In this next installment of our foot series, we are going to be taking a look at the anatomy of the ankle, the biomechanics of the ankle with particular emphasis on the talus and rearfoot tripod (yes, we have another tripod in the foot!), and the role these structures play in our ability to supinate, pronate, and ultimately integrate our feet with the rest of the body.
Anatomy of the Ankle
First, let’s review the anatomy of the ankle. The ankle is comprised of two primary joints, the subtalar joint and the talocrural joint. Just briefly watch a few seconds of the video below to get a visual of the structures involved.
What is important to notice when it comes to these two joints is that they have one key component in common: the talus. The talus is a very unique bone in the body in that it has no muscular attachments, and because of this, it provides a very specific type of proprioceptive feedback to the rest of the body. The talus serves as a gyroscope of sorts. Check this out:
Pretty crazy right? What this means is that ankle function is of utmost importance. If our talus is malpositioned or unstable, it will adversely affect how muscles not only in the lower extremity, but throughout the entire body function. In order to restore and maintain optimal position and movement of the talus, we need to make sure to have adequate control through the pronation-supination continuum. We need to ensure that not only do the talocrural and subtalar joints of the ankle function well, but also ensure that the midfoot integrates with the ankle as well.
The Second [Less Often Talked About] Foot Tripod
In a previous article [CLICK HERE], we went over the forefoot tripod, and the role it plays in foot function. What we didn’t talk about is that there is technically another tripod within the foot. The two are intrinsically linked together. The three points in the rearfoot tripod are the:
If you read the previous foot tripod article, you might remember that we briefly talked about the importance of these joints and how to mobilize them. The ability to respond to load in these joints has a drastic effect on the talus and vice versa. Because we know the talus has large-scale effects on proprioceptive input and neuromuscular control, maintaining optimal foot function must involve the integration of the forefoot tripod, rearfoot tripod, and ankle joints. This is what will ultimately allow for the fluid control of pronation and supination in the foot and ankle.
Supination vs Pronation
When we are talking about pronation and supination, we mostly associate these joint motions with walking gait. Pronation and supination allow the foot to have the dynamic stability required for shock absorption, as well as allow for the storing and releasing of kinetic energy through the lower extremities. The feet are highly involved in the Deep Longitudinal, Lateral, Anterior and Posterior Spiral kinetic chains. It at all starts with the feet.
One simple way to think about supination is to liken it to inversion, or simply the foot pointing down-and-in. We mostly utilize the foot in a supinated position in gait when we are pushing off and extending through the hips. Pronation is simply the opposite; liken it to eversion, or the foot turning out and up.
Our conversation around ankle mobility is most often centered around the idea of restoring dorsiflexion, which is primarily motion happening at the talocrural joint. Adequate ankle dorsiflexion is an important component for deep squats and activities like olympic lifting. However, as important as talocrural joint-focused ankle mobility is, we need to also appreciate the importance of subtalar joint function. I don’t think we talk enough about the rotational and lateral motions that also occur at the ankle when it comes to performance.
Chronic instability or lack of mobility in the subtalar joint will often lead to issues like knee pain and hip immobility. This has implications with almost any athletic endeavor.
In the case of the feet and ankles, my clinical experience has shown me that no matter what type of athlete you are, whether you are a weightlifter or runner, skier or cyclist, crossfitter or yogi, the feet and ankles are almost always in need of improvement. We usually get drastic improvements in strength, flexibility, power and overall athletic performance when we restore and maintain optimal foot and ankle function.
Integrating the Feet & Ankles
My usual approach foot and ankle integration is focused on simplicity. What will give us the most bang for our buck with our self-administered corrective protocols?
Focusing on restoring mobility in the requisite joints, and make sure that those joints have the ability to appropriately respond to load is a good place to start. I showed you a few drills in my Foot Tripod article that focused on three key joints of the foot tripod; here they are again in case you missed them:
https://youtu.be/16z29mho49E
https://youtu.be/OSO5g0KaLPc
Typically, if the joints feel stiff and achy while performing these drills, chances are that they need improvement. Doing them regularly and prior to any lower body training days will help to slowly progress the function of the joints over time.
Once we’ve mobilized the foot, the next step is to focus on integrating the foot and ankle with the knee, hip, and spine. There are many ways to do this depending on what your training goals are. However, I am of the opinion that the absolute best way to integrate the feet with the rest of the body is incredibly simple. The magic exercise that makes this happen that almost everyone needs to do more of is…..
…
…
…
…WALKING!!
Yes, you read that right. Walking is one of the most under-appreciated and under-utilized forms of exercise out there. Granted, not everyone’s gait pattern is a thing of beauty, but even then I recommend more walking for improved overall function. More minimal the footwear the better. Chances are high that if we ensure the feet and ankles are functioning well, and we then integrate our feet and ankles with our walking gait through copious amounts of walking, we will be well on our way to functioning and feeling a lot better. Sometimes it is that simple.
In order to further help integrate your walking gait, here are a handful of drills that can also help:
https://youtu.be/dBTcs4dPpbs
Rolling Patterns: Sequential rotation of the legs, hips, spine, and shoulders is incredibly important for walking gait. One of the primary problems that shows up in gait is a lack of rotation happening through the hips and thoracic spine. Rolling patterns are a great way to work on improving sequential rotation throughout the body, particularly because we can do so without loading the joints which helps to minimize compensation. I consider this to be a regression of walking. This drills does not allow you to use your large prime mover type muscles like your quads, lats, hamstrings, etc. and so you are forced to use your deeper stabilizing muscles predominantly.
https://youtu.be/l4SXQ6CZvhU
Slow Gait Walking: With any exercise, one way to really make sure you are owning it and able to do it properly is by slowing it down. Slowing things down forces you to recognize and work through suboptimal compensation strategies. Performing a skill more slowly forces you own each phase or aspect of that skill.
By that logic, walking incredibly slowly will make it apparent to you where you might need to improve stability, or joint response, or load capacity. By slowing down, you can pay more attention to the areas that need improvement, and then incorporate additional drills that can improve upon and reintegrate the pieces that are not functioning optimally.
If rolling patterns and slow, gait-mechanics-focused walking are feeling good, go walk! Walk your dog! Walk to work! Walk a handful of miles a week at least. It’s one the simplest and most effective ways of improving overall biomechanical function.
Wrapping Up
The feet and ankles are one the most important key areas in the body when it comes to restoring and maintaining full-body biomechanical efficiency and movement capacity. The more efficiently we move and larger capacity we have for good movement, the smaller our chances are in regards to sustaining injuries, struggling with chronic pain, and greater our overall performance.
Hopefully this article gave you guys some good insights and understanding as well as some useful tools to help facilitate better function in your feet and ankles! Stay tuned, we’re just getting started. Over the coming weeks and months, I will be continuing to write articles like this going through every area of the body.