When the ankle lies to you

When the ankle lies to you.
Yesterday I saw something I see quite often. It was a client with dorsal foot pain, nothing shocking. But, this client had plentiful ankle dorsiflexion on the table during examination but when they walked, there was barely any use of ankle dorsiflexion-ankle rocker. Heel rise was premature.

It once again proves that just because you have it, doesn't mean it is available to be used. There was adequate hip extension and glute strength so it wasn't coming from there, though that is a frequent source. The examination was detailed, but to keep it brief here today, this client, had decent strength about the ankle from what could be determined, but they failed the hop test, control was terrible, and they could tell. Once again, if you cannot control the joint under load, the body will often not give you the full range, merely out of self preservation mode to protect the joint. This client was attempting to get more ankle rocker motion via arch collapse and over pronation to get the tibia to progress forward enough for normal gait. The collapse was causing a dorsal impingement on the foot. Lots more to come on these ideas in future posts. 
None the less, it is a good lesson to all those people out there that think that everyone just needs more ankle rocker strength and range of motion. The truth is, not everyone does, and forcing it in some will cause them pain or problems or compensations . . . . and that is your fault if it is the case.

-Dr. Allen