Why That Dorsiflexion Restriction You Missed May Be Your Runner's Problem

Whether it is a foot, ankle, knee, hip, or back issue, a missed dorsiflexion restriction can be a source of many of your runner’s complaints.  How can such a little thing throw off so much?  Let’s start with the most common compensation for a lack of dorsiflexion. 

Our bodies are smart and figure out ways around our deficits.  We typically begin to collapse inward at our medial foot when we can't move forward in the sagittal plane.  Some of our runners will even externally rotate their foot to get just a little more translation of their tibia over their foot. 

Stop for a moment and try this.  Imagine yourself with limited dorsiflexion as you move into midstance?  How would you get around it?  Now, allow yourself to collapse inward at your ankle/midfoot and you can see it’s a way to get past the lack of ROM.  This is a prime contributor to many of our runners who over-pronate or remain pronated too long during their gait cycle!   

20 degrees of dorsiflexion in closed chain is required for mid stance.  When this is measured, there should be at least 30 degrees (closed chain measurement) to prevent the need to operate at the end range of the runner's motion

Knowing this, it is easy to look at how this could contribute to a variety of foot and ankle issues, but the knee and upwards?  Let’s have you do the same experiment.  Allow yourself to collapse inward at your ankle and watch your tibia follow.  Continue to trace this up to your knee and BOOM, your collapsing mechanics with excessive valgus!  This is the same findings of Rabin et al in 2016.¹  Valgus collapse at the knee is correlated with reduced dorsiflexion PROM!

If we take it a step further, we could even move this thought process to the hip. The femur is likely to follow the knee and create an internally rotate and adducted position at the hip, or in other words, moving into impingement positions.  Finally, when we internally rotate our femurs, it is common we will also anterior tilt our pelvis, which can contribute to lumbopelvic complaints as well. 

All this from a simple dorsiflexion restriction!  No matter the diagnosis, a quick screen of dorsiflexion is imperative in our runners. Identifying this deficit can go a long way towards helping multiple issues we encounter. 

If you'd like more on this, check out our 2 Mobility Fixes You Can't Miss In Your Runners short online course. It's available free for a limited time by clicking here. 

We also have our full lineup of Certified Running Gait Analyst: Level 1 courses throughout the United States.  We discuss dorsiflexion and its roll in running, but move far beyond this to help you understand running mechanics, relate it to movement, and make immediate changes in your runners.

Blog Post Written by: Ari Kaplan, PT, DPT, SCS, CSCS, COMT, Cert MDT

LinkedIn: Ari Kaplan

Instagram: CertifiedRunningGaitAnalyst

References:

1. Rabin A, Portnoy S, Kozol Z. The association of ankle dorsiflexion range of motion with hip and knee kinematics during the lateral step-down test.  J Orthop Sports Phys Ther.  2016;46(11):1002-1009.