Ankle Function: Be a chef, be a scientist, not a juice bar junkie.

Today, another "no rocket science here" post, however these are things to keep in mind.
Ankle stability is critical, whether is it walking or sport related running. We must have ample S.E.S. (skill, endurance and strength as we like to say here at TGG, and in that order might we remind you !).  
And on that point, one is building strength on a skill without being able to do that skill repeatedly with durability (Endurance) then you are probably skipping a critical step in the rehab process. Yes, exceptions do occur, but rarely.  If you cannot do something well repeatedly and maintain the clean skill pattern, they why are we adding more strength to it first ?  Do something well, often, repetatedly, with durability, then add more strength and up the skill level.
The ankles are no different. There are multiple planes of movement down there, every direction is possible. We approach things from a cylinder perspective, every quadrant of that cylinder must be stable,  have skill, endurance and strength.  There are tremendous forces going down through that area, they had better be clean, controlled and the limb better be durable ("The absolute forces in the two joints (knee and ankle) were similar, equivalent to eight to nine times body weight in both cases."-Alex Hutchinson, excerpt from Medicine & Science in Sports & Exercise by researchers at the University of Jyvaskyla in Finland, link below.
Power had better not precede, S.E.S,.  From the article:  "And the progressive loss of ankle power as we age may be one of the key reasons we slow down".

As Hutchinson extracted from the Finnish study, "But the knees were capable of much greater maximum forces – nearly 14 body weights, on average – when the subjects jumped up and down as high as they could. In contrast, the ankles had a maximum force of less than 10 body weights, meaning that they’re already working at nearly their maximum strength even during a gentle jog. This suggests that the ankles are much more likely to hold you back if they’re weak, according to Juha-Pekka Kulmala, the study’s lead author. “The muscles working closest to their upper functional limits are the ‘weakest link,’” he says."

The Hutchinson article goes into other thoughts and perspectives, read it. The link is below.

Just know that this is just not about just doing heel raises, the science is more than than. If it were that simple the schooling for all that we all do would be a 3 hour internet youtube video course.  The pieces have to play well together and if you train strength into faulty patterns, you get strong faulty patterns which can increase injury risks.  There is a time for peroneal work, time for tibialis posterior work, time for single leg balance work, time for heel raises, for double hoping, single hopping, multidirectional hopping, skipping, walking, running or sprinting. The process isn't like your morning smoothie, meaning just throw it all in and blend, there is a science and sequence.  And, that science and sequence is variable and specific to each and every client. The process cannot be "cook booked ", you will do many people injustice if you just go for the smoothie routine.  Be a chef, be a scientist, not a juice bar junkie.

- Dr. Allen, one of the gait guys


1. Med Sci Sports Exerc. 2016 Nov;48(11):2181-2189.

Walking and Running Require Greater Effort from the Ankle than the Knee Extensor Muscles.

Kulmala JP1, Korhonen MT, Ruggiero L, Kuitunen S, Suominen H, Heinonen A, Mikkola A, Avela J.


2. "Pay attention to your ankles — they can slow you down with age." Alex Hutchinson. Special to The Globe and Mail

http://www.theglobeandmail.com/life/health-and-fitness/how-weak-ankles-slow-us-down-with-age/article33458151/