Neurologic vs. Physiologic Stiffness
We all know that it’s important to have adequate dorsiflexion.
A lack of dorsiflexion prevents effective squatting, drives feet into pronation, alters pelvic tilt, promotes quad dominance, and a number of adaptations up the kinetic chain.
Ever have an athlete that no matter how hard to you try to impact dorsiflexion, you don’t see the changes in his performance during ground-based activities?
You mobilize his ankle, and his squat doesn’t change. You stretch the calf, and he still has a premature heel lift when he walks. You have him hop up on the exam table, and it looks like he should have enough dorsiflexion as you move the ankle through a full range of motion. You put him back on the ground. No dice.
So what’s the deal? What are you missing?
Let me explain with a little demonstration.
Take your shoes off and stand up…I’ll wait.
Now, keep your knees straight, stay tall, and slowly lean forward until the moment you feel like your heels will come up off the floor and hold that position. Do you feel it?
Do you feel your toes grip the floor? Do you feel the tension move up into your calves?
In an effort to maintain stability, your nervous system turns on your calves and the deep posterior compartment musculature and on up the kinetic chain. Many athletes have the exact same problem.
Your mobilization and stretching may have addressed the physiologic stiffness that would prevent normal ankle mobility, but if your athlete has poor control of his center of gravity, the stiffness will persist to maintain stability. The result is a neurologic barrier to performance and greater risk of injury.
Got an athlete with plantar fasciitis, anterior knee pain, groin pain, piriformis syndrome?
Consider looking at the factors that influence center of gravity and the associated alignment and muscular activation patterns.
Here’s a hint…start from the ground up.
More later.
What about a patient that has no lower leg compensations with a squat and gets a good amount of dorsiflexion, but when put on the table they can barely reach neutral with their ankles? Could that be neurological as well or would it be just a tight gastroc since soleus seemes to be fine with squatting and the knee flexed?
Thanks Bill, I love your work.
Great post Bill!
This is actually the subect of many debates I’ve had about about the virtues of mobility work and static stretching. Many suggest these methods are useless without first addressing the neural component of stiffness. In fact, some say that the nervous system is the primary cause of stiffness and if this is addressed there is little need for stretching at all.
Your thoughts on this would be greatly appreciated.
Keep in mind that athletes will have tissue-based adaptations that need to be addressed in addition to neuro-based adaptations. You also need to consider acute affects of methods such as stretching and mobility work and how that influences performance temporarily. You can use those acute effects to improve mobility which will influence performance and neuro issues such as proprioception.
Josh,
Look for anterior weakness. The weight bearing of the squat allows you to overcome the stiffness of the posterior compartment, but I’ll be cash money that you’ll see more pronation than you’d like during a squat. If the anterior compartment is weak, you won’t see full ROM in open chain.
Great stuff, Bill.
You can do a similar same with the head and neck…..
- Stand up tall
- Allow the head/neck to creep forward, like forward head posture, and feel the calves contract to push back against te ground and keep you from falling forward.
Some would say that this forward head posture is creating tension in the suboccipitals, causing tension down the superficial back like (into the calves and plantar fascia).
Now think of all those distance runners who complain of plantar fascitiis, achilles tendonitis, and even neck pain when running.
A little soft tissue work to the cervical region can go a long way!
Patrick
Good point. Anything that shifts the COG forward will reproduce the effect.
Thanks for the reply Bill.
I’m anxious to hear more about neural stiffness from your point of view.
Great post Bill!
Only saw this now!
Great stuff Bill.