Is your knee pain actually coming from your knee?!

Background

Ankle mobility is a common impairment leading to improper lifting mechanics. It can affect your ability to perform the movements correctly as well as lead to pain in many different areas of the body. Often I have athletes come in complaining of knee pain when it all is stemming from poor ankle mobility. You can assess your ankle mobility easily in your own home and determine if ankle mobility is an area you need to improve. Where you feel the limitation will help you determine how to treat it. I will give you the breakdown to help you perform a self assessment.

Assessment

Seated and ½ Kneeling Ankle Dorsiflexion Assessment

Dorsiflexion is just a term that means bringing your toes toward your shins. This can be assessed when you are weight bearing (foot on the ground) or non-weight bearing (foot is not in direct contact with the ground).

For this test, we will assess in weight bearing since that is the position you are in during your squat, clean, snatch, and many other lifts where dorsiflexion is required. You can use a wall or a PVC pipe as your reference point. You will need to perform this test barefoot to help prevent yourself from cheating and lifting your heel. You start by getting down on one knee with your toes against the wall/PVC pipe and your foot flat on the ground.

From this position you are going to drive your knee forward over your second toe and try to hit the wall or PVC pipe with your knee. For the test to be accurate your heel will need to stay in contact with the ground.

If you can hit the wall with your knee, you will continue to move your foot back until you can no longer hit the wall with your heel staying flat. Your goal is to have your foot 4-5 inches from the wall before your heel begins to lift. This will ensure you will have enough ankle mobility for all your lifts that require a deep squat position. You can either use a tape measure or the width of your hand is used as a shortcut (typically around 4 inches).

If Limited…

Treating a Soft Tissue Limitation

First determine where you feel your ankle limitation. If you feel the limitation in the front of your ankle (typically feels more like a pinch), it is typically a joint restriction and might need further assessment. On the other hand, if you feel a stretch in the back of the ankle/calf (indicating soft tissue limitation) then working on mobility will be key. One exercise to try would be eccentric heel raises. You can perform this by picking a weight that would be difficult to perform 10 single leg heel raises. Stand on the end of a step and perform a normal bilateral heel raise but only come down on the leg that is limited. Be sure to come down as far as possible from each rep. Repeat for 2-3 sets of 10 and recheck your ankle mobility.

Give it a try and let me know if this helped with your knee pain.  If you have any other questions or feel like you need a more in depth assessment please reach out and let me know.