Clinical Pearl: Self Ankle Distraction | Modern Manual Therapy Blog

Clinical Pearl: Self Ankle Distraction

Here is a quick Clinical Pearl I came up for one of my runner patients this week!

I had often done this on myself to restore dorsiflexion (other than some self EDGE work to my lower leg!).  A runner came in with 0 dorsiflexion, stating he did not know why his ankle had locked up again, and it felt like it needed "another manipulation."

So I started by showing him the typical distraction, with one hand web space on the superior talus, and the other on the superior calcaneus. When he stated "it does not feel like enough stretch," I suggested he actively flex his hip to provide more force and just hold his hands in place. There was actually a decent cavitation and all his ankle motion was restored! I tried the hip flexion myself, and it is a much more effective self mobilization! Give it a try!


  1. Gerat technique. Maybe try this one as well: normal siting position in chair, feet on carpet preferably ( for resistance), then alternate pushing and pulling the feet forward and back, without the feet moving. Like a PNF rhythmic stabilisation. This causes a nice translation movement in the ankle joint and can be done anytime, anywhere.

  2. Is the patient doing alternating resistance opposing the direction? Having trouble visualizing this but sounds effective.

  3. It's like you're sitting on a chair with castors like an office chair. And you're moving the chair forward and back. That's the push and pull action (but can be done on a normal chair as well), It's the push and pull that causes the translation in the ankle (and also in the knee btw) I like it because it's so easy to do in any situation....