Immediate combined effect of gastrocnemius stretching and sustained talocrural joint mobilization in individuals with limited ankle dorsiflexion: A randomized controlled trial

• We examined combined effect of stretching and talocrural joint mobilization.
• Combination of both interventions increased ankle dorsiflexion during gait.
• Combination of both interventions increased time to heel-off during gait.
• General gastrocnemius stretching did not change ankle kinematics during gait.
• Combination of both interventions is useful to improve ankle kinematic during gait.

BackgroundAlthough gastrocnemius stretching and talocrural joint mobilization have been suggested as effective interventions to address limited ankle dorsiflexion passive range of motion (DF PROM), the effects of a combination of the two interventions have not been identified.ObjectiveThe aim of the present study was to compare the effects of gastrocnemius stretching combined with joint mobilization and gastrocnemius stretching alone.DesignA randomized controlled trial.MethodsIn total, 24 individuals with limited ankle DF PROM were randomized to undergo gastrocnemius stretching combined with joint mobilization (12 feet in 12 individuals) or gastrocnemius stretching alone (12 feet in 12 individuals) for 5 min. Ankle kinematics during gait (time to heel-off and ankle DF before heel-off), ankle DF PROM, posterior talar glide, and displacement of the myotendinous junction (MTJ) of the gastrocnemius were assessed before and after the interventions. The groups were compared using two-way repeated measures analysis of variance.Results/findings: Greater increases in the time to heel-off and ankle DF before heel-off during gait and posterior talar glide were observed in the stretching combined with joint mobilization group versus the stretching alone group. Ankle DF PROM and displacement of the MTJ of the gastrocnemius were increased significantly after the interventions in both groups, with no significant difference between them.ConclusionsThese findings suggest that gastrocnemius stretching with joint mobilization needs to be considered to improve ankle kinematics during gait.