Aside from the more overt injuries, dysfunctions and other noticeable reasons to look at the ankle, I’ve found myself making sure that I always check out compression injury/impact ‘memory’ in my clients ankles. I had one client who had broken his ankle via a heel sliding into his ankle from a football tackle, throwing his ankle into severe dorsiflexion. I had another that had jumped off of a roof at some point and landed straight on the heels. The obvious examples of these kinds of compression injuries can go on and on but even if they don’t remember, the body does, and these are pretty common and can be very serious.

If your ankle feels like it just injured itself in compression, or feels vulnerability in compression…that’s going to be a problem, given that every time the heel hits the ground or even stands, it’s reinforcing this sense of vulnerability. So what it comes down to is every person I work on, especially those who are more active types or older persons (back when it seemed almost a right of passage to jump off a roof) I will give a few very light taps to the heel and see what happens. In some cases, even if they don’t remember any such impact or injury, it can blow out the whole leg, or at least part of it (and this is not necessarily related to hip compression by the way).

So if you’re having trouble in the leg, give the heel a few taps from the plantar surface and retest, and then decompress the ankle, and recheck. If there is a profound effect, you will have to retrain the body that compression is safe in the ankle. Many times something in the spine or head is more important at the time, but the ankle won’t stop being an issue until it’s resolved.

This is just one of many ‘fascial memories,’ scars certainly being included, but blunt trauma (especially to the head) and damage to joints and bones are also very common and will similarly need to be dealt with. You need to show the body that the injury is no longer active, and thereby no longer vulnerable to stop destructive and destabilizing compensation strategies that are due to it.

To treat ankle compression injury remnants I alternate decompression, heel tapping, and activations of muscles that the perceived injury is taking down. This shows the body that the injury is no longer present and that it doesn’t have to guard the ankle by inhibiting so much that contributes to compression. Dorsiflexors and flexors are definitely on the list. I would be very open to quicker and more effective techniques but this does do the trick. There may also be tarsal displacements that are worth checking into if you have the background.

Filed under: The Practitioners Corner

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