Unlocking Knee Health: The Crucial Role of Ankle Dorsiflexion in Training with Knees Over Toes

Knee pain and injuries are common issues for many people, especially those who stay active or engage in sports. Often, the focus is on strengthening the knee itself, but one key factor that is frequently overlooked is ankle dorsiflexion—the ability to flex the ankle so the toes move closer to the shin. This movement plays a vital role in knee health and function. Training with knees-over-toes positions, which naturally requires good ankle dorsiflexion, can help improve knee strength, mobility, and reduce injury risk.

This post explores why ankle dorsiflexion matters, how it benefits the knees, and practical ways to safely train in knees-over-toes positions to unlock better knee health.

Why Ankle Dorsiflexion Matters for Knee Health

Ankle dorsiflexion is the movement that allows your foot to bend upward towards your shin. This motion is essential for many daily activities like walking, squatting, and climbing stairs. Limiting ankle dorsiflexion causes the body to compensate by placing extra stress on the knees and hips, potentially leading to pain or injury.

The Connection Between Ankle and Knee

The knee joint works closely with the ankle to absorb impact and control movement. When the ankle can dorsiflex properly:

• The knee can track correctly over the toes during bending movements.

• The load is distributed evenly through the leg.

• The muscles around the knee, such as the quadriceps and hamstrings, engage efficiently.

  
  

Without adequate dorsiflexion, the knee may shift inward or outward unnaturally, increasing the risk of ligament strain or cartilage wear.

Common Causes of Limited Ankle Dorsiflexion

• Tight calf muscles: The gastrocnemius and soleus muscles can restrict ankle movement if they are stiff.

• Previous ankle injuries: Sprains or fractures may reduce joint mobility.

• Sedentary lifestyle: Lack of movement can cause joint stiffness.

• Improper footwear: Shoes with elevated heels or poor support can limit ankle flexibility.

  
  

Improving ankle dorsiflexion can relieve knee stress and improve overall lower limb function.

Benefits of Training with Knees-Over-Toes Positions

Training with knees over toes means allowing the knees to move forward past the toes during exercises like squats, lunges, and step-ups. This movement pattern is often discouraged in traditional fitness advice, but recent research and practical experience show it can be highly beneficial when done correctly.

How Knees Over Toes Training Supports Knee Health

• Strengthens the knee joint: It builds strength in the muscles, tendons, and ligaments around the knee, improving stability.

• Improves mobility: Encourages a full range of motion in the ankle and knee, preventing stiffness.

• Enhances balance and coordination: requires control and awareness of joint positioning.

• Reduces injury risk: Properly loading the knee in this position can condition it to handle real-life stresses better.

  
  

Examples of Knees Over Toes Exercises

• Knees over toes Split Squat: A deep lunge where the front knee moves over the toes, emphasising ankle dorsiflexion.

• Tibialis Raises: Strengthen the muscles that control dorsiflexion.

• Poliquin Step-Up: A step-up where the knee travels over the toes to build knee and ankle strength.

• Deep Squats: Performed with good ankle mobility to allow knees to pass toes safely.

  
  

Deep squat demonstrating ankle dorsiflexion and knees over toes

Deep squat demonstrating ankle dorsiflexion and knees over toes

How to Improve Ankle Dorsiflexion Safely

Improving ankle dorsiflexion requires consistent mobility work and strengthening exercises. Here are practical steps to enhance this movement:

Stretch Tight Calf Muscles

• Wall calf stretch: Place hands on a wall, step one foot back, keep heel down, and lean forward to stretch the calf.

• Seated towel stretch: Sit with legs extended, loop a towel around the foot, and gently pull toes towards you.

  
  

Mobilize the Ankle Joint

• Ankle circles: Rotate the ankle slowly in both directions.

• Knee-to-wall stretch: Stand facing a wall, place toes a few inches away, and bend the knee towards the wall without lifting the heel.

  
  

Strengthen Dorsiflexors

• Tibialis anterior raises: Sit with feet flat; lift toes upward while keeping heels on the ground.

• Resistance band dorsiflexion: Use a band around the foot to provide resistance while pulling toes towards the shin.

  
  

Incorporate Knees Over Toes Movements Gradually

Start with shallow movements and increase depth as mobility improves. Focus on form and avoid pain.

Practical Tips for Training Knees-Over-Toes Positions

• Warm up thoroughly: include ankle mobility drills before training.

• Use proper footwear: shoes with a flat sole or minimal heel lift support better ankle movement.

• Progress slowly: increase range of motion and load gradually to avoid injury.

• Listen to your body: Mild discomfort is normal, but sharp pain is a warning sign.

• Combine with overall leg strengthening: balance training with exercises for hips, glutes, and core.

  
  
  
  

Real-Life Impact of Improving Ankle Dorsiflexion

Athletes, physical therapists, and trainers report significant improvements in knee function and pain reduction after focusing on ankle dorsiflexion and knees-over-toes training. For example:

• A basketball player recovering from knee pain improved jump mechanics and reduced discomfort by incorporating ankle mobility drills and knees-over-toes split squats.

• Older adults increased their stairclimbing ability and decreased knee stiffness after a 6-week programme emphasising ankle dorsiflexion and controlled knee movement over toes.

  
  

These examples show how targeted training can restore natural movement patterns and support long-term knee health.

Training with knees-over-toes positions while improving ankle dorsiflexion unlocks stronger, healthier knees. This approach challenges outdated advice and offers a practical way to build resilience in the joints we rely on every day. Start with gentle mobility work, progress to controlled exercises, and watch your knee function improve.