Daily Mobility Exercises by Dr. Kelly Starrett › Forums › General › Explaning the Anatomy of the Ankles When Using Banded Distractions

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    • 09/19/2014 at 8:49 pm #71134
      AvatarMike Richmond
      Participant

      Can anyone explain me the anatomy of the ankles when using the banded distraction? I mean when wrapping the bands around the ankle from the front (pulling tibia backwards), where exactly should the band be placed and what is the role of the band, like what bones are pulled away to avoid anterior impingement?

      I still have a huge anterior impingement in my ankle when using banded distractions. Why is that? 
      Sometimes I think that some mobilitywod approaches do not work, do they? 
    • 09/20/2014 at 11:54 am #75265
      AvatarNathan Richer
      Participant

      the MWODers did a great 5 part series on the ankle:

      http://www.mobilitywod.com/daily/thursday-may-8th-2014/
      http://www.mobilitywod.com/daily/friday-may-9th-2014/
      http://www.mobilitywod.com/daily/saturday-may-10th-2014/
      http://www.mobilitywod.com/daily/sunday-may-11th-2014/

      http://www.mobilitywod.com/daily/monday-may-12th-2014/
      perhaps the answer you seek is in there.
      if you still have some impingement with the band, make sure the movement of the knee is correct. if you are moving the knee towards the big toe, that is bad and encourages impingement.  it should move towards the outside. one way to ensure it’s moving on the right path is to use a pole. stick it in the inside instep of your foot and hold it vertical. then when you move the knee, make sure you move the knee to the outside of the pole. try that – are you getting better range?
    • 09/21/2014 at 8:39 am #75269
      Avatar[email protected]
      Participant

      David,

      What about blocked feeling in medial malleolus?

    • 09/21/2014 at 11:17 am #75271
      AvatarNathan Richer
      Participant

      Dan, hmmm – do any banded distractions help with that? fwd, back, out to the side as you do dorsiflexion moves?

      Have you tried seeing a chiro/PT to release the ankles? and if they do that, try some dorsiflexion moves – does that help? sometimes the ankle can get locked up and having someone yank on it to release it helps a lot.
    • 09/21/2014 at 11:20 am #75272
      AvatarNathan Richer
      Participant

      Also there are some smashing techniques around the inside of the ankle – posterior tib, bottom of foot/heel – try getting some of the skin to move and some of the tissues to release.  i seem to remember a ball whack from way back to get some of the skin to move…

      also this from Danny in DailyRX:

      you can try this partner mob with them putting some twisting force on the lower leg to help the ankle move better.
    • 09/22/2014 at 10:34 am #75275
      AvatarMike Richmond
      Participant

      When I do the banded distraction, should I feel any stretch behind or anywhere in the ankle? or I just need to move my ankle around? 

    • 09/22/2014 at 12:04 pm #75276
      AvatarTom Matchinsky
      Participant

      When utilizing banded distraction you are mostly attacking the big thick joint capsule that surrounds the ankle. Make sure to keep your foot on the ground and don’t go into a collapsed foot or impinged position of the ankle (you’ll know if you are) and freestyle into all the corners that feel stiff and tight. Remember when working with the joint capsule you need to oscillate in and out of end range many times, like 30-50, to make change. Think breaking a credit card in half. The ankle is notoriously stubborn so it can be attacked several times a week if need be.

    • 09/23/2014 at 12:16 pm #75280
      Avatar[email protected]
      Participant

      David,

      Banded distractions seem to help a little.  But blocking feeling still there. This is my left ankle.  Creating an arch on left foot results in a stiff big toe where as on my right side the arch is more natural and my big toe can simply be soft (if that makes sense).
      Voodoo floss, smashing doesn’t seem to address the issue. Once I start creating an arch the feeling comes back.
      I am hoping there isnt a vein/spur issue.
    • 09/23/2014 at 8:36 pm #75283
      AvatarNathan Richer
      Participant

      Dan, how are you creating your arch? Are you standing on your feet, and then attempting to rotate your toes to the inside? Or something else?

      have you smashed the posterior tibialis? it runs along the inside of the lower leg, around the ankle, but then under the bottom of the foot to the big toe. Also have you smashed the bottom of your foot?
      And when you do ankle DF, are you making sure the path of the knee on the left side is slightly towards the outside of the foot, not inside?
    • 09/23/2014 at 9:33 pm #75285
      Avatar[email protected]
      Participant

      Creating my arch by having my feet straight and slightly twisting the ground or creating external rotation.  (I would imagine that my toes would be rotating to the outside)

      Yeah smash the post tib with lacrosse ball stacked.  All the way up to all the way to the bottom.   No big deal for me really.   HOWEVER
      When I smash calcaneus I end up hitting the very outside part of my foot/underneath that goes to the big toe and it does feel rather tender.  Perhaps this blocked feeling is a down stream issue?  I do smash my feet but would be hard to access that spot– kettle bell seems the only thing to access that area.
      Yeah banded distraction with Ankle DF is always to the outside — basically simulating knees out.  I have been experimenting with my foot up on chair.  It seems like my range of motion decreases with the typical knee down banded distraction http://www.mobilitywod.com/daily/friday-september-19th-2014/   In order to move my knee forward without lifting the heel I have to put the knee on the ground further behind me almost looking like I am doing a split.  
    • 09/24/2014 at 10:21 am #75286
      AvatarNathan Richer
      Participant

      Dan – yes it could be a downstream issue as well as upstream. sounds like you are going upstream?  if the tissues are tight up/downstream, that can pull the ankle in tight.

      Have you tried the ankle distraction down the length of the leg? You wrap a band around the ankle and lay down with your body away from the band. the band pulls the ankle/leg. This helps gap the ankle joint. It is however limited by how much you weigh because the band will tend to drag you towards itself when you want more tension.  
      You may need to find a professional or someone live for this one – always limited by text descriptions in a forum!
    • 09/25/2014 at 11:26 am #75290
      AvatarMike Richmond
      Participant

      What type of doctor we should see in terms of ankle mobility, PT? Chiropractor? I’m tired of this thing 🙁

    • 09/25/2014 at 11:39 am #75291
      AvatarNathan Richer
      Participant

      i would find a chiro who is also a PT and specializes in sports medicine. normal everyday chiros are risky i think. i would ask around for a referral if possible. your CF box may be able to recommend some good people.

    • 09/25/2014 at 2:28 pm #75292
      Avatar[email protected]
      Participant

      David,

      I think there is no major upstream post tib issues.  There is definitely downstream issues with the post tib tendon along my big toe.  Smashed that with a soft ball and kettle bell.  Still too soon to tell because it was so tendor that too much smashing would make things worse (something I learned along the way) A couple of more sessions I hope will do the trick.
      I messed around with the band pulling my ankle out like you recommended as well. I can feel some relief, but nothing major.  I retested with banded distraction with ankle dorsoflexion and it seemed to help.  
      All of this plays to the idea that I lean on my left leg a lot and perhaps I have jamming it up everytime.  It almost feels like I should be lighter on my feet.
       
    • 09/25/2014 at 2:38 pm #75293
      AvatarNathan Richer
      Participant

      Dan, good piece of data on that lean on left leg! Definitely other things you do in the 23 hours out of the gym can create conditions. 

      I would try evening out your weight to both legs, and don’t lean on one leg. Make sure your lower leg is perpendicular to the ground both side-side and fwd-back as well. Create the habit to stand perfectly.  It will take a while but it can help you get back to a good place.
      As an aside, when you sit, make sure your lower legs are pependicular to the floor. get out of the habit of pulling the legs under the chair, or crossing them, etc. Your knees should be at right angles also. practicing perfect position is an all day affair!  
      do this, along with the smashing and band distraction work and please report back after a few weeks!
    • 10/02/2014 at 8:03 pm #75336
      Avatar[email protected]
      Participant

      So, just for fun I got my smash partner to perform post tib smash on my leg — guess what  it fixed my ankle.  I get more rom out of it and everything.  So it is upstream — it just sucks because stacking the ball is not enough.   It does come back however.   So hopefully it is not coming back because of poor form (I really do keep feet straight and don’t lean too much)  

      I recently realized that my left ankle is naturally valgus, so that means that most of my life my navicular bone was on the floor.  I have to consciously create an arch and only recently have been doing so, does this create a stiff post tib?
    • 10/02/2014 at 9:54 pm #75337
      AvatarNathan Richer
      Participant

      try flipping a KB upside down and mashing the handle down along the posterior tib. much better than using balls. i use a 35lb/16kg KB and it provides a lot more force into the area…

    • 10/17/2014 at 9:16 pm #75386
      Avatar[email protected]
      Participant

      Could my subtalar joint be tight?  When I go through this video, it feels like my post tib gets tight again all the way to my big toe.

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