretching was completely pain free! Moral of the story: STRETCH YOUR CALVES!

Macrum et al., Journal of Sports Rehabilitation, 2012.

Bell et al., Athletic Training & Sports Health Care, 2012.

Robin & Kozol, Journal of Orthopaedic & Sports Physical Therapy, 2010.

Press & Young, Functional Rehabilitation of Sports and Musculoskeletal Injuries, 1998.

Bell et al., Archives of Physical Medicine and Rehabilitation, 2008.

Hewett TE et al. Am J Sports Med. 2005.

Messier SP et al. Med Sci Sports Exerc. 1991.

Nicholas JA, Hershman EB. The Lower Extremity and Spine in Sports Medicine. Baltimore: Mosby; 1995.

Powers CM. J Orthop Sports Phys Ther. 2003.