How Ankle Stiffness Makes Knee Pain Worse & How To Fix It

Have you ever wondered if your stiff ankles are making your knee problem worse?

Have you ever thought that your ankles could be contributing to your knee issue?

Whether you’ve got arthritis in your knees, a torn meniscus, torn ligaments in your knee, or you’ve been dealing with a knee swelling, especially if it’s been chronic…

If it’s been going on for a while, it’s important to take a look at how stiff your ankles are.

My name is Dr. David Middaugh. And I’m a specialist physical therapist at El Paso manual physical therapy. 

So let me show you on the skeleton why ankle stiffness is going to cause a me problem. I’ve got a leg here. And you can see the ankle has a little bit of motion this way. That way, this ankle on this skeleton does not move the full amount of motion. In reality, when you point your foot down, I mean, your toes should be almost maybe not quite straight. Some people do have the flexibility to get straight with their Shin, but it should be headed in that direction.

As you can see this ankle on the skeleton has a lot of stiffness. And then coming up, this is about normal, that’s about how much motion you should have going upwards. Some people may be more flexible than others, that’s totally acceptable. But if you cannot lift up your ankle and toes about that high, that’s going to cause some serious problems. If you can’t push your foot all the way down, that’s also going to cause some serious problems.

The way this works, whenever you go to take a step as you’re walking and going through your normal everyday activities. If your ankle doesn’t come up enough, as you bear weight onto your foot, and your if your shin bone can’t travel over your foot very far, then it’s going to stop short. And the forces are going to increase at your knee joint.

Interesting Side Note To Learn More About: Does Walking Help Knee Pain?

This is minuscule, it’s tiny, it’s not going to make a massive difference, you know, the data to hurt your ankle or it gets stiffer, it’s not going to hurt your knee right then and there. But if you’ve had chronically stiff ankles for years, maybe even decades, if you just if you get stiffness in your ankles, like you can just feel it, it’s kind of sore.

If you’ve been on your feet for a while your ankles just don’t feel as mobile as they have in the past, then count on trusting your gut that your ankles are moving very good. And I’ll tell you how to find a difference here in a second. But if your shin could travel better over your ankle through its full range of motion, then that normalizes the pressures up at the knee.

So it’s important to move it up. Now, let me tell you the other direction when you push down, that’s important when you’re going to take a step and you’re pushing off with your foot. Now typically, people don’t even go the full range of motion where you point your toes and ankles all the way down unless you’re an athlete, and you’re jumping and running or something like that.

But if we’re talking about just everyday walking, you should have some decent mobility going downwards and strength going in that direction too, because that’s what we call push off whenever you take a step. And you’re about to push off.

 

To take your next step, you have to have some good control and stability and mobility to move your ankle and push your leg off so that you’re not dominating that motion with other muscles that could be causing increased pressure at your knee.

Now I’m going to show you on your own how to check your ankle mobility, and then what exercise you need to start to do in order to fix your ankle mobility for the long term. It’s not what you think a lot of people think you need to be stretching, like leaning up against a wall and putting one heel back when like forward and pushing into it.

You don’t want to be doing that. So in order to tell if your ankles are mobile or not, if there’s one ankle that’s bothering you, especially if you’ve got knee problems on that side. So let’s just say it’s your right knee, and you want to see your ankles involved, what we’ll do is sit somewhere where you can look at your ankles and your legs are generally stretched out, you can sit off the edge, just like so.

But just for the best camera angles here, I want you to see what I’m doing. Look at your feet, ankles, and then all you’re going to do is move your ankles and toes all the way up as far as you can. And hold it there and just eyeball it and see if one is worse than the other as far as can it move more or can I move less. And in my case, it’s subtle, but my left ankle and toes don’t come up as much as my right my right comes up real nice and easy. And I even feel more resistance in my ankle joint right up in here when I come up with my left.

So you know I said it was my right leg but I don’t have any knee pain, thankfully, but my left ankle here is a little stiff. And I don’t know if you can see that. Let me see I can get a better angle. So I’m actually involved here to see if I could do it like this. So we keep my legs even as best as possible and come all the way up and my left, this side does not come up all the way like my right does. So this guy’s got to get a little more flexible.

Now there’s different ways to gain more stability in an ankle joint. But what I want you to know, so that you can do it in such a way that gives you the most relief for the long term. So you’re not having to over and over again, stretch out your ankle.

Because if you do a runner’s stretch or under stretches, or you lean against the wall, and you lean against the wall, and you put one leg back when look forward, in fact, I’ll just show you on the table here, for one leg back, one leg forward, and then you stretch like that, that will create a stretching your ankle joint, but it’s short lived, it won’t last as long as what I’m going to show you.

So this is not terrible to do, it’s not wrong, it’s just not the best thing to do for the long term, you could do that stretch, if you wanted to do it, 30 seconds to a minute is enough, several times, maybe three or four times is typically enough, you get diminishing returns, after you stretch more than that. In other words, you don’t get much more benefit for stretching more, typically doesn’t hurt you.

But it’s kind of a waste of time if you stretch more than that. And stretching is beneficial in the short term. So it may make you feel more flexible, more limber, but the muscles were retitled again, in the future in the near future, you know, within minutes or hours, maybe a day at most, if you don’t strengthen strengthening is what I want to talk to you about.

Let me grab the leg again. So you can see what I mean. In in the ankle stiffness occurs right about here. So here’s your shin bones, your femur, your fibula, and your tibia. And they connect to the taylorist, which is the top of the bottom half of the ankle. And there’s motion right here in an up and down direction. What’s interesting about this taylorist bone is it has the ability to subtly shift forward and backwards.

And what tends to happen when you have ankle stiffness, especially when you can’t come up very good, like I couldn’t on my left is that tailors is wanting to shift forward because of a muscle imbalance typically, now, the muscle imbalance in the foot and ankle that leads to knee problems is almost always toe weakness.

So there’s muscles that bend your toes that curl your toes, just like we have muscles have been their fingers. And if you think about making a fist with your hand, you can kind of do the same thing with your toes, your foot, of course, your foot shaped differently than your hands, you’re not going to ball it up.

But you’re going to curl your toes down like that, when you do that motion, you can feel the muscles tighten up, of course in the ball of the foot in the arc of the foot. But as well as into the cafeteria, the back of the leg. those muscles that help you curl your toes helped to reposition the ball backwards.

On I’m sorry, the tail is backwards onto the tibia and the fibula. So they reposition it. So I’m going to do the exercise that I want you to do right now let’s see if my ankle gets better. And I haven’t done a single, I haven’t done a single other thing to my ankle today. So you might get a fresh improvement, a real life improvement. Or just to demonstrate here, I’m going to come up Yep, it’s still stiff. You show you from this angle. T

hat’s all I got my left side doesn’t come up more than that. So what you would do for the exercise is curl your toes as much as you can for 10 seconds. Make sure you don’t get any cramps. If you feel like you’re going to get a cramp, then you can let off. So let me give you percentages. So if that was 100%, which it is for me, and you feel like a cramp starting to come on, let go right away and just do like 80 or 90%.

Basically, whatever you can do without beginning to get a cramp is you’re on the edge of getting a cramp basically. And after you do this for a few days, your muscles will get stronger and you won’t feel like you’re going to cramp. Typically cramping happens in this situation because you’ve got weak muscles or some centers nerve involvement too.

It’s not the electrolytes like a lot of people have thought of in the past. I mean, you’d have cramps all over your body if you had an electrode like weaknesses. So I’m going to do 10 second holds 10 times or so. And, you know, people will ask me, can your heel be touching something or not? I haven’t seen a big difference. But I’m going to do it just like this for the sake of the video. And let me curl my other side.

If you curl both feet at the same time, you generally get a better contraction the side that you’re focusing on, plus the other side my needed anyway, so might as well do it. And I’m not counting 10 seconds I’m going until I get tired. I tell people do 10 seconds.

There’s a scientific reason for it’s called muscle tetany but basically you know you’re there whenever you feel like your muscles are getting pretty tired because you’re giving it 100% This isn’t like attraction, you should be curling as much as you can. Another question that I get about this exercise is, is it okay to point your whole ankle down or up? Where does your ankle need to be basically.

And what you’ll find is if you curl your toes down, and then point your toes down, it gets harder, but your toes kind of want to uncurl. So you have to kind of keep them keep your ankle in the position that’s most comfortable, I haven’t found a big difference in having people point their ankle down or not, I would say just do it in a position that feels most comfortable for you.

So let me just do another two reps here, I lost count, I’m not a good counter, and just go until I feel really tired. And then we’ll check my ankle mobility again, I’m going to do one more. And hopefully, we get a good improvement. I’m a little nervous, because I don’t know what’s going to happen here.

I wasn’t expecting my ankle to be stiff. And I feel pressure in my ankle like it was sliding back. Of course, the muscles in my foot are tired up and my calf retired as well. But let’s see what we got here. It is better, it’s even in it doesn’t feel as hard to come up on my left side. I would say it’s even a smidge better than this side.

Okay, now I’m getting tired over here. But the mobility is better. I think I’m tired just because I just finished that exercise out. So if you have knee problems right now at home, and you find that your ankles a bit stiff, try this toe exercise out, it should free up your ankle just a bit in order to keep your knee less painful to take some pressure off your knee. And if you’ve got chronic ankle problems, you can be doing that exercise as frequently as you need.

When we have people in here that have unknown ankle problem that’s feeding into their knee problem. All usually have them do this exercise as often as possible, don’t do it every hour. And that’s kind of easy to do, especially if you have a desk job or if you’re at home, if you’re on your feet all day.

Or if you’re just in a position where you can’t take off your shoes because you generally have to have your shoes off to do this, you can’t really curl your toes all the way with the sole of the shoe blocking you, then, then it’s pretty easy. If you’re just in a place where you can’t take off your shoes, then do it as much as you can at home and when you’re not at work or at a place where you can’t take off your shoes.

But if you can kick off your shoes at the office or at home fairly easily, then go ahead and start curling your toes and avoid the cramping the crap is just going to make this exercise miserable. So if you get a cramp or to fine, but back off on the intensity that you’re curling, if you do get a lot of cramping, and you’re not getting the result that we’re looking for, then you have to go through some strengthening.

Initially, I would stick with this exercise and work at that you know 50, 60, 70% intensity that you can do without cramping. And over the course of several days, maybe a week or two, you should be able to get to 100% where you feel like you can grip your toes, make a fist of your toes as hard as possible without getting the cramping.

Now once you’re at that point, you should have enough muscle power enough force generated from your muscles to start shifting that ankle bone into position so that you have the full mobility whenever you’re going to go walk.

Now the two most common places that we see weaknesses that feed into knee problems that cause muscle imbalances and change the forces at the knee joints are at the foot and ankle which is what we just talked about. And then also up at the hip. And so if you’re looking for more exercises to do for your knee problem to make it feel better naturally without injections, pain medications and getting to avoid surgery.

So you can sell the doctor’s office basically, then check out another video that we’ve made called the top five glute exercises for knee pain because oftentimes up in the hip area, it’s the glute muscles above muscles that are quite weak and are setting up the need to move in appropriately down at the end of the thigh.

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Check out the article below to learn more about how your heel pain might be coming from a knee, hip or even lower back problem.

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