Ankle Dorsiflexion and Landing Mechanics in Female Soccer Players: What This New Study Means for Podiatrists, Clinicians, and Athletes | Find Your Stride | Edinburgh Podiatrist

Introduction

The relationship between ankle dorsiflexion range of motion (DF-ROM) and landing biomechanics has long interested podiatrists and sports clinicians. A newly published study by Rad et al. (2025) explores this link in female soccer players using a novel statistical approach (quantile regression) to examine how ankle mobility relates to landing quality in both amateur and elite athletes. For clinicians working in sports podiatry, ACL injury prevention, and running performance, this paper offers valuable insights, along with some important limitations worth discussing.

Research by Rad et al. suggests that amateur female players with limited ankle dorsiflexion demonstrate poorer landing mechanics, especially in those with high landing error scores.

Study Overview

Rad et al. conducted a cross-sectional study involving:

• 102 female soccer players (55 amateur and 47 elite)

• Mean age: 21.3 years

• Assessment of non-dominant ankle DF-ROM via weight-bearing lunge test

• Evaluation of landing mechanics using a Soccer-Specific Jump-Landing task (SSJL) adapted from the LESS scoring system

Key Findings

The key findings of the study were:

• Overall moderate negative correlation between DF-ROM and landing errors (r = −0.33)

• Strong negative correlation in amateurs (r = −0.63, p < 0.001)

• No significant relationship in elite players (r = 0.22, p = 0.13)

• Quantile regression showed DF-ROM mattered most in amateurs with the worst landing scores (Q75–Q90 percentiles)

In practical terms: In amateur female players, limited ankle dorsiflexion was associated with poorer landing mechanics, especially in those already demonstrating high landing error scores.

What the Study Gets Right

1. Sport-Specific Biomechanics

Unlike generic drop jump protocols, the SSJL included:

• A cone jump

• Ball heading task

• Double landing

• Video analysis of 17 landing criteria

This improves ecological validity for soccer athletes compared to traditional LESS testing. For podiatrists, this matters: movement screening must reflect real sporting demands.

2. Clinical Relevance of the Weight-Bearing Lunge Test

The use of a closed kinetic chain weight-bearing lunge test enhances transferability to:

• Running gait

• Cutting mechanics (i.e. deceleration, plant/turn, and re-acceleration)

• Jump-landing

• Change of direction

The mean DF-ROM values recorded by Rad et al.:

• Amateurs: 35.0°

• Elite: 33.6°

Interestingly, elite players had slightly lower average DF-ROM yet did not demonstrate the same relationship with landing errors. This suggests mobility alone does not dictate performance in higher-level athletes.

3. Use of Quantile Regression

Traditional sports medicine studies rely on mean-based linear models. This study used quantile regression, allowing analysis across different performance percentiles. Clinically, this means:

• DF-ROM matters more in poor movers than in high-functioning athletes.

• Screening may be most valuable in athletes already demonstrating biomechanical deficits.

For sports podiatry clinics, this supports targeted intervention rather than blanket mobility correction.

Where the Study Falls Short

1. Cross-Sectional Design

This study cannot determine:

• Whether limited DF-ROM causes poor landing mechanics

• Whether improving DF-ROM improves landing biomechanics

• Whether either variable predicts ACL injury

For clinicians focused on ACL injury prevention in female athletes, this is a critical limitation.

2. Exclusion of Previously Injured Players

Participants had no severe lower limb injuries in the past year. This reduces clinical generalisability because:

• Athletes presenting to podiatry clinics may have prior ankle sprain or ACL injury

• Chronic ankle instability significantly alters dorsiflexion and landing mechanics

The population studied was (as far as we can tell) injury free.

3. Focus on the Non-Dominant Limb Only

While justified biomechanically, this limits:

• Bilateral asymmetry analysis

• Real-world screening utility

• Understanding of dominant-limb compensation

In running and soccer performance, interlimb asymmetry is often more predictive than absolute ROM.

4. Elite Athlete Interpretation May Be Oversimplified

The authors suggest elite players compensate for limited DF-ROM via:

• Better neuromuscular control

• Strength and conditioning

• Improved motor coordination

However, without strength, hip mobility, trunk control, or force plate data, this remains speculative. From a podiatry perspective:

• Elite athletes often show stiffness adaptations that enhance energy storage and running economy.

• Reduced dorsiflexion is not inherently pathological in performance contexts.

Mobility ≠ (is not equal to) function.

Clinical Implications for Podiatrists and Sports Clinicians

1. DF-ROM Screening Is More Relevant in Amateur Female Athletes

Especially those demonstrating:

• Knee valgus

• Flat-footed landings

• Reduced knee flexion on landing

• Poor dynamic control

2. Mobility Interventions Should Be Targeted

The quantile findings suggest:

• Improving DF-ROM may benefit athletes with high landing errors.

• It may have minimal impact in well-coordinated elite athletes.

3. Consider the Entire Kinetic Chain

Limited ankle dorsiflexion can contribute to:

• Increased knee valgus

• Hip stiffness strategies

• Trunk compensation

• Increased ACL load

But it is only one variable in a complex system.

4. Mobility Alone Is Not Enough

Interventions should integrate:

• Eccentric calf strengthening

• Proprioceptive training

• Single-leg landing retraining

• Hip abductor strengthening

• Running mechanics analysis

Performance Perspective: What About Running?

While the study focuses on landing, dorsiflexion is also relevant to:

• Stride length

• Tibial progression

• Midstance loading

• Achilles tendon strain

• Running economy

However, excessive dorsiflexion is not necessarily advantageous for performance. Optimal stiffness and elastic return are key in elite athletes. This may explain the null findings in the professional cohort.

Big Picture: Is Ankle Dorsiflexion a Risk Factor for ACL Injury?

This study strengthens the argument that: Limited dorsiflexion may influence landing biomechanics in amateur female soccer players. But it does not prove causation. Future research should:

• Include prospective injury tracking

• Assess interlimb asymmetry

• Incorporate force plate data

• Measure hip and trunk contributions

• Evaluate intervention outcomes

Final Verdict for Sports Podiatry Practice

Strengths:

• Sport-specific protocol

• Innovative statistical analysis

• Clinically applicable mobility measure

• Clear differentiation between amateur and elite players

Limitations:

• Cross-sectional design

• Limited biomechanical variables

• No injury outcomes

• Restricted population

Bottom Line

For podiatrists and clinicians:

• Ankle DF-ROM matters in amateur female soccer players with poor landing mechanics.

• It appears less influential in elite athletes.

• Mobility assessment should remain part of screening, but not in isolation.

• Intervention should be multifactorial and performance-informed.

This paper adds nuance to the ongoing conversation about ankle mobility, ACL injury prevention, and sports performance in women’s soccer.

Citation

Rad, N. F., Alimoradi, M., Antohe, B., Uysal, H. Ş., Korkmaz, S., Relph, N., & Mohammadian, Z. (2025). Modelling of ankle joint range of motion and landing quality scores in female soccer players with quantile regression approach. PLOS One, 20(6), e0325180. https://doi.org/10.1371/journal.pone.0325180

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