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Hi Kit, Olivia, and all other forum members. too long; didn't read: this log is documenting my bodyweight squat progression and rehabilitation of bilateral anterior ankle impingement and patellar tendinopathy using Stretch Therapy principles along with other techniques (joint distractions etc.) that i've found beneficial. "The What" I have never achieved a full bodyweight squat. I believe this will assist greatly in my rehabilitation of the following injuries: Left leg: - Patellar tendinopathy (24 months - in the disrepair stage on the tendinopathy continuum) - Anterior ankle impingement (24 months; occurs very quickly - and painfully - into dorsiflexion) Right leg: - Patellar tendinopathy (1 month - hopefully still in the reactive stage) - Plantar fasciitis (2 months - right foot loses structural integrity when loaded; this isn't my greatest concern as it's minor and manageable) - Anterior ankle impingement (cannot put a time on this. It is a gradual compression sensation in the front of my ankle which in contrast to the acute pain experienced in my left ankle). The injuries to my left occurred around the same time - I was playing indoor soccer and rolled my ankle. I remember hearing a distinct crack and this sidelined me for about 6-8 weeks - I haven't played sport since. I knew nothing of proper rehabilitation and I didn't get it checked out at the time; coming from a military background, ankle sprains are like hot dinners. I would estimate 4 decent sprains to each ankle in my lifetime. At the same time as the sprain, I began to develop fat pad impingement and patellar tendinopathy. I had a cortisone injection and this provided some relief. My left ankle impingement hadn't really been a noticeable concern until 6 months ago, where the restriction in movement and pain really started to kick in. Even bearing weight causes pain at the front/outside of the ankle. I've managed to progress well with my tendinopathy rehab through a progressive loading protocol - the injury is still there, but I can walk up stairs now without limping. The injuries to my right, other than plantar fasciitis, seem to have occurred recently as part of my attempt to rehab the left patellar tendinopathy. What rehabbed my left patellar tendon appeared to aggravate my right. "The Who" I am a stretching novice and I have never put any serious time into stretching other than 'holding for 30 seconds' after a run or lifting weights. I never thought there would be a reason to take my flexibility and mobility seriously because, up until 2 years ago, I have been able to play sports and perform all activities pain free (even without being able to bodyweight squat - I got by). I'm 26 years old and I've played footy, cricket and social sports all my life; I also served 5 years as a full-time infantry soldier. "The Why" My intention in creating this log is threefold: Personal accountability and a journal to document my progress and learning Assistance from other forum members Provide assistance to others in my current position, whether they be other forum members or someone searching keywords on Google. "The How" Ankles/Calves I will be using the Master the Squat series and modifying the exercises accordingly - not that I believe I know better - but, for example, I currently impinge too quickly for any posterior tension to occur in my left leg when performing Master the Squat E1A-E1D (calf exercises) - except the single leg down dog, where the tension is all in my hamstrings. Conversely, I can get a good contraction on my right gastroc from performing the calf exercises - so a bit of experimentation will go a long way. I am excited to get in and progress with the other stretches in the routine, however, my main focus lies in my ankles/calves. So far, in attempts to stretch my soleus, I have learnt (specifically for my left): a) 2 minutes of joint distraction is the minimum - 3 yields better results - and from different angles (foot facing in/out/straight); b). Once some posterior tension can be achieved in any bent knee stretch, generally through using a kettlebell on my knee as leverage, it's critical to spend time (10 minutes-ish) holding that tension. I also find it difficult to contract into the tension, so i'm still experimenting with ways to achieve this; I know ST principles don't suggest a sets/reps/time set up, but I currently have difficulty in performing a contract > relax > go deeper. c) Using my shins to pull myself into dorsiflexion seems to assist the stretch In my toolbox I have a voodoo floss band, resistance band, and a seat belt type band that I am using for really distracting the ankle joint (the resistance band doesn't provide traction to my left ankle). Photo of seat belt type band below. Patellar Tendinopathy I have yielded best results by training legs every day - preferably loaded - using box squats, lunges, bw squats, back squats, front squats, squats with lifting shoes, split squats. For anyone reading that is currently unable to perform leg movements without pain, I was also in that position at one stage. I started with isometric loads (45 second holds of wall sits, Spanish squats etc), moved onto squatting patterns (lunges, box squats) and then next will be plyos/energy storage movements. I used feedback on how I felt immediately post workout and also the next morning - if I felt good, then I would progress that previous workout. Discomfort while training is okay - pain is not. I found load to be the biggest driver so far. The amount of weight I put through my tendon is yielding better results than the number of reps i'm performing. I have slipped up and jumped the gun when I thought I was completely rehabilitated (eg. I went out to football training after I had been sprinting/jumping in my rehab without pain only to push the tendon further than it could handle as a result of the acceleration/deceleration/change of direction). I have done something similar on 3 separate occasions which has provided me with a good learning experience. By freeing up my ankles, my knees will improve. When I hit end range dorsiflexion (the impingement), I can feel my patellar tendon compensating for the lack of ROM. Plantar Fasciitis Heavy, slow loading of the windlass mechanism seems to be doing the trick. When progress stops here, there is plenty of good information on this website on pronating ankles/plantar fasciitis. Current Stats: Knee to wall tests: Left (cold, and taken to full impingement): 51mm Right (cold, and taken to full impingement): 70mm Squat (cold, from the front - left leg is on the right side of the photo): Squat (cold, from the side - right leg is closest to camera): I welcome both discussion and criticism. Thanks.
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- ankle impingement
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Hello all, **UPDATE**. I added a new combination ankle-hamstring-sciatic nerve-fascia stretch taught to me by Mike Goldfield (we did some work today with Matthew Darling, in Michigan, and adding this here seemed very timely). See revised exercise 9 for details, below. At the request of my US Super-Host, Robin Truxel of tru Pilates fame, has asked me to document a routine that is guaranteed to free up tight calves and ankles. As well, tight calves could even be the cause of your back pain. But first, the test. Can you squat down, in bare feet, with the knees together, and keep your heels on the ground? If you can't, then your ankles are too tight—that's all there is to it. The heels have to come off the ground, to keep your centre of gravity in front of your balance point, and if the ankles cannot allow this, either you fall backwards, or your heels come off the ground. Let's change this. **Note: all images can be enlarged by clicking on them*** 1. The first stretch is the straight-leg wall calf stretch; you all know this one, but make sure that the knees are over the forefoot (middle of the second toe) and the full arch height is preserved (press weight on the little toe side to ensure this), and press the knee straight. Make sure you have remembered the new cue of externally rotating the whole leg in both the ankle and hip joints (this is what actually creates the arch as well as winding up the fascia). See which leg is the tightest. 2. Then the classic Downward Dog, but our 'one-legged' dog version. All the same alignment cues as the standing wall calf stretch, above, but with the addition of flexion at the hips—this increases the neural and fascial dimensions incredibly. And if you can't reach the floor easily, lean your hands on stairs, or a box/chair against the wall. Work the tighter side one more time. Note how I am applying a downward force on the ankle as well as a gentle back-straightening pressure at the same time. As you loosen, move the heel further back from the support. The way Robyn is supported, there is less hamstring effect and maximum ankle/fascia/soleus and gastrocnemius effect. 3. Then back to the wall calf stretch, but this time, apply the 'rod of correction': this is a piece of dowel; the smaller the diameter, the more intense the sensation, so start with one of at least 25mm (one inch) diameter. Make sure your partner is wearing material of some sort on her legs, to facilitate the sliding of the rod. Apply pressure onto both sides of the rod and work the outer, middle, and inner borders of the lower calf, from just below the knee to all the way down soleus. Apply gentle pressure the first few times to get the person used to it, then increase the pressure (applied at 90 degrees to the surface you are working on). Once the pressure is applied, slide the stick down the leg while holding the pressure on. This is intense (for your subject!), so be gentle the first few times. Then, once that's done, do the usual contractions and re-stretch. You will see noticeable improvement between the first iteration (#1 above) and the final position following the fascial work and the contraction–re-stretch. The first image above shows a central pressure/stretch application position, and the second the outer border. As well, please note how I am bracing the leg I am working on with the outer part of my thigh; this is essential. Do not move the rod too quickly over the skin; the fascia has to be coaxed into releasing. 4. Now the new one (I will make a video of this soon). Get into a gentle wall calf stretch once more, and ask your partner to press on the calf muscle, just below the knee. Don't move the lower leg—but 'sit' the hip away from the wall (this bends the knee more if you have the right position). As well, with your hip back further than usual, you can add your own weight more easily to the stretch. Now ask your partner to use his other hand to grip the ankle just above the heel, and help you press the heel onto the floor firmly. Use the first hand to press the back of the knee further forward (to increase the angle at the ankle). Do not lose the arch shape. Once you can go no further, try to relax: this will be an intense feeling in soleus, as well as at the front of the ankle joint (we are levering off the tibia and the talus bone of the foot). (If you dip down to exercise 7, below, you will see the hand position for this variation; the exercise will look similar, except the heel will be on the floor.) Now repeat the toe-pointing (pressing the ball of the foot into the floor) contraction; this time, because the knee is bent, the sensation will be felt mainly in soleus; it is a much deeper sensation than stretching gastrocnemius. And when the contraction is done, ask your partner to help you bring the knee further forwards in good form (the 'stretchee' can definitely help here, too, of course), and bring the knee as far forwards of the toes as you can. This, too, will be intense. A note on breathing for the re-stretch: even if you are really experienced, once a stretch becomes intense, you will forget the basics (blame it on the body's self-preservation mechanisms!). Before you try any re-stretch, breathe in fully, relax the part you are working as much as you can, and only while you are actually breathing out do you do the stretch into new territory. If you need more time than one breath out, stop, breathe in again, and only go into new ROM while actually breathing out. 5. Find a set of stairs, and do the classic single leg, ball of foot on stair, heel drop stretch. Apply all your weight to one leg, and ask your partner to once more hold the stretching leg's heel, and ask them to help you stretch deeper by leaning some of their weight onto the gripping hand—thereby intensifying the stretch. Note that my 'top' arm is helping Robin straighten her knee. Do a few slightly bouncy contractions in the bottom position (may as well get some fascial involvement here too) and then some slower standard contractions, and re-stretch. And a close-up of the grip position: 6. Find something to hang on to, and with feel parallel, spread the knees, and lower hips into a full squat (this is also an ankle stretch, as well as one of the best lower back stretches). Try to bring the body as far as possible through the thighs to deepen both stretches. As well, once you have the wide knee version, try again with the knees together: this intensifies the ankle part (and limits the lower back movement for the same reason). 7. If you are up to it, repeat the stair stretch (#5 above) but ask yor partner to bend the knee on the leg you are stretching; as before, this action focuses the effect on the ankle. 8. I added this today (because I forgot it in the sequence when writing yesterday); but if you have partner assistance, this one and the bent-leg one above will have the strongest effect on improving ankle flexibility of all of them (and this strongly and preferentially affects soleus, too). Kneel as shown, holding something firm, and press as much of your body's weight as you can through the forearm of the other arm. This is the start position (and you can do contractions and re-stretches this way too). On the other hand, if you have a partner, the big guns can be brought to bear. See how I am leaning my weight straight down on the knee? This both holds the heel on the ground and pushes the ankle further forward. Very strong contractions can be effected, and you can control the amount of the re-stretch, by adding your own forces to the same knee through your forearm. Look at this picture of the setup: As well, here's an image that shows additional supports: my hand on her back, and my thigh is assisting, too. New exercise 9. You will need a sturdy Yoga chair for this; turn over as shown, and place a sticky mat inside the now-upside down seat. Place your feet as wide as possible on the base, and press the edges outward. Now, keeping your back as straight as you can, lean forwards to the maximum calf stretch point, then bend forwards at the hips. Whew: intense. I am pulling myself further forwards by holding on to the legs. Contractions can be added to enhance the effect. See the setup: And the close-up that shows just how much flexion the ankles are enjoying! 10. Then the big test: on flat ground (or slightly sloping downhill for a bit of assistance—or even a thin support under the heels, or a small weight held at arms' length!), try to squat down, keeping your heels in the ground. If this sequence has worked for you, you will find you can lower your hips deeper before feeling like you are going to overbalance and—one day—you will get all the way down. Now you are ready for the SLS (Single Leg Squat) progressions; see HERE. Good luck and please report back. KL
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Hello all, This is a taste of the programs we start making the day after tomorrow (Tues, Apr. 15 now; I like date stamps). Olivia takes you through a follow-along single leg dog pose: this is THE KEY to ankle and calf flexibility, but that's not all. For many (especially those of you have tight calf muscles) this is the key to unlocking forward bending. Don't just watch; try it—it is very strong, and very effective. Comments most welcome, and please share this as widely as you can.
- 27 replies
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- ankle flexibility
- soleus
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I modified the wall calf stretch to make it really get into soleus; it can be done solo, but in our experience, partner assistance is both more effective, and needed to get the sensation of how to move the lower leg in this stretch. Assume you are leaning on the wall with both hands, and pressing weight down through the heel of the stretching leg to hold it down onto the floor and you are in a gastroc-type stretch position. This time, though, do not press the knees straight (which is essential to target gastrocnemius; leave it a bit loose. Now, as in the gastroc. assist, your partner grasps your stretching heel with one hand, and all their body's weight directly above the heel, and that arm close to vertical. Really put weight down into the heel. The new bit is that your partner uses her other hand to gently force the knee to bend, while your and her weight holds the heel in place. Assume 5–10 degrees of knee bend—now when you do the contraction, only soleus will be affected. Following, the restretch is for your partner to help to press the back of the knee into further flexion, and the result is a massive, soleus-only, stretch. When I did this for the first time the other day, I got at least an extra 10–15 degree dorsiflexion, and the sensations are still being felt in the lower leg. This had an immediate effect on the depth of the full squat position, and everyone else in the workshop had a similar improvement, some (like Linda) full squatting for the first time. Don't forget the for this part of the body, too (somewhere around the three minute mark you will see the position I use).For soleus, gastrocnemus and the Achilles tendon, in my view the TravelRoller is too thick: the fascia in this part of the leg is dense and in my experience, it needs finer point pressure and more weight than you can get via the TR. Sitting on your legs with the stick in between, and moving it all the way up to behind the knee (or as close as possible) and all the way (gently) from the calcaneum, working the legs by rocking side to side as well as letting the body's weight settle as deeply as possible will work. The thicker the stick, the more intense, so do not hurry to use a thick one (fascia adapts relatively slowly). Let me know if you need more explanation on how to do this. I will shoot a video as soon as I can.