Pelvic floor dysfunction is not just about the pelvic floor despite what most think. It does involve the pelvic floor but the floor does not function by itself in isolation! So, focusing on just the floor of the pelvis and expecting to get results is simply wishful thinking! If pelvic floor dysfunction was the name of a book it would have many chapters. Some of which you know and others you may have never thought were related. For a list of these symptoms and a better understanding of pelvic floor dysfunction, please refer to my blog. While the causes of pelvic floor dysfunction are complex and multifaceted, limited ankle mobility has been identified as a potential contributing factor.
Relationship Between Ankle Mobility And Pelvic Floor Dysfunction
Your ankles are the supporting joint for the whole body and your connection to the ground. That is a huge role to play and any instability above the ankles has to be balanced by the ankles so you stay on your feet. This means that in most instances, the ankles become more rigid in response to making the instability above safer to protect you from falling!
Conditions such as EDS and other hypermobility/connective tissue conditions make this task especially difficult. This is one of the reasons why hyper-mobile individuals often experience pelvic floor dysfunction. During walking, running, or jumping, the ankle joint needs to move through a full range of motion to allow for proper shock absorption and propulsion. If ankle mobility is limited, compensations may occur in other parts of the body, including the pelvis.
How Does Ankle Mobility Impact The Pelvis?
One way that limited ankle mobility can contribute to pelvic floor dysfunction is by changing the way we move. When we move, our body is constantly adjusting to maintain balance and stability. If the ankle joint is unable to move freely, it can impact the way that force is transmitted up through the leg and into the pelvis. For example, if a person has limited ankle flexion, they may compensate by rotating their hip outward, which can place additional stress on the pelvic floor muscles.
Restricted ankle mobility also impacts muscle activation patterns. When the ankle joint is unable to move through a full range of motion, other muscles have to compensate to maintain proper function. With limited flexion of the ankles, for instance, you have to lift the leg to clear the ground to avoid falling. This results in an overuse of the hip muscles and an underuse of the ankle muscles. That is the initiation of the pelvis instability and weakness of the pelvic floor. Bear in mind that weakness is not always a muscle that does not work hard enough, but a muscle that works too much and is tight gets weak from not resting!!
Top 6 Exercises To Increase Ankle Mobility
When it comes to the ankles, both feet and legs are the bare minimum areas that need to be worked on and the following are my recommended exercises:
Figure 8 Exercise:
While sitting, put your ankle over the opposite knee, grab the heel and move the foot in a figure 8 fashion and reverse the direction.
Towel Exercise:
Throw a towel on a tile or wood floor and with your toes, pull the towel closer and closer to yourself. With all of your toes grab and pick up the towel and repeat.
Calf Exercise (Gastroc.):
Use a dumbell or a steady surface to lift your toes on while your heel is on the ground; lean forward to stretch your Gastroc. Hold for 30 sec and repeat. Make sure to do it on both sides. Once you don’t feel as much tightness, you can actually step higher on the dumbell so your heel is lifted off the ground and try to lift your heel up higher than your toes.
Calf Exercise (Soleus):
Do the same as above, but only bend your knee. Hold for 30 sec and repeat. Do this on both sides. Once you don’t feel as much tightness, you can actually step higher on the dumbell so your heel is lifted off the ground and try to lift your heel up higher than your toes. Make sure to bend your knee!
Wall Exercise:
Stand 1 foot away from a wall. Make sure you’re standing up plumb! This means the ear hole, middle of your shoulder, middle of your hip, and the outside bump on your ankle all line-up. Hinge forward at the ankle without leading with the neck, chest, or pelvis. Pretend you are all fused and can’t bend anything but your ankles. This is a great way to practice stability while allowing the ankles to do the moving.
Deep Squat Heel Lift:
This is certainly a more advanced move and is for those who have better hip mobility. While deep squatting, hinge slightly forward while keeping the spine as neutral as possible and lift your heels off the ground.
Pelvic floor dysfunction requires a multi-level approach! Working on the pelvic floor is only a small part of the treatment and should not be the first thing addressed. If you have pelvic floor dysfunction and have not received the result you wished to see, contact me.
Dr. Shakib
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