Following an injury, the surrounding muscles go into a protective spasm, preventing movement and effectively becoming tight and shorter in length. This reduces how much you can move the joint these muscles act over. This is known as a reduction in your range of motion (ROM). This reduced ROM will have implications down the line on the duration of your rehab and return to sport. Insufficient ROM can leave you more vulnerable to injuries, some of which may be more damaging than the initial injury.
Following injury, the first step I take is to help recover lost ROM before anything else. This is because, when we build strength, speed and power, they are acquired within a trained ROM. We cannot gain strength in a ROM we do not use or have access too.
Ankle sprains are an easy to understand example of how this works in practice, as most of us have either had this injury ourselves or know someone who has. When we sprain our ankles, they tend to swell up and are obviously injured. It becomes difficult to weight bear on that leg and we are uncomfortable moving the ankle through its full ROM from pointing our toes to pulling them towards our shin. Therein lies the first hurdle of not moving it, hence the time old saying, use it or lose it.
Following a week of inactivity we start to move again and it feels really stiff and uncomfortable. With the majority of muscles in the lower leg behind the shin, they effectively become the tightest and stiffest part of the lower leg. Stretching them becomes on of the most challenging movements because of being immobile the past few days. As these muscles resist dorsiflexion of the ankle, dorsiflexion is the ROM we want to recover. The test I use to assess dorsiflexion is the knee to wall test. I like this test because of its simplicity, it shows instant results in the first session and can be done at home easily, meaning you can monitor your own progress between sessions. This gives us an indicator of how well you respond to treatments, when they start to plateaux and we need to switch things up.
If we didn’t have this test, and I asked you to stretch your calf for a week after not assessing ROM in the first session and on return you had no pain or stiffness we may think your dorsiflexion was normal. Having this test in place allows us to compare to your non injured ankle AND shows us the progress we are making. The inverse is true as well. If no difference is noted between your ankles, if no difference is found after my treatment or if no improvement is made between sessions then we would be none the wiser.