Lower back pain is of course one of the most common complaints that brings people into the clinic. In the search for relief, folks often focus on the usual suspects: core strength, hip flexibility, and time spent sitting. And while these areas are undoubtedly crucial, there is a smaller, often-ignored joint at the very bottom of the chain that could be silently sabotaging your efforts: the ankle.
The kinetic chain: how the ankle affects the spine
The human body is an interconnected system, a concept known as the kinetic chain. Movement at one joint inevitably influences the movement (or stability) of all the joints above it. When it comes to the lower back, the ankle joint plays a foundational role.
The primary movement we’re concerned with is dorsiflexion—the ability to bring your shin forward over your foot, such as when you walk, climb stairs, or perform a squat.
If you have limited ankle dorsiflexion, your body must find a way to complete these movements. It’s a mandatory compensation, and that compensation almost always travels up the chain:
Knee and hip: Your knee may collapse inward (valgus), or your hip may not be able to flex as deeply.
The lower back: To get low enough in a squat or to maintain forward momentum during a step, your pelvis will often tilt anteriorly (forward), causing an excessive arch in your lower back. This increased lumbar extension puts undue stress on the facet joints, discs, and surrounding muscles.
In short, a stiff ankle forces your stable lumbar spine to become a mobile, compensatory joint—a job it is not designed to do. We've discussed the importance of proper core and hip function in previous articles, but even a perfectly strong core can't fully counteract a major issue at with the ankle.
When your ankles don't move enough
The issue often goes beyond acute injury and stems from habits like:
Wearing high-heeled or heavily cushioned shoes: These positions often keep the ankle in a perpetually plantar-flexed (toes pointed) state, allowing the calf muscles to shorten over time.
Prolonged sitting: Lack of dynamic movement means the ankle rarely goes through its full range of motion.
Previous injury: Even a seemingly minor ankle sprain can leave scar tissue and neurological guarding that restricts mobility long after the pain is gone.
This restriction leads to chronic, low-grade compensation during everyday activities, eventually manifesting as pain or stiffness in the lower back that seems unrelated to the site of the problem.
Simple tests for ankle mobility
You can perform a quick self-assessment called the "Knee-to-wall test" to check for restricted dorsiflexion:
Place one foot perpendicular to a wall.
Start with your big toe about 4 inches away from the wall.
Keeping your heel flat on the ground, try to touch your knee to the wall directly over your second toe.
If you can easily touch the wall, slide your foot back an inch and try again. The goal is to find the maximum distance you can move your knee forward without your heel lifting.
A healthy range is typically 4–5 inches. If you cannot reach 4 inches, or if one ankle is significantly worse than the other, ankle mobility may be a key factor in your back pain.
Exercises to improve ankle mobility
Fortunately, the ankle is a highly adaptable joint. Incorporating a few simple exercises into your daily routine can quickly unlock significant gains:
Wall dorsiflexion stretch: Stand in the test position (foot 4–5 inches from the wall). Lean your body and knee forward, holding the maximum stretch for 30–60 seconds, focusing on keeping the heel down. Repeat 3 times per side.
Calf release with a ball: Use a lacrosse ball or tennis ball to apply pressure to tender spots in your calf muscle (gastrocnemius and soleus). Roll over each spot for 30 seconds to release tension that restricts ankle movement.
Heel-elevated squats: Place a small plate or wedge under your heels (about 1/2 to 1 inch high). Perform a squat. This bypasses the ankle restriction and allows you to squat with better form, training your body what good hip/back mechanics feel like without compensating at the lumbar spine.
A mobile ankle creates a stable foundation, which is a great defense against persistent lower back pain.
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