Injury Prevention Screen Part 5: Squat/Ankle Mobility

On December 24th, 2013, posted in: Ankle, Hip, Injury Prevention by 0 Comment
Injury Prevention Screen Part 5: Squat/Ankle Mobility

The video below demonstrates the Squat/Ankle Mobility Test, which is part 5 of a 5 step Functional Movement Screen I taught to a group of personal trainers. This set of movement tests is designed to identify predispositions to injury so they can be addressed before a problem occurs.

VIDEO TRANSCRIPTION (Please excuse grammatical errors, as this is simply a transcription of conversational speaking)
So if you do see that you know there’s issues with the single leg squat in terms of the hip stability, the knees going in, things to watch out for or to wait on until you’ve got them strong and showing that stability would be lower body plyometrics, like box drops, a lot of cutting agility stuff. I’d wait on that until you saw that they’re really, really stable with that test. Is there anyone here with a history of ankle sprains or ankle issues by chance? I just want you to face everybody and, with your legs apart a little bit, however you would do a squat keeping your heels on the ground. Just go ahead and do a squat for us and come on back up.

With this, what you’re looking at, what you’re going to look from all sides-from the back, side, and the front. From the front, you’re looking for: Are the knees dropping in? From the back and the front you’re looking- Are they loading each side equally? Are they you know are they overloading one side versus the other? Go ahead and do another squat for us. This is pretty classic. From what she did there, I can immediately tell it was her left ankle before she said anything because when she drops down she gets to a point where she can’t go further with her knee because she doesn’t have enough dorsal flexion in her ankle but this one you can go further. What happens is this: It’s a rotator, so I’ve had a lot of patients in the past with let’s say a right hip/right knee/right ankle or some kind of back issue and the thing that led to it was the fact that they sprain their ankle two years ago and they’ve been doing squats like this. So they’re just loading that side. So you want to look from the front and back-are they loading evenly, first of all. If they’re shifting, are they immediately shifting like it’s some some kind of a neural pattern or they just got in the habit of staying off one side versus the other. Are they real nice and symmetrical till they get low and then they tilt off? That’s usually going to be more of a hip or ankle range of motion issue. If both ankles are limited, what you’ll see is they get to there they can’t go further, so to get deeper, I see a lot of high school athletes in the clinic and it amazes me that they’re told to do box squats. You know, touch the box down here but they have no dorsal flexion. They’re stuck there so what they do is they can either fall backwards or they have to lean forward with this big load on their back and then they strain their back, so the consequences of ankle issues on one side is that you’ll usually overload the opposite side. Then if they’re both tight you’ll usually bend forward too much and then the back’s at risk.

To look at each of them individually I have them do knee drives. Put your hands here, put one foot forward. Let’s do the right foot first and this foot back and you’re just going to drive this knee forward over your toes as far as you can. Keep the heel down. Don’t worry about this, we’re just looking at the right. So as far as you can keeping the heel down. Can you tell me what stops you? Is it a pull back here? A binding in the front? Come out of that. So that’s good on her right side. She’s good. What you want to feel at the end ranges is that what you want them to feel is that they have a stretch here somewhere along the in the gastroc soleus or down in the Achilles. If they’re having a binding in the front, that’s a problem and it needs to be fixed and manual therapy, those who know how to do that, can do so really quickly.

Go ahead and try that on your left now. Keep that heel down. What keeps you from going further forward there? So it’s surprising to me that she doesn’t have that block feeling in the front even though she’s really limited. What I would do with her is probably work on the posterior side of her leg, loosen that up, and then the next time she did it, she probably would get the block feeling because that’s more of a scar tissue thing that can build up, especially from ankle sprains. So again, with this squat you’re looking at it from all sides. Are they loading evenly? Is there an issue like a pinching at the hip? Or block at the ankle that is causing them any pain? You know what you kind of have to communicate with them-why aren’t you loading symmetrically? Try to get to the bottom of that. You know if it’s something like the ankle stuff, just stretching the tight ankle. If it’s a joint this, it’s probably just going to grind the ankle. It needs to be released with some manual techniques. If it’s just a stretch in the back, foam rolling, stretching, things like that should knock it out.

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