Ankle dorsiflexion, or the ability to bring the foot upwards towards the shin, is important for maintaining mobility, stability, and balance. It’s also a key component of proper leg and foot alignment, which helps prevent injuries and falls. In this article, we’ll discuss several ways to improve ankle dorsiflexion, including stretching, strengthening exercises, and devices that may improve walking if dorsiflexion is reduced.

The following are not intended as medical advice; rather, they are educational tips. Always consult with your doctor before trying new stretching programs, exercises, or devices.

1. Stretching

One of the simplest, yet most effective ways to improve ankle dorsiflexion is through stretching. Several stretches target the muscles and tissues around the ankle joint, including the calf muscles (gastrocnemius and soleus) and the deep flexors of the foot (tibialis posterior and flexor hallucis longus).

Here are a few stretches to try:

Towel stretch: Sit on the ground with your legs extended in front of you. Place a towel around the ball of your foot and use your hands to gently pull the towel towards you, creating a stretch in your calf and ankle. Hold the stretch for 30 to 60 seconds, then repeat on the other side.

Wall stretch: Stand facing a wall with your hands on the wall at shoulder height. Step back with one leg, keeping the heel pressed against the ground. Lean forward and bend your front knee, feeling a stretch in your calf. Hold the stretch for 30 to 60 seconds, then repeat on the other side.

Downward dog: If you’re comfortable performing this exercise, downward dog is a great stretch for ankle mobility. Place your hands and feet on the ground and your hips lifted towards the sky. Walk your feet towards your hands, keeping your heels pressed towards the ground.

Remember to stretch slowly and gently, avoiding any sharp or intense sensations. Stretching is most effective when it’s a regular part of your routine.

If you have underlying mobility issues as a result of neurological disorders such as multiple sclerosis (MS), cerebral palsy (CP), or stroke, it can be challenging to perform certain stretches, and modifications may need to be made. Always consult with a healthcare professional before beginning a stretching program.

2. Strengthening exercises

In addition to stretching, it’s also important to strengthen the muscles around the ankle joint to improve overall stability and mobility. Here are a few exercises to try:

Resisted Dorsiflexion: Using a resistance band can add an extra challenge to your ankle-strengthening exercises. While sitting with your legs outstretched, loop the band around the top of your foot and bring your foot and ankle towards your body.

Calf raises: Stand with your feet hip-width apart. Lift your heels as high as you’re able to, then lower them down again. You can also try doing single-leg calf raises to challenge your balance and stability. Be sure to stand near a stable surface such as a counter for support.

3. Address underlying mobility or stability issues

In some cases, reduced ankle dorsiflexion may be related to underlying neurological conditions. To address these challenges, you may need to work with a physical therapist or other healthcare professionals to develop a personalized treatment plan.

This may include exercises to improve foot and ankle alignment, as well as using assistive devices to improve function (read on for more detail)…

4. Use orthoses or other devices

Orthoses and other devices can be a helpful addition to a treatment plan if an individual is experiencing mobility or balance challenges related to a decrease in dorsiflexion. These devices provide support and stability and may help facilitate a more typical gait pattern.

Here are a few common types of orthoses and devices that an individual may use when dorsiflexion is reduced:

Cionic Neural Sleeve: 

The Cionic Neural Sleeve is a wearable assistive device designed to improve ankle dorsiflexion and overall mobility. It is worn around the leg and uses sensors and electrical stimulation to correct muscle movement.

One of the key benefits of the Cionic Neural Sleeve is that it is a lightweight, breathable garment that can be worn during daily activities on its own or under clothing. The technology automatically updates with each step the wearer takes and delivers personalized stimulation based on their unique needs. This can help to facilitate muscle re-education and improve range of motion and overall function over time.

The Cionic Neural Sleeve is recommended for individuals with difficulty walking due to neuromuscular diagnoses like multiple sclerosis, stroke, cerebral palsy, and spinal cord injury. It is not intended to be used as a replacement for stretching and strengthening exercises, but rather as a supplement to these activities to help facilitate muscle function and coordination.

Consult with a healthcare professional before using the Cionic Neural Sleeve. It may not be suitable for everyone.

Ankle-Foot Orthosis (AFO)

AFOs are designed to help individuals with foot drop, a condition in which the foot cannot be raised due to weakness or paralysis in the muscles. These orthoses are worn around the foot and ankle to help maintain the ankle in a dorsiflexed position during walking.

Orthoses or other devices should be used as part of a comprehensive treatment plan, with the guidance of a healthcare professional. They are not a replacement for proper stretching, strengthening exercises, and addressing any underlying mobility or stability issues. However, when used in conjunction with these other strategies, they can be an effective tool for improving ankle dorsiflexion.

Learn more about devices to improve ankle dorsiflexion

So, there you have it! Four evidence-based ways to improve ankle dorsiflexion. If you struggle with limited mobility due to multiple sclerosis, cerebral palsy, or neurological conditions and have not made the progress you’d like to with stretching, strengthening, and AFOs, you may benefit from the Cionic Neural Sleeve.

The first multi-site research study testing the effectiveness of this wearable device for foot drop resulted in significant improvement in ankle dorsiflexion in people with mobility conditions such as stroke, multiple sclerosis, and cerebral palsy.

In fact, in back-to-back paired tests, 94% of participants showed a positive increase in dorsiflexion at heel strike. How does it work? The Cionic Neural Sleeve is the first FDA-cleared product to combine the diagnostic power of a multi-million-dollar gait lab with the therapeutic power of Functional Electrical Stimulation, or FES, or short.

Sensors in the sleeve monitor movement in real-time to evaluate muscle firing and limb position. Based on these findings, personalized algorithms deliver functional electrical stimulation. The stimulation activates the necessary muscles to increase range of motion, facilitate muscle re-education, and improve walking.

CIONIC began shipping the first Neural Sleeves in early 2023. To learn more about the Cionic Neural Sleeve, visit cionic.com.