GTP TV: Ep 4 – The one all about ankles

Hey, gang. It’s Maria here from GoalieTrainingPro.com, and welcome to Goalie Training Pro TV episode number four!

 


You can also find the video of the episode here which helps for the visual stuff! >> https://youtu.be/Ai5L2jehqwQ

So we are doing this bottoms up thing. Last week we started with the foot, and we talked about all the little bones and how they can be finicky, and strengthening the muscles in our feet, and how important our feet are because they’re the interface between our skate and the ice or our body and our skate, and our skate and the ice. In case you missed it, it’s episode three. It will be somewhere in the feed, or you can catch it on Goalie Training Pro TV on YouTube, so no problem.

Today we’re talking about the ankle, and next week we are gonna talk about the knee. You don’t want to miss that one, because your knees take a beating because of certain things that you do and you’re not mobile in certain areas, so then the knee takes up the slack, and it causes a lot of wear and tear.

(The week after that, we’re gonna be talking about the neck, which I know is not really bottoms up, because we’re kind of skipping your hips and your pelvis and your back and your thoracic spine and your shoulders, and we’re just going straight to your neck. But I really want to share this with you ’cause it’s … and I don’t usually say cutting edge, new … But it actually is cutting edge.)

I want to remind you this episode’s brought to you by PriceBlocks.com. If you know goalie coach Mike Valley, fantastic guy, super smart, amazing coach, but this is one of the things he started because he had the same problem. It’s like, how do people know when I have time available in my town and how much my rates are and how can I make it so that it’s easy for people to find me, to book me, to pay for me and have a lesson rather than you’re gonna call, “What time do you have?” So this way it just … they can go to one place online. “Okay, you’ve got an opening here.” As soon as they book, that comes off your schedule, so somebody can’t double book. They pay right there, and you’re all set. So anyway, PriceBlock.

The other thing you want to check out on there is … The Network Goaltending Symposium is going to be in Nashville this year. It will be June 1st to 3rd. It’s basically a who’s who of goalie coaching. And they’re the nicest people. You’ll talk to anybody, and they’ll just spend so much time with you and help you out. This year, there are gonna be NHL goalies. There’s gonna be an on-ice component this year. If you’re a goalie coach who’s looking for better ways to help your goalies win more games, then you should be there too. It’s cheap as anything in terms of what conferences go for. That info is on PriceBlocks.com as well. It’s the Network Goaltending Symposium.

Let’s talk ankle stuff. We have a few different planes of motion. So one is dorsiflexion, which is bending forward. Then there’s plantar flexion, which is when I go up on my tiptoes. Then there is inversion, when I turn the sole of my foot up. There is eversion, when I turn the sole of my foot out. So those are gonna come into play as we go through the anatomy of the ankle.

It gives us quite a bit of mobility, especially in plantar flexion and inversion, and for some of us, dorsiflexion. Not so much in eversion, which is probably a good thing. But it’s also pretty durable, and you look at how much abuse that thing takes and the things we do to it and twist and turn. It’s pretty compact, so it’s an amazing device and we should look after it, ’cause if you’ve ever had something wrong with your ankle, you know how limiting that’s gonna be on you.

We’ll go over a little bit of the anatomy of the ankle, and then we’ll come back to it as we talk about injuries. But I want you to sort of get the lay of the land. So we’ll start by looking at kind of the inside part of our foot and our ankle bone, which is actually gonna be the medial malleolus. (That’s from the tibia of your big shin bone.) Then there is a main ligament on the inside … it’s a deltoid ligament, and it’s pretty rock solid. That’s part of the reason … Part of it’s the boney anatomy that you doesn’t really let you roll, because you’re gonna smash into your lateral malleolus before you kind of get over there. But also your deltoid ligament is pretty strong, so it keeps you from rolling your ankle where the bottom of your foot rolls away from you.

Then if we look at the outside of our foot, this is where normally, when you sprain your ankle, you roll your ankle in. This is called an inversion sprain. Around your ankle on the outside there are talofibular ligaments. There is sort of an anterior, a medial, and a posterior. But the anterior talofibular ligament is the one that usually goes first, and it’s the most vulnerable position for your ankles when your toes are pointed down a little bit and you roll your ankle. That one’s gonna snap. *Insert finger snap here*

If we look at performance-wise, obviously you want to have strong, stable ankles, but one of the things that I see a lot of goalies lacking, is an active dorsiflexion. Their ankle gets stuck when bending the knees forward. I don’t know what explains it, but you need to have that dorsiflexion so that you can get balanced in your stance and get those knees a little bit forward, have your shoulders over your feet tilted forward from your torso so that you’re appearing nice and big in the net and big to the puck, but without being folded.

If I can’t get that position, kind of get deep in my ankles, if I get stuck, well then my bum can still go back. But then my chest has to come down to hold that position, ’cause I just can’t fold my back in half and get that chest up. If I can get that dorsiflexion, that lets me be taller in the net and just in a better position all around to move.

So dorsiflexion is really important, and people don’t realize how much they lack in it.

It also helps you get a good pushing angle, so you have a nice, good, strong push position. Again, if I’m kind of stuck, it’s not as strong a position to push from or even if I’m in my butterfly and come up, you can see how I need that ankle dorsiflexion to load it up. If I don’t have that dorsiflexion, I have to bring my knee up a little higher to get that clearance. It’s important.

Then, as well, off the ice, if you lack dorsiflexion, it can mess up how you squat, how you run.

Here’s a test to see if you’re covering your bases. You should be able to balance on one foot and close both your eyes, and not fall over and take out your china cabinet or anything like that.

You should be able to lunge in all four directions and come back up to balance. Stick that balance for about three seconds. It should be pretty familiar that the feedback that your brain is getting from the proprioceptors in your ankle. It’s working with your hips and your knees, and you’re finding that perfect point of balance.

The last one that you can use for a little test is you should be able to ankle bounce, so this is one where we just come up on our toes and bounce nice and relaxed, but our heels come down and just lightly kiss the ground, so it’s not heavy. It’s just light, light, light, but getting all the way up and all the way down, you should be able to do that for 30 seconds and sort of find that rhythm, ’cause we want those joints to have some smarts too.

If we look at some prehab exercises we can do to help you look after your ankles, we do just active dorsiflexion. Again, with my heel on the ground, making sure my heel and my middle toe are in line pointing straight ahead and my heel stays on the ground, I’m just going to bring that knee forward and back.

This tricks people, ’cause people say, “Oh, I don’t really feel it,” ’cause you’re expecting to feel a stretch in your calf and this isn’t a calf stretch. It’s an active mobilization, and you should just feel a little in the sort of the lower third in the back, just right around your Achilles. We’ll do about 15 on each side.

Then we also sometimes do what I call an FRC active dorsiflexion, ’cause it’s based on some of the stuff I learned from Dr. Andreo Spina. But we’ll just come, sort of in a runners starting stance to start with, and work on driving the knee forward cutting the angle down to get in that nice, deep dorsiflexion. But then we’ll also come out to the side, like a side lunge, and get sort of an active inversion, so keeping my foot flat, getting that active inversion.

Then I can come underneath (bring the straight leg in the lunge behind to the other side) as well and get an active eversion. But also look at what’s going on at your hip as you do all these movements. You’ll be in adduction and external rotation as well as in nice extension. Other times you’re in some abduction. That’s kind of a nice one too, and we just kind of flow around that and kind of work those positions. You can even mobilize back and forth a little bit.

When you do ankle bouncing. It’s a good one to sort of get those muscles firing and learning to sort of fire in a controlled and rhythmic manner. Also tiptoe walking, and then heel walking as well. Those are a few things we can work on.

We usually don’t do a lot of inversion- eversion-specific isolation work, unless there’s been an injury in the past or it’s a specific area that we’ve identified as being problematic. If we were to do that, we would just grab a pretty light resistance band and strap it to the foot. You would put your other foot underneath the opposite leg, (’cause I don’t want my heel scraping along the ground). But my knee has to stay still, and then I’m gonna invert my ankle and control it back.

My foot’s in a nice, relaxed position, so I’m not pulling my toes up. I’m not pointing them. And as I come back, there’s a little bit of a cogwheel there. It kinda goes, “Uh uh uh uh uh,” coming back. That’s okay. It’s just that muscles aren’t used to kind of working in isolation like that. So nice and controlled, getting that going. Then I would switch around to the other foot and do the other way out to the side, coming back down. Again, making sure that knee isn’t rolling back and forth, ’cause a lot of you want to use your hip to work on that rather than the muscles in your lower leg.

Another one that we sometimes do is you’ll get in the back of your ankle with a lacrosse ball. If you’re really having some trouble getting it, and we just kind of push in there and kind of turn around. It’s just a different kind of self-myofascial release just to try and work on that a little bit.

Now let’s go back to dorsiflexion and say you start working on your active dorsiflexion and every time you come forward into that position, instead of feeling that little tightness in the back, you feel a pinch or a block in the front. That suggests that there’s sort of a boney block at the front of the joint, and that’s what’s limiting your active dorsiflexion or your dorsiflexion in general.

That will probably need to be mobilized by a physiotherapist or a massage therapist, somebody who knows how to mobilize joints, because again, when we looked at those bones in the foot and the ankle last week, one of those, it’s probably stuck and you’re not gonna be able to stretch it. You’re actually just mashing on it and maybe make it irritated. So they’ll do a little mobilization and again, it should be like, “Yeah, that got it,” and then away you go.

So again, don’t ignore it. It’s not something that’s like if your hips were so tight and you had no butterfly, you’d right away be looking to get it looked at. This dorsiflexion’s just kind of like, “Huh. That’s weird.” But it really has that much of an impact all the way up the chain that you shouldn’t just be ignoring it.

Let’s talk about some injuries again. So we already talked about the inversion sprain. Usually it’ll be your ATFL that goes first. But also there are two other ligaments as well. They join bone to bone. (Deltoid ligament, eversion sprain, not that common. We’re good.)

Now we’re gonna talk about the high ankle sprain. When I was a girl back in university, we called this a syndesmosis sprain, but now it’s called high ankle sprain, and it’s a funny injury.

A syndesmosis sprain is a rotational injury. Your ankle is sort of a mortise and tenon joint, so when the foot spins under the leg or the leg spins on top of the foot, it kind of spreads those bones. So my lower leg rotates in and my foot rotates out, and that springs this syndesmosis joint or the joint between the tibia and the fibula. So if you picture your ankle spinning, it spreads the two bones apart and puts a strain on that syndesmosis.

So there is syndesmosis, but then there’s also interosseous membrane. That’s just the connective tissue membrane that goes between … sort of knits between the two bones. Let’s think about this for a second. Picture your lower leg and that the bones that make up your ankle are two different bones that are just connected by ligaments. It’s not a solid thing. They’re two different bones. It’s crazy.

So anyway, the interosseous membrane gets sprung, and that creates a problem because there aren’t muscles that we can work on. “Oh, well, let’s just strengthen the muscles that hold the fibula and the tibia together.” Well, there aren’t any. Those were left out for whatever reason.

It really is you got to have to give it time, which is why these injuries are so frustrating, and sometimes too they’ll feel just fine. Walking around, it’ll feel great and people think, “Oh, that high ankle sprain. No problem. Man, I feel better already. I’m gonna get back on the ice.” Then they get back on the ice, and start rotating or stop or a crossover, and that pain comes back and they think, “Oh, man. It was so much better. Now I’ve irritated it again.” Well, probably you didn’t really irritate it again. It probably just wasn’t ready for that action.

Now if you suspect that you have a high ankle sprain or a syndesmosis sprain, this is what we do sometimes to sort of see if that’s maybe what it is, and we can even use it when you’re getting back to the stage of getting better, we can do this to give it a little bit more support.

But we’ll take just athletic tape, just your normal white athletic tape, and we’ll come just above the ankle bones, but low, and we’ll put it on really tight … go around a couple of times, quite tight. Not, “Errr,” but tighter than you would tape an ankle, ’cause you’re not gonna leave it on for long. You’re just gonna put it on and then go through some motions.

Before you tape it, you’ll kinda get a feel by going through some motions. “Okay, yeah. That’s pretty sore when I just do it like that.” Then we’ll tape it up, and then it’s like, “Oh, actually, that feels a lot better.” The good news is we know what’s wrong with you. The bad news is it’s probably a syndesmosis sprain.

That’s just a little thing you can try. I don’t use that as your sole diagnosis. Actually sometimes even when you do inversion sprain sometimes your ligaments can pull off a little chunk of bone. Sometimes actually you can even pull off the base of the fifth metatarsal. A little chunk’ll come off. It depends where you’re feeling your pain and your swelling and things like that, but still get it checked out.

So high ankle sprain for you guys, picture your … maybe your in a reverse VH and somebody falls on your leg and it torques your … or even just really going in the position hard and it torques your lower leg in while your boot’s on the ice. That could give you one. Skate getting caught in a rut, kind of spinning you. That can give you one. Umm, yeah, time to heal. That’s it, and you can still work on the inversion, the eversion, the balance, getting your balance back, your proprioception, but it’s just gonna take its time to heal.

So that is the ankle! That is your bottoms up Goalie Training Pro TV this week. Next week, we’re gonna talk about the knee. That’s a really important one. I see a lot of guys chew up their knees by just not quite doing the right things on or off the ice, and then we’re gonna talk about the neck after that and we’re gonna talk about the TopSpin and how we can reduce the severity or maybe even the incidence of concussions. That’s gonna be a big thing.

Hey … Oh, yeah. This is important. Those of you in the States, Happy Thanksgiving! Also, I am going to be doing a Black Friday sale, so if you’ve been waiting to get Ultimate Goalie Training 3.0, Rapid Response Goalie Training 2.0, In-Season Goalie Solution, Puck Battle Domination, which is the youth training program, wait till tomorrow. We’re gonna have a coupon, but don’t tell. It’s a secret. It’s a secret. Mum’s the word.

Have a good one. Eat lots of turkey and get one … a humongous spoonful of stuffing for me and just put it right in your face. I love stuffing.

Have a good one. Cheers.

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