Problem - Alleviating Ailing Ankles: Part 2

In the first round of Alleviating Ailing Ankles, I discussed the function of the ankle joint and demonstrated a few exercises to help achieve additional range of motion in dorsiflexion. While on the surface it seemed to be a very extensive article, luckily for you and I alike, the foot and ankle are extremely complicated and thus true ankle health and “mobility” is a multifactorial issue, and often just training “dorsiflexion” is not sufficient.

In this article, I will discuss with you further the structure, function, and pathomechanics of the ankle in another critical motion to foot and ankle health—subtalar inversion and eversion—and also give you a few practical solutions for restoring mobility.

Why do we want eversion?

While dorsiflexion is often trumpeted as critically important for ankle health (and it is) we often forget the importance of the “red-headed step child” of movements, eversion. Like most things in the body, rarely does a joint move one way without there being other accessory joint movements. With regards to the ankle, pure dorsiflexion is nice, but in gait dorsiflexion occurs with eversion and also abduction, which the sum of the three create “pronation.”

Unless the joint is adequately mobile in all three planes of motion, we are doing our athletes a disservice as they will eventually seek and find mobility in places where they should not. Those familiar with the concept of joint by joint training can certainly appreciate this idea—our body is composed of relatively mobile joints connected via relatively stable segments.

Understanding the mechanics

As you will remember from AAA: part 1, pronation or supination at the subtalar joint can help the ankle achieve additional dorsiflexion or plantar flexion range of motion, respectively. But what exactly is the “subtalar joint”?

The subtalar joint is composed of three articulating facets—anterior, middle, posterior—between the talus and the calcaneus. The flat, calcaneal anterior and middle facets offer a gliding motion, whereas the posterior facet is saddle shaped, which permits triaxial movement. The joint is reinforced by a joint capsule surrounding the anterior and middle facets and a capsule surrounding the posterior facet. It seems that the collateral ligaments of the ankle play a role in the position of the subtalar joint, including the oft-injured anterior talofibular ligament (ATFL).

Problem - Alleviating Ailing Ankles: Part 2