Ankle and Foot Flashcards
Squeeze test for high anlke sprain
Squeeze upper 1/3 of leg. If positive test, pain around distal tibia/fibula.
Distal Tibiofibular joint diagnosis
- Basically pushing distal fibular head forward and backwards.
- Patient supine, flex knee so heel plants, stabilize middle foot with medial hand, other hand grab lateral malleolus, do anterior and posterior motion. If likes to come anterior its an anterior lateral malleolus. Can get stuck in either position. Anterior tends to have more of a plantar flexed preference. posterior tends to have more of a dorsiflexd preference
Distal Fibula Anterior Art (push it posterior)
Patient Supine, physician standing, one hand stabilize lower ankle/foot, other hand grab distal fibula. Engage the dorsiflexion passive barrier, use articulatory techniques to improve.
Distal Fibula posterior ART (push it anterior)
Patient prone, physician standing, one hand stabilize ankle, engage plantaflexion, other hand grab distal fibula, engage RB and use articulatory to improve motion.
Tibiotalar joint diagnosis
Moving foot up into dorsiflexion, feel the talus doing posterior glide. Move foot into plantarflexion, talus is anterior glide Lots of different hand holds for this.
Dorsiflexed Talus MET
One hand on ankle, other hand on dorsum of foot. Bring into plantar flexion, they push into dorsiflexion, etc.
Plantarflexed Talus MET
One hand anlke, other hand bring them to dorsiflexion. They plantar flex, you hold, etc.
Talocalcaneal joint diagnosis
To block out linkage and move just talus, bring to 90 degree standing position, then one hand on plantar side of foot, other grabbing top of ankle. Evert foot (with anteromedial glide of talus), then invert foot (with posterolateral glide of talus). See which one they prefer. Everted talocalcaneal favors eversion, inverted favors inversion
Articulatory with traction (for talus eversion or inversion)
One hand grab heel, other grab talus and dorsum of foot. Traction on calcaneus and articulate figure 8 inversion and eversion until no new RBs or quality of ROM normalizes (heel and toes making 8)
Tarsal bones: cuboid, navicular, cuneiforms diagnosis
Inspect and palpate bilaterally,use thumb and index finger, the cuneiforms only have anterior posterior glide, the navicular and cuneiforms also rotate on an axis, navicular will rotate medially and cuboid will rotate laterally (pantar glide preference= goes downwards. Dorsal glide preference= goes upwards)
Dx: Plantar Glide somatic dysfunction (Navicular, cuboid, cuneiform)
Tart changes and resistance to pressure applied to the plantar source of these bones is diagnostic
Plantar Glide SD MET
If plantar glide SD of cuboid navic or cuneiform, cross thumbs underneath the bone that has disfunction, push force up, have them actiate by plantarflexing foot and ankle, next barrier thumbs going a little more apart and up dorsally, and relax, keep going till no new barriers.
Metatarsal Dx and Articulatory Tx of metatarsals plantar and dorsal glide
Finger on top and bottom, go up and down, if cant feel that go more distally on that metatarsal. We name it plantar or dorsal based on distal part of it, if it likes to go plantar that’s a plantar first metatarsal. If want to evaluate second, block 1st with your right hand then check the second. Do articulatory to treat it.
Dx: Metatarsophalangeal and Interphalangeal joint
Use one hand to block rest of toe off leading up to where you are inspecting, then Inspect for Plantar/dorsal glide, medial/lateral glide, and internal/external rotation
Metatarsophalangeal/interphalangeal joint SD: ART
check at each joint for Plantar/dorsal glide, medial/lateral glide, and internal/external rotation. When a restrictive barrier is met, motion through the barrier towards anatomic barrier.
