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Corrective Exercises for Foot and Ankle Pain | Trainer Tips

Posted on December 25, 2022

To watch the full video, click here: https://youtu.be/cwxN1mv2s7M

Hey coaches athletes, Michael Hughes here with Gymnazo Edu, introducing a brand new series on tweakology. Now I gotta give some credit to the great institute here for inventing this word, at least that’s who I think invented it. And understanding what it means to be a tweakologist. And it’s basically taking an exercise modification environment, and changing it so it fits the person in front of you, so that the workout the session doesn’t stop doesn’t crumble when you hit a brick wall. And like, I don’t know what to do more, we’re going to help unpack what to do with different parts of the body, kicking off with a foot and ankle complex, it is going to be quick hitter videos, just to spin your mind up on what’s going on. And in this video, I’m gonna be covering the muscle anatomy of the Foot Ankle, the major players of what’s going on. And then, most importantly, the common exercises and the dysfunctions, and therefore tweaks that can get associated with the Foot Ankle complex, and how you can start thinking about it. Now there’s a revolutionary process happening in the fitness and athletic industry, and is being fueled by the knowledge that in the past has been held by those who could obtain a six figure graduate degree but even then, that knowledge is vastly incomplete in its application, it is muscle at US goal to share the knowledge and therefore enable a greater capacity to those individuals who have the most power and capability to possibly help the greatest number of people. And those are the movement trainers of the world. Before us trainers can do that, we need to know more about how and why the human body functions the way it does, not just from a textbook, or traditional education. But from the multitude of methodologies that are rooted in the principles of physical, biological, and behavioral sciences or the applied functional sciences. It is then and only then us movement trainers can fill that gap that has been the void of our healthcare system. So if this series be just a drop of water, a dip of your toe in the pond or a starting point on how to think about human movement in the training and conditioning environment, and how we, when we are well educated and driven by applied principles, thinking first, then we can vastly improve our capacity and capability training condition. Every single athlete and client, we have the amazing opportunity to get in front of if you support this revolution, hit that like button, so this content can get started and shared with more and more people. And if you want to join this revolution, we can start by hitting the subscribe button and also applying to our multi dimensional movement coaching mentorship. More information on that, check the link in the description. Let’s kick this thing off here with the anatomy of the Foot Ankle complex. Let’s talk about the bones. Well, you’re going to have to talk about the metatarsal, those crazy bones that just can expand and contract so well and drive the calcaneus. And how that heel bone that back kind of rudder helps really steer ultimately, the talus right above it, and how that talus is just a launching point to move the tibia and the fibula and the rest of the chain reaction that happens above it. The muscles and connective tissue that go with that we’ll start from the bottom is the plantar fascia, right, that huge sheath right underneath our foot that is kind of encompasses the arch of our foot. Moving up from there, we cannot cannot talk about, we just can’t miss that Achilles tendon, that Achilles tendon, what it does and how it connects to that calcaneus and drives up and connects the soleus and the grass struck namias to the calcaneus. And not just to take those two back calf muscles. But we can’t forget the lateral calf muscles, the peroneus longus, the front calf muscle, the anterior tibialis and then just kind of holding it all together. So it pivots right through a pulley system, the ankle retinaculum. All those different pieces come together into this vast complex of what makes this Foot Ankle complex, so vastly functional and important. And this is why we have to understand the biomechanics so well. And just a quick little dip into this one, right, we have to understand how that calcaneus heel bone, how the talus and the metatarsal bones when they impact the ground when they come into contact with the ground. They go through a cycle what we call transformational zone one and how that interacts with this TIB fib bone on top. So as it goes interaction, we’re going to get a relative pronation and E version in that foot. And how that spinning how that compression how the expanding of the metatarsal bones come together how that internal rotation relative at the ankle foot all comes together to drive the tip and fib to drive the knee joint to drive the femur into that spinning in concept. And how it happens is in a linked pattern, it doesn’t happen all at once. It’s kind of bit by bit by bit depending on how the driving of the body happens. Now the cool thing about the ankle is that it can steal land and do the exact opposite of what I just said. You can steal land and cut and go the opposite direction, which is literally everything I just said, reversed, and still has the function to do that, if all the greater connective tissue allows it to happen, so is this crazy, crazy, crazy joint that needs to do both needs to be trained to do both. But we also want to understand how it does on a base basic level, which is just with gait and walking. Now, when it’s in front of us, we call that transformational zone one, but what about when it’s behind us? Well, I just described it right, it’s pretty much the opposite of all those things. But we certainly want to be able to get through that supination through that ankle rotation out through the TIB fib rotating out through the knee rotating out through the femur rotating out and through that pelvis, spinning with it at a greater, faster level. So we can get that supination that rolling, that ability to kind of just push off the ground, take those mid tarsal joints, jam them together in a good way, create a stable surface from for us to propel off of. So the quickest thing to remember about the ankle foot is it has that ability to load and soften, and then also harden up and be amazing propeller. So those are things I want you to take away when understanding and looking for ankle foot biomechanics. Now what about some exercises, and some dysfunctions that sneak up in our training and conditioning? Well, let’s just call it the lunge, right? So it’s a drill we do all the time, we like to three dimensionalize it to add some variety and capacity growth to our training and conditioning. But with our lunges, often comes or can come plantar fasciitis, or essentially, anything that bothers the bottom half of the foot may not be a fasciitis, but it could be just some pain down there. And there’s two ways that I want to look at plantar fasciitis, right or just pain at the bottom of the foot. Is it happening when the foot takes contact into the ground? Or is it happening when the foot is being pushed off of right? tz one or tz two? Well, that’s tz one I want you to think about is there enough deceleration happening through the posterior lateral chain and abling the that brake pedal to happen through here, coil on the inside and then allow that foot to go through proper pronation decelerating in a timely manner. If it isn’t, then that heel is more than likely going to be the impact point of that plantar fasciitis. How do you go about that? Well, there’s a certain way to train that. One is to allow more internal or same side rotation at that affected hip joint when the foot is being landed. So if I can spin my pelvis, my truck more into or same side rotation, we’re going to pre lengthen, pre load that post your lateral chain, and hopefully get these guys to wake up a little bit more, hopefully allow them to say Come on show to the party, we need more brake pedal action before that foot gets too much load through it. You can also do this by putting onto a wedge we can allow quicker, more excessive flexion flexion dorsiflexion, at these three respective joints to allow that to happen faster and sooner if this box of this wedge was a little higher up out to get even faster, relative flexion faster relative flexion. And then therefore less impact on that heel. On loading landing foot pain, the same would be true on push off right, we need to make sure we can get relative good supination with enough spinning capability of this femur into that hip. So if we have pushed off plantar fascia or bottom of the foot discomfort pain is that heel, getting enough inversion as it that inverted ankle complex allows us metatarsal to lot together, those bones take a lot of stress which is designed to do and therefore doesn’t get transmitted to the fascia. So it’s a big, big point. So how can we get more supination? Well, we can get more rotation of the pelvis. Right if I can get more rotation of the pelvis, perhaps even a bigger step, which sounds weird, but a bigger step will get that pelvis to rotate more in theory, if I can get a medicine ball rotational toss, right, if I can throw the arms more through a training drill, that gives me more spinning, the more I can wrap and get that heel to load in to spin in and allow it to roll through that process, the less stress gets transmitted to the bottom of the foot. Again, there’s a lot of chain reaction biomechanics going on here. But I want you to get your mind thinking about what you can do and how to tweak it to make that happen. Don’t forget about the wood wedge we’re going to use a lot of wedges in a sense. You can also have push off with more of an inverted position as you’re doing a drill that allows that process to happen. So really think about how you can get collagen supplement, just like you with a multivitamin, right, supplement the joints of the body with positions that would enable a greater environment of success, whether it be through motion, whether it be through position, and later on to talk about actions and ranges of motions, etc, etc. But that’s how you can help lunges out from a push off standpoint as you lunge or on a landing standpoint, when you are loading. What about with squats? What about the ankle complex foot complex with squats? Well, typically, we get this kind of jamming sensation in the front part of the ankle, right? When we go down, it’s like, I just I can’t go that far, where you start to heal, see that heel lift? Not because it necessarily can’t, because it just hurts, right? That front anterior part of the ankle doesn’t want to just dorsi flex into it more essentially doing this drill would make it worse, right? If I have more dorsiflexion present, it’s going to impact that joints. Basically, that wreck Nachum just gets pinched sooner.

So what do we do about that? Well, the cool thing about a squat is

it doesn’t have to be just perfectly down, you can get a squat through many different ways you can do more lateral squats, you can do more anterior load squats, you can do more rotational squats. So the dorsiflexion, it’s in pair with a few other motion patterns, it’s in pair with it with a spinning in, or kind of that tip and fifth spinning in. So the more we get here, well, that’s probably going to impact it more. But if we can get a squat that allows the body to rotate out, we’re technically going to get less dorsiflexion. And therefore, with a little bit of transverse plane, maybe taking a medicine ball squatting that way, squatting that way, with a right impingement on that ankle, you’re going to just get them enough range of motion to complete that squat to complete the workout. Which is great. A really easy option, though, is just take that foot and load that heel up to a higher. So now we have relative more plantar flexion on this side versus that side. So we don’t even get into that range of motion, we just we just honestly bypass the dorsiflexion altogether, certainly that will help will fix the problem. Not necessarily. But again, we’re just tweaking options, we want to get things to happen. So we can continue the workout, not stop it and allow our training conditioning to progress. Now let’s not forget the all important ability of physics, right how we can take physics and apply to our body, we have to do this very appropriately. Because we can certainly take a band, wrap it around our ankle. And what that does is it takes the base part of my tibia and fibia and distracts it posterior li back backwards a little bit. And honestly, that’s more than likely the problem is that we have too much tension in the back calf. And that too much tension is literally shortening the muscle, which actually takes the tip and fifth and pushes it forward. Because that’s the path of least resistance with his band does it fights that tension with tension sounds like a pretty cool strategy. So as I squat, yes, I’m getting my relative dorsiflexion. But I’m getting tension pulling backwards. And it’s a great way to try that out. And honestly even combo it with a wedge with a band for ultimate success. And then the cool thing is with that ultimate success, you can now reduce the band, go back to there, and then start to transition more and more to ground and then even further challenge it all the way through through a progression of tweaks in the workout. So something to consider there with your squats. What about jumping? Well, in the jumping motion, boom, boom, or leaping, or hopping, there’s a greater impact, right? There’s ballistic movement that’s happening. And worst ankle just can’t handle it, handle it right. Just think about like getting shin splints, right right through through here. That’s typically a problem, but just it just can’t handle the stress. It’s too much too soon. It’s like you want to hang out at the lake got a sunburn. And then you’re going to the next day again, and just got another sunburn and you’re gonna go out again and like, man, where’s the SPF at here? Right? It’s just too much it can’t it can’t recover fast enough. So how are we going to allow that ankle foot joint to react and still train? Well take away the ballistic impact. Very simple. There’s so many drills that we do on a day to day basis in our group training and conditioning that just don’t have high impact. Taking a speed ladder drill, right that was jumping left and right and wrong. You can step that out, taking a leaping drill and turning it into a shuffle. Taking into a box jump and turning into a box step up. There’s so many of those kinds of easy, quick hitters that allow that trainer to still function in their training and conditioning without putting him at a negative risk to overtrain and then decrease their time in tension in workout. So To think about decreasing impact, also decreasing range of motion, the height of the box, etc, or even the length of distance that you’re going to be going. And then start testing other planes of motion. If a jump up anterior onto a box hurts, try a lateral box shop, even try a rotational box jump and see how those different physics are being applied to motion angulation change how the ankle response, you may be quite surprised that a lateral Box Jump has no impact on that on that dysfunction where an anterior one does. So things to consider as we’re talking about jumping as well. The hope this video gives you a greater understanding and insights of how you can start to think about your coaching and training sessions. And for all your moving pictures out there applying this your clients, it’s a huge win. Now all those athletes are doing the dy game, you can also take the same video and apply it to yourself. Because we need to start thinking about not where the dysfunction is, but where it’s coming from. And that’s something to do after the session is over. But it’s very important to start to tweak on the fly understanding how to do that using principles of human movement versus just a new fad out there. Now, this is just the first installment of the tree ecology series. But you begin looking for the knee coming up next, and it’s going to be an awesome video. Understanding how this works is only going to make you understand how this works more more and we have a whole podcast on that as well. You can also follow Gymnazo or Gymnazo Edu on Instagram. You can follow me Michael Hughes at 3d underscore athlete on Instagram and we will see you all next time.

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