Self Assessment | Exercise Tool Kit

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I often joke with clients that calf stretches cure allergies. This is obviously ridiculous, but improving motion at the ankle may help address or prevent a large number of issues including:^1,2,3

Patellofemoral pain/Patellar tendon injury
Achilles Tendonitis
Muscle strain injuries
Plantar Fasciitis

Addressing tightness in the calves/ankle may also help optimize body mechanics when: ^2,3

Landing from a jump
Squatting
Walking/Jogging/Running
Stair Climbing

The Calf Muscles

The muscles we are particularly concerned with are the:

Gastrocnemius – This muscle originates just above the knee and crosses the knee until it runs into the Achilles tendon, ultimately inserting into the heel. The gastrocnemius (gastroc) crosses both the knee and ankle. To get a definitive idea if this muscle is tight, somebody experienced in goniometry would need to assess it.

Soleus – This muscle originates in the lower leg. It does not cross the knee, and together with the gastroc forms the Achilles tendon inserting into the heel.

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Testing for Tightness⁴

In order to test for a lack of ankle mobility or tightness of the soleus, position the foot perpendicular to a wall:

Lunge knee towards wall keeping heel on the ground
Progressively move the foot back and re-test
When the foot has reached a maximal distance from the wall, measure the distance without lifting the heel from the ground.
Measure from the big toe to the wall

If the test is less than 11cm (~4.5 in) the ankle is generally thought to be lacking mobility.²Variations in what constitutes “stiff” may occur if the person is rather tall or short.

What to do with this information

If you are healthy and have decreased mobility of the ankles, it may be beneficial to perform the test for sets of ten seconds, holding each repetition for 5-10 seconds. Typically, people report a sensation of stiffness of the ankle or stretching in the back of the calf. If you experience pain with this exercise, consult a healthcare professional.

Static calf stretching is also very beneficial for improving ankle mobility and flexibility.

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Author: Christopher (C.J.) Eberley, PT, DPT

Board Certified Orthopedic Physical Therapist

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Disclaimer: The views discussed on this website are for educational purposes only. Should you have any questions please consult your physician or physical therapist. Copyright© Kinesis Physical Therapy. All Rights Reserved.

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References

1 Hess, Gregory William. “Achilles Tendon Rupture A Review of Etiology, Population, Anatomy, Risk Factors, and Injury Prevention.” Foot & Ankle Specialist 3.1 (2010): 29-32.
2. Kasuyama, Tatsuya, Masaaki Sakamoto, and Rie Nakazawa. “Ankle joint dorsiflexion measurement using the deep squatting posture.” Journal of Physical Therapy Science 21.2 (2009): 195-199.
3. Malliaras, Peter, Jillianne L. Cook, and Peter Kent. “Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players.”Journal of science and medicine in sport 9.4 (2006): 304-309.
4. Bennell, Kim, et al. “Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion.” Australian Journal of physiotherapy 44 (1998): 175-180.

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Tight hip flexor muscles can hamper the ability to extend the hip. This may affect the mechanics of simple activities such as walking or more complex activities such as kicking a ball.^1,2

The Hip Flexors

The muscles we are primarily concerned with are the:

Gray430

Iliopsoas – This muscle(s) originates on the vertebrae of the lower spine/pelvis and inserts in the upper portion of the thigh bone. The term iliopsoas is a common reference to two muscles: the iliacus and the psoas major.

Rectus Femoris – This is one of four quadriceps muscles. It is unique in that it crosses both the hip and knee. It originates in the pelvis and inserts at the kneecap.

Exercise professionals typically refer to these muscles when the hip flexors are tight. In such a scenario, extending the hip and keeping the spine in a neutral position may be difficult.

Testing for Tightness^3,4

In order to test for hip flexor tightness, sit at the edge of a table or bench and proceed to:

Roll backward bringing your knees to your chest
Release one leg while keeping the lower back against the table
Ensure that your lower back is against the table and release the leg to be tested.
The leg needs to be relaxed

“Normal” Test

This picture represents a “normal test.” Notice that the thigh is parallel to the table and the knee is bent to nearly 90 degrees.

Rectus Tightness

This picture suggests tightness of the rectus femoris which crosses the hip and knee. Notice that the knee is lacking in the knee bend compared with the normal depiction.

Psoas/General Tightness

This picture depicts tightness of at least the iliopsoas and possibly the rectus femoris. The ligaments and joint capsule of the hip may also be contributing to decreased hip extension.

What to do with this information

If you are healthy and have tight hip flexors, you may want to perform static hip flexor stretches to help improve how you move. Improvements in mechanics during walking or kicking a ball are examples of potential benefits.

Stretches targeting the hip flexors can improve mobility and function and potentially decrease mechanical stress on the hip and lumbar spine.

In some cases, attaining “normal” hip flexibility may not be optimal. For example, the rhythmic gymnast or cheerleader may require greater hip flexibility.

Stretching

I have covered two effective stretches in an article on static hip flexor stretching. Below is a picture of one of my favorite hip flexor stretches.

Psoas/Rectus Stretch

Place the leg to be stretched on a table or bed
The other leg will remain on the floor
Use a strap or dog leash to pull the leg toward the buttocks
A gentle pull should be felt in front of the thigh or hip

To specifically address the iliopsoas, bring the leg on the floor further forward and allow the leg to remain flat on the table.

Hold for 3 sets of 30 seconds.