The knee and ankle are commonly overlooked contributors to mobility, strength, balance, and coordination. Walking, climbing stairs, hiking a trail, or participating in recreational athletic physical activities such as tennis, golf, or pickleball all depend on the seamless relationship between these two joints. When they move well together, life feels fluid. When they do not, balance declines, steps shorten, and the risk of tripping and falling rises.
Every time a step is taken, the knee and ankle simultaneously perform coordinated actions of flexion and extension. Knee flexion occurs when the knee bends. Knee extension occurs when the knee straightens. As one leg swings forward during walking, the knee must bend to allow the foot to clear the ground. As the heel strikes the ground, the knee begins to straighten, preparing to recalibrate one’s center of gravity before the stride is taken with the opposite leg.
At the same time, the ankle performs its own essential movements. Ankle dorsiflexion is the action of pulling the toes upward toward the shin. Ankle plantar flexion is the action of pointing the toes downward. During the forward stride phase of walking, dorsiflexion helps prevent the toes from catching the ground. During push-off, when the leg and foot travel backwards to propel the body forward, plantar flexion helps drive the body forward.
If either joint lacks mobility or strength, walking becomes less efficient and more unstable. A lack of knee and ankle strength can lead to compounded difficulties with everyday functional movements over time, contributing to shuffling gait patterns in which the feet don’t lift off the ground efficiently, shorter strides while walking, and the risk of clipping one’s foot on objects on the ground. These hindrances to movement caused by deconditioned knee and ankle joints could increase fall risk.
While the quadriceps are often the more visible muscles on the front of the thigh, the hamstrings play a critical role in knee control. Located on the back of the thigh, hamstrings assist in knee flexion, which is the bending of the knee. The hamstring also supports hip extension during the follow-through portion of walking after the foot has planted, propelling the body forward. Additionally, the gastrocnemius, or calf muscles, are critically important for walking because they power the foot to drive off the ball of the foot and lift the ankle to push the body forward. Therefore, investing time in exercising the knee and ankle joints, such as the hamstrings and gastrocnemius, strongly influences our ability to walk without distraction, pain, or weakness.
An example of a hamstring strengthening exercise we perform with our personal training clients is the supine hip extension:
To perform the supine hip extension, start by lying flat on your back on the ground, with your arms extended and your knees bent. Press your feet into the ground and lift the hips upward until a brief muscular sensation is experienced in the hamstrings and glutes. Repeat this movement for five to 10 repetitions.
Additionally, an example of a calf-strengthening exercise that promotes strong plantar flexion is an isometric “calf raise”:
To perform the isometric calf raise, position yourself next to a stabilizing object, such as a wall or sturdy post. While pressing both the balls of the feet and the toes into the ground, lift the heels off the ground until a brief muscular sensation is felt in the calf muscles. Hold this position for about fifteen to thirty seconds.
It’s hard to think twice about walking, running, stepping up stairs, or hiking if we don’t have any problems in our ankles or knees. However, a simple roll of the ankle off a curb can tweak an ankle or cause a knee strain. The repercussions of an unexpected injury can make us quickly aware of how important these two joints are. For example, following an ankle or knee strain, the simple task of getting out of bed in the middle of the night and walking to the bathroom becomes laborious due to intense pain occurring in such a seemlingly simple walk throughout short distance.
Taking time to invest in practicing a ritual of knee and ankle strengthening exercises can significantly decrease the likelihood of knee injuries to keep a capable, strong, and confident body during the activities we enjoy in our everyday lives.
Sean McCawley, the founder and owner of Napa Tenacious Fitness in Napa, CA, welcomes questions and comments. Reach him at 707-287-2727, napatenacious@gmail.com, or visit the website napatenaciousfitness.com.