Dorsiflexion is that motion where your foot and shin get closer together. It is a very important motion for normal lower body functioning but is often over looked. A loss of dorsiflexion is not only relevant to our foot and ankle patients but those with knee, hip and lower back problems as well. All of those areas are forced to compensate for a lack of dorsiflexion as your weight comes forward over your foot when you bend, walk or run. We can measure this motion in the clinic on a table with a protractor-looking device called a goniometer or we can measure this on the ground (see photo below). The ground measurement is ideal because that is actually how we use our legs. On the ground. This way the measurement best mimics the real world.
When it is determined that dorsiflexion is decreased, the next question is why? The most common cause is soft tissue restriction(s) in the muscle mass of the calf. These restrictions can be caused by trigger points and/or connective tissue tightness from old or new scar. When this is the case we often employ the technique called "seek and destroy." With this technique the person uses the shaft of a golf club to seek out these trigger points and tight areas, which will feel tight and tender. Then, once found, "destroy" them with appropriate pressure until they go away. We recommend you do this for a minute or two several times a day so keep the golf club in plain sight to help remind you. Also employ the "rule of three." Three surfaces (inside, outside and backside) and three levels of pressure (light, medium and deep). Clear out all the tender spots on all three surfaces with light pressure before going any deeper. It will be more effective and more comfortable.
Together with seek and destroy we will also employ a stretch for the calf called a soleus stretch. This stretch is performed with the knee bent. So again it best mimics the real world you perform in. The soleus stretch is best performed with something under your foot to prevent the force of the stretch from going anywhere other than your calf. Remember with stretching allow the force to be noticeable but not strong, hold it 30 seconds and repeat it frequently. For best results we ask you perform both seek and destroy and the soleus stretch to help normalize your dorsiflexion and lower extremity biomechanics.
