Mobilize Those Ankles! A Fun Guide to Ankle Mobilization with Movement

Open up Better Movement With Ankle Mobilization Techniques

Ankle mobilization with movement is a hands-on technique that combines joint mobilization with active movement to improve ankle range of motion and function. Here's what you need to know:

• Definition: A manual therapy technique that applies a gliding force to the ankle joint while the patient actively moves the joint
• Main Benefits: Increases dorsiflexion by ~4°, improves walking speed by 0.08 m/s, and improves balance
• Basic Technique: Stabilize the talus bone while applying posterior glide as the ankle moves into dorsiflexion
• When to Use: For limited ankle mobility, post-ankle sprain, chronic stiffness, or as part of stroke rehabilitation
• Safety: Should be pain-free during application; stop if pain increases

When your ankles can't move properly, everything above them suffers. Limited ankle mobility—particularly dorsiflexion (the motion of bringing your toes toward your shin)—can create a chain reaction of problems throughout your body. From altered walking patterns to compromised squat form and even increased knee pain, stiff ankles often contribute to issues you might not immediately connect to your feet.

Research shows that mobilization with movement (MWM) techniques can significantly improve ankle function, especially in people recovering from injuries or those with chronic stiffness. What makes MWM different from regular stretching is the combination of joint gliding with active movement, which helps restore normal mechanics while reducing pain.

I'm Lou Ezrick, founder of Evolve Physical Therapy, and I've spent nearly two decades helping patients overcome mobility limitations using specialized ankle mobilization with movement techniques to restore function and prevent recurring injuries. At Evolve, we've refined these methods to ensure you get lasting relief, not just temporary flexibility gains.

Why Ankle Mobility Matters for Everyday Movement & Sport

Your ankles might seem small compared to other joints, but they're mighty in importance. Think of your ankle as the foundation of a house—when that foundation can't move properly, everything built on top becomes a little wobbly.

Ankle dorsiflexion (that upward motion bringing your foot toward your shin) isn't just a fancy term physical therapists throw around. It's the movement that allows you to walk normally, climb stairs without stumbling, and squat down to pick up your grandchild—or that heavy Amazon package.

For our athletes in Brooklyn, we see how limited ankle mobility creates a ripple effect throughout the body. Ankle mobilization with movement techniques often become game-changers for them because proper ankle function affects everything from how you squat in the gym to how efficiently you run in Prospect Park.

"I had no idea my knee pain was actually coming from my ankles until my therapist at Evolve showed me the connection," is something we hear regularly from surprised patients. Your body truly is a connected chain—restriction in one link affects all the others.

Hidden Costs of Stiff Ankles

The consequences of poor ankle mobility go far beyond not being able to touch your toes to the wall. Here's what we commonly see in our Brooklyn practice:

Increased injury risk becomes almost inevitable when ankles can't move properly. Your body is smart but sometimes too accommodating—it will find ways to move even if that means overloading your knees, hips, or lower back.

Chronic pain patterns often develop as a result. That nagging plantar fasciitis? The Achilles tendon that always feels tight? Your ankle mobility might be the hidden culprit behind these persistent problems.

For our older patients, restricted ankle mobility significantly contributes to balance problems and fall risk. When your ankles can't adjust quickly to uneven surfaces, you're more likely to stumble.

And for our stroke recovery patients, the challenge is often compounded by spasticity (muscle tightness). This is where ankle mobilization with movement techniques become particularly valuable, as they address both joint restrictions and neurological factors affecting movement.

Research Snapshot: How Much Motion Do You Really Need?

Science gives us clear targets for healthy ankle mobility:

Walking down Smith Street requires about 10° of dorsiflexion. Seems small, but without it, your gait becomes inefficient and potentially painful.

For our runners hitting the Brooklyn Bridge Park paths, you'll need nearly 20° during the stance phase of running. Without this range, other joints compensate, often leading to injury.

And if you're working on those deep squats at the gym? Your ankles need almost 35° of dorsiflexion to maintain proper form without your heels lifting.

These aren't arbitrary numbers. Research published in Physical Medicine and Rehabilitation confirms these requirements for normal function.

What's particularly exciting is how effective proper treatment can be. Studies show that adding ankle mobilization with movement techniques to conventional exercises for stroke patients improved:

• Gait speed by 0.08 m/s
• Cadence by 9 steps/minute
• Step length by 5 cm

While these might seem like small numbers, they represent meaningful improvements in daily function and independence.

Common Culprits Behind Tight Ankles

Understanding what's causing your ankle stiffness helps us target treatment more effectively. Here at Evolve Physical Therapy, we commonly find several factors at play:

Previous ankle sprains often leave a lasting impact, even years later. That "rolled ankle" from your basketball days might still be affecting your movement patterns through joint restrictions.

Periods of immobilization from wearing a boot or cast can create both joint stiffness and positional faults that don't automatically resolve when the boot comes off.

Your footwear choices matter more than you might think. Those stylish high heels or even overly supportive athletic shoes can limit natural ankle movement over time.

ATFL scarring (that's the anterior talofibular ligament—the most commonly injured ankle ligament) often heals with adhesions after sprains, limiting how well your ankle moves.

Muscle guarding is your body's protective response after injury. While initially helpful, this persistent muscle tension can restrict movement long after healing.

For our older patients, arthritis changes in the joint surfaces can mechanically block normal motion, requiring specialized treatment approaches.

If you're experiencing ankle pain or stiffness, our specialized team can help with comprehensive treatment options. Learn more about our physical therapy for ankle pain at our Brooklyn clinic.

At Evolve Physical Therapy, we carefully assess each patient to identify the specific causes of their ankle mobility restrictions. This allows us to target treatment precisely, rather than using a one-size-fits-all approach that might miss the true source of your limitations.

Ankle Mobilization with Movement: Science & Step-by-Step

Ankle mobilization with movement (MWM) was developed by Brian Mulligan, a New Zealand physiotherapist who recognized that joint "positional faults" could be corrected through specific mobilization techniques performed during active movement.

The basic principle is simple yet profound: When a joint isn't moving correctly due to a positional fault (like the talus bone being slightly out of optimal position), applying a corrective glide while actively moving the joint can restore normal mechanics and reduce pain immediately.

How Mobilization with Movement Works

MWM works through several mechanisms:

1. Correcting positional faults: The manual glide helps restore proper joint alignment
2. Joint distraction: Creating space in the joint reduces impingement and pain
3. Neurophysiological effects: Stimulation of mechanoreceptors can decrease pain signals
4. Improved proprioception: Improved joint position sense leads to better movement control

Research suggests that in many ankle conditions, particularly following lateral ankle sprains, the talus bone may be positioned slightly anteriorly. By applying a posterior glide to the talus while the patient actively dorsiflexes the ankle, normal joint mechanics can be restored.

This is different from traditional passive joint mobilization because the active movement component improves the neurophysiological effects and makes the technique more functional.

Core Technique Walk-Through — Posterior Talar Glide MWM

Here's how we perform the basic posterior talar glide MWM at Evolve Physical Therapy:

Therapist-Applied Technique:

1. Patient position: Standing with the affected foot on a stable surface, hands supported for balance
2. Therapist position: Kneeling or sitting at the level of the patient's ankle
3. Hand placement:
   • One hand stabilizes the distal tibia and fibula
   • The other hand contacts the talus just below the malleoli (ankle bones)
4. The mobilization:
   • Apply a gentle but firm posterior glide to the talus
   • Maintain this glide while instructing the patient to actively bend the knee forward over the foot (dorsiflexion)
   • Hold end range for 2-3 seconds, then return to starting position
   • Maintain the glide throughout the movement
5. Dosage: 6-10 repetitions, 2-3 sets

The technique should be pain-free. If pain occurs, adjust the direction or force of the glide, or try a different technique.

Self-Ankle Mobilization with Movement on an Incline Board

We often teach our patients self-mobilization techniques to continue their progress between visits:

Incline Board Self-MWM:

1. Setup: Position a slant board or wedge (approximately 10° incline) with the high end away from you
2. Foot placement: Stand with the affected foot on the board, heel down
3. Stabilization: Use a non-elastic strap or belt wrapped around the lower leg just above the ankle
4. The mobilization:
   • Pull the strap backward to create a posterior glide of the talus
   • While maintaining this glide, slowly bend your knee forward over your foot
   • Focus on keeping your heel down and feeling a stretch in your calf
5. Dosage: Hold each repetition for 2-3 seconds, perform 10 repetitions, 3 sets daily

This self-mobilization technique can be particularly effective for patients to practice at home between therapy sessions at our Brooklyn clinics.

Immediate Benefits Backed by Evidence

The research supporting ankle mobilization with movement is compelling:

• Range of motion improvements: Studies show an average increase of 4° in dorsiflexion range of motion after MWM techniques
• Walking improvements: Walking speed increases by an average of 0.08 m/s, cadence by 9 steps/min, and step length by 5 cm
• Balance improvements: Berg Balance Scale scores improve significantly with MWM compared to static stretching

One study of chronic stroke patients showed that the MWM group experienced a 53.5% increase in dorsiflexion range of motion compared to just 7.5% in the control group. These improvements translated directly to functional gains in walking and balance.

What's particularly impressive about MWM techniques is the immediacy of results. Many patients experience noticeable improvements in their first session, unlike traditional stretching which often requires weeks to show significant changes.

DIY vs. Clinician-Applied Techniques

When it comes to ankle mobilization with movement, you have options – do it yourself at home or work with a trained physical therapist. Both approaches can be effective, but they come with different advantages.

I've seen many patients try self-mobilization techniques after watching online videos, and while some make progress, others struggle with the precision these techniques require. Let me break down the key differences:

Aspect	Self-MWM	Clinician-Applied MWM
Precision	Limited by self-visibility and reach	Precise targeting of specific joints
Force control	May be inconsistent	Carefully graded and adjusted
Feedback	Limited self-assessment	Immediate professional feedback
Technique variety	Limited options	Multiple techniques based on assessment
ROM gains	Moderate	Often greater due to precision
Equipment needs	Straps, wedges, etc.	Minimal - therapist's hands

At Evolve Physical Therapy in Brooklyn, we typically start with hands-on techniques during your session. This gives us the chance to feel exactly how your ankle responds and make real-time adjustments. Once we see how your body reacts, we'll teach you effective self-mobilization methods to practice between visits.

Some of our more advanced clinical techniques include talus taping to maintain the corrected position after mobilization, banded MWM using resistance bands during functional movements, and combining MWM with specific Maitland grade mobilizations for optimal results.

When to See a Physical Therapist

While I'm all for taking charge of your own health, certain situations definitely call for professional help. Your ankles are too important to risk making things worse!

You should book an appointment if you're dealing with:

• Recent ankle sprains, especially if walking is painful
• Any post-surgical ankle condition
• Severe mobility limitations affecting your daily activities
• Pain that appears during your mobilization attempts (these should never hurt!)
• Complex health conditions like diabetes or neuropathy
• Self-care techniques that haven't improved things after 1-2 weeks

At our Brooklyn clinic, we specialize in thorough ankle assessments that pinpoint exactly what's causing your mobility restrictions. This allows us to develop a targeted plan that addresses your specific needs, not just generic exercises. Learn more about our physical therapy for ankle injury.

Integrating MWM into a Full Program

Ankle mobilization with movement works best when it's part of a comprehensive approach. It's like trying to fix a car – changing just one part rarely solves the whole problem!

When working with patients at Evolve, we combine MWM techniques with strengthening exercises for key muscles like the peroneals, tibialis anterior, and calves. We'll also incorporate eccentric calf training (slow, controlled lengthening exercises) that research shows is particularly effective for tendon health.

Balance training is another crucial component – we'll progressively challenge your proprioception (your body's position sense) on various surfaces. This helps "rewire" your brain's connection to your ankle.

We also focus on correcting movement patterns in everyday activities like walking and squatting. Sometimes we'll even include neurodynamic techniques when nerve tension contributes to your symptoms.

This well-rounded approach ensures that your newfound mobility actually translates into better function in real life – whether that's simply walking without pain or returning to high-level sports. After all, improved range on a measurement tool means nothing if it doesn't help you move better in your daily life!

Programming, Safety & Progress Tracking

Getting the most from ankle mobilization with movement isn't just about doing the technique correctly—it's also about smart programming. At Evolve, we've found that consistency is key to seeing lasting improvements in ankle mobility.

For most of our Brooklyn patients, we recommend practicing these techniques 3-5 times weekly. A typical 4-5 week program usually produces significant gains in mobility and function. Don't worry about spending hours on these exercises—quality matters more than quantity.

When structuring your sessions, aim for 3 sets of 10 repetitions for each MWM technique with a short 30-second breather between sets. We usually suggest performing these mobilizations before any strengthening work in the same session—this helps "open up" the joint before asking it to work harder.

"Think of mobility work as opening the door before you walk through it," I often tell my patients. "It makes everything that follows more effective."

Your progression journey should follow a logical path. If weight-bearing is painful initially, start with techniques lying down or seated. As comfort improves, progress to partial weight-bearing, then full weight-bearing, and finally incorporate the movements into functional activities like walking, squatting, or sport-specific drills.

Must-Know Contraindications

While ankle mobilization with movement techniques are generally safe and effective, they aren't right for every situation. Safety always comes first at Evolve Physical Therapy.

These techniques should be avoided or modified if you have acute fractures (let proper healing occur first), severe osteoporosis (which may require gentler approaches), or significant ligament instability. If you're experiencing an inflammatory arthritis flare-up, it's best to wait until the inflammation subsides before starting mobilization.

Some people actually have too much mobility (hypermobility) and need stabilization rather than mobilization. Others may have vascular compromise or circulation issues that require medical clearance before beginning these techniques.

It goes without saying, but we'll say it anyway—don't perform these techniques over open wounds or skin infections in the treatment area. This is both for comfort and to prevent potential complications.

At our Brooklyn clinic, we always perform thorough evaluations before recommending any mobilization program to ensure it's appropriate and safe for your specific situation.

Measuring Success

How do you know if your ankle mobility is actually improving? We believe in tracking objective measures rather than just going by feel (though that matters too!).

One of our favorite assessment tools is the half-kneeling wall test. We measure the distance from your toe to the wall when your knee can touch the wall while keeping your heel firmly planted. As mobility improves, this distance increases.

For more precise measurement, we use a goniometer to measure dorsiflexion range in degrees. The weight-bearing lunge test is another reliable option, where we measure the angle of the tibia during a forward lunge with the heel down.

Beyond these specific mobility measurements, we track functional improvements that matter in daily life:

• Walking speed using the 10-meter walk test
• Overall mobility with the timed up-and-go test
• Balance capabilities through single-leg balance time
• Comprehensive function via the Berg Balance Scale (especially helpful for our neurological patients)

We document these measurements during your initial evaluation and regularly throughout treatment. This gives us—and you—clear evidence of progress and helps us adjust your program as needed.

Beyond the Basics: Advanced Variations

Once you've mastered the fundamental techniques and are seeing improvements, we can introduce more advanced ankle mobilization with movement variations to further improve your results.

Talus-Stabilizing Taping offers a way to maintain the corrected talus position between sessions. We apply non-elastic tape from front to back, creating a gentle posterior glide force. This allows you to perform active movements throughout the day with the joint in optimal alignment, essentially extending your therapy beyond the treatment room.

For patients with fibular positional faults (common after rolling your ankle), we often use a Modified Fibular MWM. This involves applying an anterior glide to the distal fibula while you actively move your ankle in and out. It's remarkable how often this technique dramatically improves lateral ankle pain and mobility in a single session.

Athletic patients returning to jumping activities benefit from our Hopping MWM approach. We apply the appropriate glide (usually to the talus) while you perform mini-hops, gradually increasing height as symptoms allow. This bridges the gap between basic mobility work and the dynamic demands of sports.

These advanced techniques aren't for everyone—they're tools we select based on your specific needs and goals. At Evolve, we're committed to personalizing your care rather than applying a one-size-fits-all approach to ankle mobility.

Frequently Asked Questions about Ankle Mobilization with Movement

What's the difference between MWM and regular joint mobilization?

When patients ask me this question at our Brooklyn clinic, I explain it simply: think of regular joint mobilization as a passive experience—like being a passenger in a car. The therapist does all the work while you relax.

Ankle mobilization with movement is completely different—you're an active participant in the process. While I apply a specific glide to your joint, you're actively moving your ankle at the same time. This teamwork approach is what makes MWM so special.

This isn't just a technical difference—it creates real results. The active movement engages your nervous system in a unique way that often produces immediate pain relief and better movement. Many of our patients are surprised when they can walk with noticeably less pain right after their first session. Research consistently shows that this combined approach works better for improving ankle dorsiflexion than passive techniques alone.

How long before I feel improvements in my dorsiflexion?

The good news? You might feel better after just one session! Research shows a single ankle mobilization with movement treatment can increase dorsiflexion by 2-3 degrees immediately. Many of our patients at Evolve are pleasantly surprised when they stand up and can bend their ankle more freely right away.

For lasting changes, though, consistency matters. Most research points to a 4-5 week program (usually 3 sessions per week) for significant, sustainable improvements. During this time, you'll likely notice gradual improvements in walking speed, balance, and ability to climb stairs.

In our Brooklyn practice, we typically see meaningful functional improvements within 2-3 weeks when patients combine their in-clinic treatments with their home exercise program. Every person heals differently, but this timeline gives you a realistic expectation of progress.

Can I perform ankle MWM if I've had a recent sprain?

I get this question often, and the answer is: it depends on where you are in the healing process. If you've just sprained your ankle in the last few days, your priority should be protecting the joint and managing inflammation.

However, gentle ankle mobilization with movement can often be introduced earlier than many people expect—sometimes within the first week after injury. The golden rule we follow at Evolve is that MWM should never increase your pain. If a technique hurts, either the timing isn't right or we need to try a different approach.

For those chronic ankle issues—maybe you sprained your ankle months ago but it still doesn't feel right—MWM is often exactly what you need. Research shows that after ankle sprains, the talus bone often shifts slightly out of its optimal position. These techniques are specifically designed to address those positional faults.

I always recommend consulting with a physical therapist before trying self-mobilization on a recently injured ankle. At our Brooklyn clinic, we can assess your specific condition and create a personalized approach that respects your body's healing timeline while maximizing recovery.

Conclusion & Next Steps

Ankle mobilization with movement isn't just another stretching technique—it's a transformative approach that can change how you move through the world. By combining specific joint glides with active movement, these techniques often produce immediate improvements that you can actually feel from your very first session.

Whether you're dealing with lingering stiffness from an old ankle sprain, working through post-surgical recovery, or managing chronic ankle tightness that's affecting your daily life, MWM techniques can be the missing piece in your mobility puzzle.

At Evolve Physical Therapy + Sports Rehabilitation in Brooklyn, we believe in the power of hands-on care. Our approach blends the science of rehabilitation with the art of manual therapy—we're not just treating your ankle, we're treating you as a whole person with unique needs and goals.

"The foundation affects everything above it," we often tell our patients. When your ankles move better, your knees, hips, and even your back often feel better too. That's why we take ankle mobility so seriously.

Our team proudly serves the Brooklyn communities of Marine Park, Gravesend, Midwood, Park Slope, and Mill Basin with specialized programs custom to diverse needs. Our Rock Steady Boxing program for Parkinson's patients (featured on NBC News) demonstrates our commitment to innovative, effective care for complex conditions.

The journey to better mobility doesn't have to be complicated, but it does require expert guidance and a personalized approach. We're here to provide both, integrating ankle mobilization with movement into a comprehensive plan that addresses your specific challenges.

Ready to feel the difference that proper ankle mobility can make? We'd love to help you take that first step. Contact us today to schedule an evaluation at one of our Brooklyn locations, and experience how our approach to ankle mobilization with movement can transform not just your ankles, but your entire movement experience.

Don't let ankle stiffness keep you from the activities you love. Your body deserves to move with freedom and confidence—and we're here to help make that happen!