Effects of Adding Posterior Ankle Joint Mobilization to Eccentric Training on Ankle Range of Motion and Athletic Performance in Basketball Athletes with Restricted Ankle Dorsiflexion: A Randomized Controlled Trial

Background: Restricted ankle dorsiflexion is common in basketball athletes and has been associated with altered lower-limb mechanics and reduced athletic performance. Although ankle joint mobilization is widely used to improve mobility, its effects on athletic performance remain unclear. The aim of this study was to examine whether adding posterior ankle joint mobilization to a structured exercise-based program incorporating eccentric strengthening and stretching improves ankle mobility and athletic performance in basketball athletes with restricted dorsiflexion. Primary outcomes were dorsiflexion range of motion (DF-ROM) and the Weight-Bearing Lunge Test (WBLT); secondary outcomes included jump performance, hop tests, Reactive Strength Index, Fatigue Index, and maximal isometric strength. Methods: In this randomized controlled trial, 38 basketball athletes (mean age 21.26 ± 2.52 years) with unilateral restricted ankle dorsiflexion were randomly allocated to an exercise-only group (n = 19) or to an exercise plus talocrural mobilization group (n = 19). The intervention lasted 5 weeks, with assessments performed at baseline, post-intervention, and at a 3-month follow-up. Results: Both groups improved ankle dorsiflexion; however, greater gains were observed in the intervention group for both dorsiflexion range of motion (DF-ROM; interaction p < 0.001; mean difference [MD] = 3.52° post-intervention and MD = 5.17° at follow-up) and the Weight-Bearing Lunge Test (WBLT; interaction p < 0.001; MD = 1.39 cm and MD = 1.34 cm, respectively). The intervention group showed superior improvements in countermovement jump and Triple Hop Test performance (both p < 0.001), as well as a small but statistically significant advantage in the Single Hop Test (p = 0.015). No between-group differences were found for the 6 m timed hop test, Reactive Strength Index, Fatigue Index, or maximal isometric strength (p > 0.05). Conclusions: Adding ankle joint mobilization to an eccentric strengthening and stretching program produced greater improvements in dorsiflexion and jump performance than exercise alone, without affecting speed, reactive ability, or maximal strength. Ankle mobilization may be a useful adjunct for improving functional mobility and selected performance outcomes in basketball athletes.