The Ankle Dorsiflexion Strength Test measures how much force a client can produce when lifting the foot upward toward the shin against resistance. It is commonly used to assess dorsiflexor force output in a controlled isometric setup. This can provide useful context for foot clearance, walking, running, stair use, lower-limb control, sport preparation and progress tracking.

The Muscle Meter is a handheld dynamometry tool used to measure force output during push, pull and isometric strength assessments. When used on its own, the Muscle Meter primarily measures peak force, which is the highest force value produced during the test. When used with Measurz, Muscle Meter data can be recorded and analysed with a broader set of strength and force-time metrics, including peak force, impulse, torque, rate of torque development, rate of force development, time to peak and fatigue index.

For routine ankle dorsiflexion testing, peak force is usually the main metric. Force as a percentage of body weight may be useful if directly calculated from the client’s test force and body weight, especially for baseline comparison, side-to-side comparison and retesting. Rate of force development and time to peak may be useful when rapid foot lift, sprinting, cutting, landing or reactive lower-limb tasks are relevant. Impulse may be useful if sustained force over a defined time window is intentionally tested. Fatigue index is only relevant if repeated or sustained dorsiflexion contractions are part of the protocol.

The result can support assessment reasoning and progress tracking, but it does not diagnose foot drop, nerve injury, ankle pathology, balance risk or readiness for sport or work on its own.

What Is the Ankle Dorsiflexion Strength Test?

The Ankle Dorsiflexion Strength Test is an isometric force assessment where the client pulls or pushes the top of the foot upward into the Muscle Meter without visible ankle movement. The device is usually positioned on the top of the foot, commonly around the distal metatarsal region.

The movement direction is ankle dorsiflexion. The purpose of the test is to measure how much force the client can produce in that specific direction and position.

Consistent setup matters because ankle angle, knee position, contact point, strap angle, footwear, stabilisation and client effort can all affect the result. This test measures force output in a specific setup. It does not fully measure walking ability, running performance, balance, endurance, neurological status, sport performance or movement quality on its own.

Step-by-Step Protocol / Practice

1. Prepare the client

Explain that the test measures how strongly they can lift the foot upward into the Muscle Meter. Record baseline symptoms, ankle stiffness, shin discomfort, foot symptoms, fatigue, recent activity and any current neurological symptoms such as numbness, altered sensation or weakness.

Use at least one submaximal practice trial so the client understands the movement and effort required. This is especially useful for youth clients, older adults and clients who are unfamiliar with dynamometry testing.

2. Set the client position

A common setup is seated with the hip and knee flexed, the ankle near neutral and the foot unsupported or lightly supported. Supine or long-sitting setups can also be used, but the same position should be repeated at retest.

Record:

• Seated, supine or long-sitting position
• Knee angle
• Ankle start position
• Foot position
• Whether footwear was removed
• Whether the opposite limb was supported

3. Set up the device or straps

For a handheld setup, the professional holds the Muscle Meter steady while the client pushes into it. For stronger clients or improved repeatability, a strap-stabilised or fixed setup may be used.

If using a strap, record the anchor point, strap angle, strap length and whether the anchor moved during testing. Push, pull and strap-stabilised scores should be recorded separately unless the protocol supports direct comparison.

4. Place the device, strap or handle

Place the Muscle Meter over the top of the foot, commonly around the distal metatarsal region. Avoid uncomfortable pressure on sensitive bony areas.

The client should push the top of the foot upward into the device. The force direction should be pure dorsiflexion rather than toe extension, inversion, eversion or whole-leg lifting.

5. Stabilise the position

Stabilise the lower leg so the client does not compensate with hip flexion, knee movement, toe extension, trunk movement or ankle twisting. The aim is controlled ankle dorsiflexion force.

Stabilisation should allow the client to produce a strong effort while keeping the test position repeatable.

6. Give clear instructions

Use consistent instructions such as:

“Pull your foot up toward you as hard as you can and hold.”
“Build up smoothly, then push hard.”
“Keep the knee still and avoid twisting the foot.”
“Keep breathing.”
“Tell me if you feel pain, cramping, tingling or anything unusual.”

Use the same wording at retest where possible.

7. Record trials

Use 1–2 practice trials, then record 2–3 maximal trials. A common contraction duration is 3–5 seconds. Rest for 30–60 seconds between trials, or longer if symptoms, cramping or fatigue occur.

Record whether the final score uses the best trial or the average of recorded trials. Either approach may be used if it is applied consistently.

8. Identify invalid trials

Repeat or mark a trial as invalid if:

• The foot twists into inversion or eversion
• The knee or hip moves
• The device slips
• The strap or anchor moves
• Toe extension dominates the effort
• Pain or cramping limits effort
• The client starts before the device is ready
• The client holds their breath excessively
• The professional cannot hold the device steady

9. Record symptoms

Record pain, cramping, shin discomfort, anterior ankle discomfort, paraesthesia, confidence, apprehension and symptom response after testing. Do not repeatedly test through high pain or worsening neurological symptoms.

For retesting, match the same position, device placement, instructions, contraction duration, rest period, scoring method and symptom recording.

Why It Is Used

The Ankle Dorsiflexion Strength Test is used to quantify dorsiflexor force output in a repeatable setup. It may be useful for:

• Baseline ankle strength assessment
• Side-to-side comparison
• Monitoring change over time
• Tracking lower-limb strength after reduced loading
• Assessing foot-lift capacity during gait-related tasks
• Strength profiling for running, field sport or court sport clients
• Workplace context where foot clearance, stairs or walking confidence matters
• Fitness and performance progress tracking
• Client education
• Comparing strength with gait, balance, calf strength, toe strength or ankle mobility

The test should support assessment reasoning. It should not be used as a stand-alone diagnostic or clearance measure.

What It Measures

The test primarily measures isometric ankle dorsiflexion force in the chosen setup. It reflects the client’s ability to produce upward foot force through the dorsiflexor muscle group, including tibialis anterior and related contributors.

It may provide useful information about:

• Dorsiflexor force capacity
• Side-to-side force difference
• Confidence producing force
• Pain response during resisted dorsiflexion
• Change in force over time
• Relationship between strength and related functional tasks

It does not directly measure:

• Ankle dorsiflexion range of motion
• Nerve conduction
• Cause of foot drop
• Tendon integrity
• Joint mobility
• Gait quality
• Balance
• Endurance
• Power
• Readiness to return to running, sport or work

Understanding the Result, Reference Values and What to Look For

What a higher or lower result may suggest

A higher score may suggest greater dorsiflexion force output in that specific test setup. A lower score may suggest reduced force output, but the reason should be interpreted carefully.

Lower force may be influenced by pain, apprehension, poor familiarisation, fatigue, altered sensation, previous injury, guarding, poor stabilisation, inconsistent device placement or reduced confidence.

One result should not be interpreted in isolation. Interpretation is strongest when the same setup is repeated over time and reviewed alongside symptoms, confidence, movement quality, related tests and functional goals.

What can influence the result

Important influences include:

• Pain
• Apprehension
• Poor familiarisation
• Fatigue
• Guarding
• Poor stabilisation
• Toe extension compensation
• Different device placement
• Different strap angle
• Different knee or ankle position
• Footwear
• Breath holding
• Client confidence
• Professional strength if using handheld resistance

Normative, reference and comparative values

Published Muscle Meter-specific universal norms for ankle dorsiflexion are limited. Because of this, reference values should be used as context only and not as direct targets unless the test position, device placement, stabilisation and scoring method are closely matched.

More user-friendly comparison data include:

• In one study of healthy young adults, ankle dorsiflexion strength was approximately 228 N for men and 120 N for women using handheld/fixed dynamometry methods. In practical terms, 228 N is roughly similar to about 23 kg of force, while 120 N is roughly similar to about 12 kg of force.
• In healthy older adults with a mean age of about 73 years, reported dorsiflexion strength values were approximately 122 N for men and 81 N for women. These are older reference values, but they help show that dorsiflexion strength tends to be lower in older groups. In practical terms, 122 N is roughly similar to about 12 kg of force, while 81 N is roughly similar to about 8 kg of force.
• A foot and ankle handheld dynamometry study found that older adults were approximately 24–37% weaker than younger adults across several foot and ankle strength measures. This percentage describes an age-group difference, not a bodyweight-strength target.
• For side-to-side comparison, a difference of around 10% or more is often worth reviewing more closely in strength testing, especially if it matches symptoms, confidence changes, previous injury or functional differences. This should not be used as a strict pass/fail rule.
• If force is recorded as a percentage of body weight in Measurz, use it mainly for the client’s own baseline, side-to-side comparison and retesting. Published bodyweight-percentage norms for this exact Muscle Meter dorsiflexion setup are not currently strong enough to use as universal targets.

These values are best used as comparison data. They can help provide context, but they should not be used as diagnostic, clearance or pass/fail cut-offs.

Practical interpretation priorities

Use this order:

1. Compare with the client’s own baseline.
2. Compare right and left sides when relevant.
3. Consider symptoms during and after testing.
4. Consider confidence and effort quality.
5. Review whether compensations were present.
6. Compare with related strength, mobility or performance tests.
7. Relate the result to walking, running, sport, work or daily-life demands.
8. Retest under the same conditions to monitor change.
9. Do not use reference values as pass/fail criteria.

What to look at for each relevant Muscle Meter metric

Peak force
Use for maximum dorsiflexion force output, baseline strength, side-to-side comparison, progress tracking and comparing force across retests. Look for best score or average score, consistent setup, side-to-side difference, change from baseline, pain response and compensation during maximal effort.

Force as percentage of body weight
Use only when calculated directly from test force and body weight. Look for changes over time and side-to-side differences, but do not treat it as a universal target unless the comparison data use the same method.

Torque
Use only when the lever arm is measured and a more biomechanical interpretation is needed. It can help when foot length or device contact point changes the raw force reading. It should not be used as normative data unless the reference data match the setup closely.

Rate of force development
Use when rapid force production matters, such as foot clearance, sprinting, cutting, landing or reactive tasks. Look for early force production and whether RFD changes while peak force stays similar.

Time to peak
Use to understand whether force is produced quickly or gradually. Look for delayed peak force, faster time to peak across retests, and whether a slower time reflects caution, pain, poor cueing or an actual performance difference.

Impulse
Use only if a sustained force window is intentionally tested. Look for whether the client can sustain force briefly and whether impulse improves while peak force stays similar.

Fatigue index
Use only if repeated or sustained dorsiflexion contractions are part of the protocol. Look for drop-off across repeated trials, symptom-related fatigue and whether fatigue improves across a training block.

Assessing and Providing Context for Different Client Populations

Youth clients
Consider growth, maturation, coordination, attention, training age and familiarisation. Practice trials are important because young clients may improve quickly once they understand the task. Results should be interpreted relative to age, body size, sport participation and confidence with testing.

Adults and general fitness clients
Use the test for baseline strength, progress tracking and confidence with loading. Compare results with ankle mobility, calf strength and general exercise goals.

Older adults
Consider balance, transfers, daily tasks, walking confidence, foot clearance, fatigue, rest periods and function. A lower score may provide useful context, but it should not be interpreted without functional assessment.

Athletes and sport clients
Consider sprinting, cutting, jumping, landing and rapid foot repositioning. Peak force alone does not equal sport performance, but it can support a broader lower-limb strength profile.

Workplace and manual task clients
Consider walking surfaces, stairs, ladders, carrying, prolonged standing, bracing and footwear demands. Do not use one strength score to clear work duties.

Clients returning after injury
Use the test to monitor force output, confidence and symptom response over time. Strength alone should not confirm readiness.

Clients with pain or persistent symptoms
Pain, fear, guarding, fatigue, apprehension and confidence may influence force. Record symptoms carefully and compare with related findings.

Higher body mass clients
Absolute force and force relative to body mass may both be useful. Avoid assumptions and interpret the result in relation to goals, symptoms and function.

Reliability, Validity and Measurement Considerations

Repeatability improves when the same setup is used each time. Record and standardise:

• Same test position
• Same device attachment
• Same device placement
• Same strap setup, if used
• Same anchor height and distance, if straps are used
• Same strap angle, if straps are used
• Same knee and ankle position
• Same stabilisation
• Same instructions
• Same contraction duration
• Same rest period
• Same scoring method
• Same symptom and compensation recording

Handheld dynamometry for foot and ankle strength has shown good-to-excellent reliability when protocols are standardised. However, manual resistance can be limited by professional strength, especially with stronger clients. Strap-stabilised or fixed setups can improve consistency when available.

Dorsiflexion testing can also be affected by device position and unwanted foot movement. This means device placement, foot alignment and stabilisation should be treated as essential parts of the protocol, not minor details.

Common Errors and Limitations

Common errors include:

• Inconsistent device placement
• Allowing ankle inversion or eversion
• Allowing toe extension to dominate
• Poor lower-leg stabilisation
• Testing with different ankle angles across sessions
• Device slipping
• Strap or anchor movement
• Breath holding
• Testing through high pain
• Comparing different protocols directly
• Treating the score as a diagnosis

Limitations include:

• Testing is setup-dependent
• Manual resistance may be limited by professional strength
• Strap setup requires careful anchor control
• Muscle Meter-specific universal norms may be limited
• Published norms are not universal across protocols
• Pain, fear or guarding can reduce force output
• Peak force does not measure endurance or movement quality
• Side-to-side symmetry does not automatically mean function is ready for sport or work

Practical Applications

The Ankle Dorsiflexion Strength Test may be useful for:

• Establishing a baseline
• Tracking dorsiflexor strength over time
• Comparing right and left sides
• Reviewing force relative to body weight if directly calculated
• Monitoring response to exercise or intervention
• Supporting gait and foot-clearance reasoning
• Comparing with calf strength, toe strength and ankle mobility
• Educating the client about measurable progress
• Reviewing sport, work or daily-life demands

Ideas to Make the Result Better

If force is low on both sides, consider assessing ankle ROM, calf capacity, balance, walking tolerance, general lower-limb strength and confidence with loading.

If one side or direction is much lower, compare with symptoms, injury history, ankle mobility, toe strength, calf strength, balance and functional tasks.

If pain limits the result, record the pain response and review whether the test position, pressure point or effort level needs modification.

If force is good but function is limited, compare with gait, hopping, change-of-direction, stair tasks, balance and sport or work demands.

If the client is improving, keep the same protocol and monitor whether strength, symptoms, confidence and function improve together.

Recommended Standard Protocol Summary

Position: Seated, hip and knee flexed, ankle near neutral
Start position: Foot relaxed, ankle close to neutral
Joint or trunk angle: Record ankle and knee position
Trials: 1–2 practice trials, then 2–3 recorded trials
Contraction duration: 3–5 seconds
Rest: 30–60 seconds between efforts
Metric: Peak force, plus percentage of body weight only if directly calculated
Attachment or device setup: Muscle Meter on dorsal foot near distal metatarsal region, or strap-stabilised if used
Final score: Best trial or average of trials
Key retesting requirement: Same position, device placement, instructions, contraction duration, rest and scoring method

FAQs

What does the Ankle Dorsiflexion Strength Test measure?

It measures isometric dorsiflexion force output in a specific test setup.

Should the result be recorded as percentage of body weight?

It can be if you calculate it directly from test force and body weight. Use it for internal comparison rather than as a universal target.

Are there universal dorsiflexion norms for the Muscle Meter?

Published universal Muscle Meter norms for this exact protocol appear limited. Baseline comparison, side-to-side comparison and retesting under the same setup are usually more useful.

What numerical values are available for comparison?

Published comparison values include approximately 228 N for young adult men, 120 N for young adult women, 122 N for older adult men and 81 N for older adult women in handheld or fixed dynamometry examples. These are not direct Muscle Meter targets unless the protocol is closely matched.

Can this test diagnose foot drop?

No. It can measure dorsiflexion force, but it does not diagnose neurological conditions or explain symptoms on its own.

Why does device placement matter?

Small changes in where the device sits on the foot can change the force reading. Record the placement and repeat it at retest.

What can make the result unreliable?

Different device placement, ankle position, stabilisation, fatigue, pain, compensation and inconsistent instructions can affect results.

What should be recorded in Measurz?

Record side, position, device placement, peak force, percentage of body weight if directly calculated, symptoms, compensations, confidence, scoring method and related findings.

Key Takeaways

• The Ankle Dorsiflexion Strength Test measures isometric dorsiflexion force output.
• Peak force is usually the main routine Muscle Meter metric.
• Published examples include approximately 228 N, 120 N, 122 N and 81 N across different age and sex groups, but protocols vary.
• Percentage of body weight should only be used when calculated directly from force and body weight.
• Baseline comparison, side-to-side comparison and retesting consistency are usually more useful than broad norms.
• Reference values provide context, not diagnostic or clearance cut-offs.
• Measurz should capture setup, symptoms, bodyweight-normalised values where directly calculated, compensations and retesting conditions.

References

Bohannon, R. W. (1997). Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Archives of Physical Medicine and Rehabilitation, 78(1), 26–32. https://doi.org/10.1016/S0003-9993(97)90005-8

Martins, J., da Silva, J. R., da Silva, M. R. B., & Bevilaqua-Grossi, D. (2017). Validation of ankle strength measurements by means of a hand-held dynamometer in adult healthy subjects. Rehabilitation Research and Practice, 2017, 5426031. https://doi.org/10.1155/2017/5426031

Mentiplay, B. F., Perraton, L. G., Bower, K. J., Adair, B., Pua, Y. H., Williams, G. P., McGaw, R., & Clark, R. A. (2015). Assessment of lower limb muscle strength and power using hand-held and fixed dynamometry: A reliability and validity study. PLOS ONE, 10(10), e0140822. https://doi.org/10.1371/journal.pone.0140822

Spink, M. J., Fotoohabadi, M. R., Menz, H. B., & Lord, S. R. (2010). Foot and ankle strength assessment using hand-held dynamometry: Reliability and age-related differences. Gerontology, 56(6), 525–532. https://doi.org/10.1159/000264655