Old untreated ankle sprain, anterior talar block, ROM that won't stick: what would you do?
Hey everyone! I know you from YT videos :)
I'm a recreational soccer player in my 40s. Back in 2000 I had an ankle sprain that was never properly treated, and in early 2026 my PT identified it as an anterior talar block causing chronic dorsiflexion restriction on my left side.
[Where I'm at]
Knee-to-Wall test:
- Left: 0.5 cm at baseline, now 4.5 cm after 2 months of work
- Right: ~9 cm (no symptoms)
The problem is that the ROM gained during the session almost entirely disappears within a few hours. I go back to around 2 cm. My PT suspects neurological guarding rather than a purely mechanical block, but we haven't nailed it down yet.
[What I'm doing]
- Astragalus mobilization with elastic band before any load
- Post-mobilization activation: SEBT, squats, short runs to reinforce the new ROM
- Gait re-training with tripodal foot contact focus
- Breathing work (4-7-7) to reduce psoas and diaphragm tension
[My question]
At this point, would you keep pushing for more ROM or shift focus toward building stability and motor control within the current range? Is there a KTW threshold where it starts to actually transfer to real movement, or is the "ROM that won't stick" itself the problem to solve first?
Would love to hear from anyone who's been through something similar.
Every suggestion is precious!