Ankle Plantar Flexion Challenges!

This question was sent to us from Tresa Sauer, and we though others might be interested too!

I have two (2) clients who have difficulty with ankle plantar flexion.  Geez – usually it’s the other way around and I gotta bark about their quads and knees, but with both of these cases, the insufficiency is nearly debilitating.  One woman’s plantar flexion is so poor that during tower class, I show her to the Stability Chair for Ankle Exercise so she doesn’t come crashing down during Push Through with Feet on the push-thru bar (yeah, I know she can keep her knees slightly bent, but I have 4 other people to worry about). When she does Ankle Exercise, I can see that she’s sliding her knee up and down on the edge of the chair to make the movement, but also – her calves seem TIGHT. Tight and weak. Hmm… My other client, during Lift and Lower footwork, actually levitates her pelvis off the reformer!  We scream with laughter and I suppose her gastroc and soleus are weaker than weak, but why the pelvic levitation?  Dynamically, what’s going on?!? Both of them do a lot of BIKING!

Response from Melanie:

Hi Tresa!!!
How are you doing, wonderful? And how is your son managing with his brace and exercise? I still listen to your DVD regularly and love it! I  thought I had replied to you already about the dreaded lack of plantar flexion, but as I cannot find it, here goes!

Crazy that these two clients lack PF to such an extreme. I love the levitation visual! There is hope! I suspect a couple of things: First I expect that they grip with their toes constantly; Secondly, I suspect that they have significant rigidity of the midfoot joints in association with their cycling; finally I suspect that their postures are such that the pelvis is not centered over their feet habitually, and that they are likely slightly flexed at the hips with tight/ dominant hip flexors.
Here are a couple of suggestions:
1. Have they come to class  a little early and mobilize/ roll  their feet on a half tennis ball or full tennis ball. Have them step on the ball at various points of their feet, roll their feet up and down on the ball, and rock their feet side to side  and in circles.
2. Try footwork initially with the midfoot on the bar; this will help to open up the muscles and joints of the midfoot, and may help some of the tension they have to plantar flex against. Then progress so that you help her up into plantar flexion (you do the concentric work and reduce the load she is pushing), then have the client lower the heels down eccentrically. Repeat that several times and then see how much plantar flexion she can achieve.
3. Try footwork with the jump board and toning balls. Place the toning balls under their heels and have their metatarsal heads on the board. In this way they are being supported in plantar flexion. Cue them to relax their feet and push the carriage out with their legs.
4. Try Lower and Lift with the knees bent. This may help stop the levitation, and target the deeper plantar flexors including the tibialis posterior and soleus. So this both supine and in side lying (sleeper)
5. Try side lying (sleeper on the reformer, and side lying leg springs on the V2Max/ cadillac). I hope this will help them open up the front of the hip joint, and use the hip abductors and peroneals (which are plantar flexors)
6. Try Elephant in as much plantar flexion as they can tolerate. Focus on the work coming from the abs, hip flexors and hip adductors instead of gripping with the feet.
See how these go and please report back. I will come up with another series of ideas if these do not help to restore some power and range of plantar flexion.
Say hi to everyone at the club!!!
Melanie