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Writer's pictureChristine Ruffolo

SHINS: the Hamstring – Dorsiflexion Connection

The lower leg can be a mess.  The shins are responsible for two main movements, dorsiflexion (top of foot pull) and plantar flexion (bottom of foot push).


                     dorsiflexion                                                                   plantarflexion

(Notice that the are NOT equal in their abilities.  I have more dorsiflexion on my left and more plantarflexion on my right.  This is an important point we’ll get back to a bit later).

Feet and ankles aside, the calves and shins tend to be full of stiff spots. If a tissue is tight, the mainstay go-to is first practicing self-myofascial release.  Aside from the typical front and back roll-outs, the REAL sweet spots can be found on the inner and outer angles,  just inside the tibia (for the tibialis posterior) and throughout the fleshy outside (for the tibialis anterior and peroneals).

SOFT TISSUE WORK 

Inner shin – Finding the tibialis posterior:


Outer calf – Using crossfriction and trigger point holds for the tibialis anterior and peroneals:


Once you’ve mobilized a tissue with pressure/ force, the next step is to stretch or ‘lengthen’ it.

STRETCHING

Foot supported dorsiflexion:


Perform this move with both feet pointed forward (check that back foot!) and hips square to the surface the plate is resting against.  (Yes, that is your everyday, run of the mill 25-lb plate.  Those slant boards are expensive)  Front heel should barely reach the floor.

Body weight assisted plantarflexion (as well as foot/toe mobilizations):


UTILIZING/ EXPANDING RANGE OF MOTION

I borrowed Dr. Andreo Spina’s high box idea into an exercise in stability and dorsiflexion:



A post shared by Chris Ruffolo (@ruffolous) on Oct 9, 2015 at 5:57pm PDT


The foot close up hopes to show lateral shifting while the knee is kept forward.  There will be a shearing force felt in the ankle as the foot attempts to keep still (and it’s arch) while the already dorsiflexed ankle mobilizes left and right.

Eccentric Neural Grooving:


This will seem downright impossible for those without the mobility and control to weight shift.

Note how close his heels are to his butt.  The same could be observed from Dewey Nielsen in the top featured photo.  The ability of the hamstring to pull the heel to butt is a necessary pre-requisite for dorsiflexion.

LINKING DORSIFLEXION TO TERMINAL KNEE FLEXION

I had ACL reconstruction on my left knee in 2006.  They used a graft from my hamstring to make a replacement.  Much as I rehabbed it into athletic function, I still struggle greatly with the end range of hamstring flexion.  As a result (or coincidence), I have less plantar flexion (foot point) on my left side.  Pointing is pulled from the posterior chain, for which the hamstring is a large part.


wallplantarFLEX

That same left side as more dorsiflexion (foot pull), WHEN UNWEIGHTED, however.  Bearing weight or load, it’s still found lacking due to pelvic and hip shifts that unconsciously occurred for years throughout my injury and rehab.  (I waited almost a year to get the surgery from that first partial tear).  I’m sure overcompensation by my quads and anterior leg has a lot to do with it, but it also feeds into the joint pendulum theory that a deficiency in one direction leads to excessive motion in the opposite.


dorsiflex

If interested in gaining dorsiflexion, look at the ability to plantarflex the foot and maximally flex the knee.  This sequence has proven particularly helpful with multiple trials and individuals:

  1. body weight assisted dorsiflexion (sitting on foot) with external rotation of the heel

  2. passive plantarflexion with sit-back and knee pull

  3. hip flexor stretch (with active top of foot press down – keep the working foot/ankle busy! )

  4. terminal knee flexion

Visually, it’s much simpler than it sounds.


More proof of the knee flexion- ankle dorsiflexion connection can be seen in sit-to-stand, no-arm assistance get ups:


If it’s hard to see, this is my original ‘active knee flexion’ set up before the passive shin pull:


topTKFgetup

That inch or two matters.  What the hamstring fails to do the shin muscles will over compensate for.  Tight ankles can stem from ill-functioning hamstrings.

TO REVIEW:

  1. The ankles are fed information by the feet and shins

  2. Dorsiflexion is necessary for squat patterns

  3. Plantarflexion is necessary for proper gait “push off” patterns

  4. Tight tissues can get released through soft-tissue work and stretching, but, to be utilized, the new range of motion needs to be practiced consistently under load

  5. The cause of stiffness is often found above or below the problematic joint

  6. Full flexion of the knee is a prerequisite to full dorsiflexion of the ankle

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