I have talked about our goals with stretching before, but a brief recap: if I am trying to stretch my calf, where should I feel it? This seems like a simple question, I should feel it in my calf! Now do me a favor. Try and stretch your calf.
Where did you feel it?
If you are like a large number of my clients over the years, you felt it in the front of your ankle. Right between the two bones on either side, where the joint folds when you bend it.
Now think about where your calf is located. Your calf is made up of two muscles: the gastrocnemius and soleus.
If you look at the picture above, neither muscle goes to the front of your ankle. So, if we are stretching those muscles, why do we feel it in the front of our ankle?
What if we are not actually stretching those muscles when we think that we are? Let’s look a bit closer at the anatomy of the front of the ankle.
We have 3 major bones in play here: the tibia, fibula, and talus. The tibia is the big bone on the right of the picture, it is the inside bone of your lower leg. The fibula is the smaller bone on the left side of the picture, it is the outside bone of your lower leg. The tibia is the bottom bone that forms a joint with them called your talocrural joint.
The picture above is a side view of the ankle and the bone in red is your talus. Imagine you go to stretch your calf. Where do you think the talus goes?
It has to move up and between your tibia and fibula. The movement is small, but your tibia and fibula separate to allow the talus to glide and move your foot.
Maybe you see where this is going, but imagine that your talus doesn’t move like it should. What do you think happens? It runs into the front of your tibia and fibula, almost like a drawer that cannot close. What would you feel if this happened? You guessed it, pain or tightness in the front of your ankle!
Now imagine that your ankle is limited from motion because this joint is stiff. Can you move it enough to actually stretch your calf muscles? Probably not. Is repeatedly trying to stretch going to fix anything? Have you ever gotten mad and tried to slam a drawer that would not close? It does not help.
So then what do we do? You want your ankle to move more, right? How do we get that joint to loosen and allow you to actually stretch your calf?
We have a couple options. The first possibility is to make more space at the joint. If you are familiar with traction, this is the goal. If you gently pull on the distal foot, it can allow increased mobility of the joint temporarily. Once you have that mobility, you can try to stretch again. If it still hurts in the front of the ankle, you either need more traction or to try something different.
Another option is looking at the next level. I mentioned that the calf muscles stay on the back of your leg, but there are muscles in the front of your leg. The biggest one is your tibialis anterior.
See how it runs right in front of your ankle? Imagine that muscle getting tight and shortening. It would compress the joint and limit its mobility. So, what can we do about that? Well, you can try and stretch your tibialis anterior. Stretching it involves doing the opposite motion you were doing before and pointing your toes like a ballerina. This seems strange, but our bodies are strange. Sometimes doing the opposite motion can help unlock a movement in our body. Think of pulling the drawer out a little before trying to push it in again. Sometimes that works.
Now what if both of those options do not work? Then we need to bring in the big guns. More aggressive soft tissue mobilization of the tibialis anterior can be helpful, but it is tricky. It is a narrow muscle, so foam rolling or a lacrosse ball can be difficult. I have found some success with scraping the muscle. If you are unfamiliar with scraping, it involves using some sort of lotion and repeatedly rubbing a metal implement gently to relax the muscle. The rhythmic nature of scraping can desensitize the nervous system and let the muscle relax.
The biggest guns involve trigger point dry needling. If you are unfamiliar with dry needling, it involves using a very thin needle to release the muscle. Someone who is certified in dry needling (such as myself) can use the needle to address trigger points or knots in the muscle. The theory is that by using a tiny needle you are creating a reflexive twitch of the muscle that causes it to release. Think about when your knee gets tapped to test your reflexes. It is a very localized version of that. The twitch of the muscle essentially fatigues it and causes it to relax, almost like resetting a computer. Dry needling is obviously the most invasive treatment and I only use it for stubborn injuries or limitations, but it is highly effective.
So, there you have it. If you find that the front of your ankle is tight or painful when you try to stretch your calf, then give these a try. I will be posting some more detailed videos and ideas on social media over the next couple days, so look out for those!
If you have any questions, thoughts, or chronic ankle problems that you want resolved, reach out to me at danny@eclipsewellnessnova.com
If you are in the Sterling, VA area, let's schedule an assessment to get to the root cause of your ankle pain!