The Ankle – A Critical Link in the Chain of Stability and Performance


When it comes to maximizing lower extremity strength and stability during any sport or activity the entire kinetic chain is extremely important. We talk a great deal about the importance of gluteal strengthening in stabilization of the hip joint and these critical muscles cannot be overemphasized. But we must not overlook a small very distant joint that many times holds the key to accessing the strength of those larger gluteal muscles.

Instability at the ankle can quickly derail the maximal performance of any athlete. When the foot hits the ground, forces are translated through multiple bones, muscles, tendons, and ligaments (Figure 1). The ultimate goal is a solid push-off through the first metatarsal head or big toe bone. This contact is critical for proper knee alignment, gluteal firing, and hip stability while standing on one leg, running and cutting. If foot / ankle stable is insufficient, no amount of gluteal strengthening will solve the problem since access through the kinetic chain is insufficient. Many times a simple but ingenious dynamic insole called an ALINE (Figure 2) can align the foot so the first metatarsal head makes solid contact with the ground, forces properly translate up the lower extremity, and full activation and strength of the gluteal muscles unleashed. 

Other times the problem is a bit more complex and stabilizing the integrity of tendons, ligaments, and the ankle joint capsule through prolotherapy, PRP (platelet rich plasma), or stem cell therapies is required. It is always recommended to also restore normal muscle balance and lower extremity alignment whenever we use regenerative medicine to optimize results – here is one example of combining these three therapies.

Phil came to us with progressive right lower lateral leg pain (outside of the leg extending from the knee to the ankle) while golfing. The strain and compensatory motor patterns had gone on for some time and pain was limiting his game. This combination of interventions was recommended.

  1. Stabilization of the connective tissue and supportive structures of the lateral ankle using regenerative medicine.

  2. Assessment, fitting, and use of ALINE prescriptive insoles to keep his foot from rolling in when weight bearing on one foot, followed by compensatory over supination (rolling out) when he pushes off the ground, decreasing the strain on the outside of the lower leg and ankle.

  3. Addressing the root cause of muscle compensation and strain, specifically, re-activation of the gluteus medius on the right side to improve hip stability and lower extremity function utilizing the closed kinetic chain Redcord – Neurac Method.

These therapies used together produced an excellent result, but it all started when his foot hit the ground.

You can be assessed for ALINE prescriptive insoles by one of our movement specialists at CHARM in less than 30 minutes. Time and again, ALINE’s have proved themselves a critical link in the chain of stability, maximal power, protection from injury, and ultimate performance – – They may just change your game!

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