Research Corner - Q&A No Cartilage in Ankle by Anthony Carey | Date Released : 08 Jun 2004 1 comment Print Close Question: I have a client who has no cartilage in his ankle joint. What exercises do I need to avoid and what exercises should I work on? Answer: When you refer to “ankle joint,” I would have to assume you are referring to the talocrural joint. This joint consists of the mortise formed by the talus sitting between the lateral malleolus of the fibula and medial malleolus of the tibia. The primary motion at this joint is plantar flexion and dorsi flexion. Unless your client was born without cartilage, with the limited amount of information provided I am going to have to assume it is a result of trauma or prolonged misuse. In either event, the primary role of the cartilage at that joint is to facilitate the gliding movement of the talus for plantar flexion and dorsi flexion. Therefore, I would be most concerned with limits to those motions. Typically, because of the shape of the joint and possible trauma to the ligaments, dorsi flexion is more limited than plantar flexion. Normal dorsi flexion in a closed chain environment (i.e. foot on the ground) is critical to normal motion of the knee, hip and even spine. This is where you might consider looking initially, to be sure your client is not compensating up the kinetic chain. Consider having your client’s ankle range of motion assessed by a physical therapist. In addition, evaluate your client’s ability to squat. If there is not normal motion in the talocrural joint, your client’s heel may come off of the floor as he squats, he may over pronate on that foot as he squats and/or he may feel a “pinching” in the front of the ankle the lower he goes down. Sometimes to restore this motion, it initially can be expedited with manual mobilization by a physical therapist or chiropractor. One of your first priorities is to make sure your client is not compensating up the kinetic chain in any ground-based exercises. Back to top About the author: Anthony Carey Anthony Carey M.A., CSCS, MES is PFP Magazine’s 2009 Personal Trainer of the Year and owner of Function First in San Diego, California and an international presenter on biomechanics, corrective exercise, functional anatomy and motor control and their relationships to pain and function. Anthony has developed the Pain Free Movement Specialist certification and is the inventor of the Core-Tex®. 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I did basic fitness assesment OHS and I found out that she can not squat at all. She can do lunges and I think that she may have missing cartilage. Could you please advice me on the right exercises that she should be doing. Her fitness goal is to get into shape and to Improve her fitness level. She is very active and training 5 times a week: 3 x Pillates, 1 x with Personal Trainer and 1 x gym session. Her RHR is very high so the first I want to focus on is to improve her stanima and endurance to Improve her Fitness Levels. My client is 35 yrs old and generally she is slim with a good body fat range. I know that I shouldn't be doing any high impact exercises so could you please advice me on a few different exercises she could be doing. Reply Back to top