Ankle And Foot

Question 1

Special tests

Answer 1

1) Anterior draw test
2) Medial (deltoid) ligament stress test
3) Lateral ligament stress test
4) Talar tilt for lateral ligament complex
5) Simmonds squeeze (TA rupture)

Question 2

1) Anterior draw test

Answer 2

Test for integrity of the Anterior Talofibular Ligament (ATFL) and mechanical stability of the lateral ligament complex

Sitting with ankle off the plinth in slight
plantarflexion

Therapist grasps the maleoli to stabilise then grasps calcaneus and talus posterior and firmly applies and anterior gliding force brings it forward

Positive test= if there is excessive anterior drawer of the talus with respect to the tib/fib mortise compared to the other ankle, indicating a tear (partial or complete rupture) of the lateral ligament complex, particularly the ATFL

Question 3

2) Medial (deltoid) ligament stress test

Answer 3

1/2 lying

Therapist grasps the forefoot and calcaneous

one hand grasp at heel then the foot and ankle are passively everted/ abducted in plantargrade feeling for any opening up of the medial joint line of the ankle with the index finger of your other hand

Positive test= excessive movement present compared to the other ankle, indicating a tear (partial or complete rupture) of the Deltoid ligament. Pain may also be elicited if there is a partial tear

Question 4

3) Later ligament stress test

Answer 4

1/2 lying

Grasp the models’ foot with one hand and fully passively invert whilst feeling for any opening up of the lateral joint line of the ankle with the index finger of your other hand

Pain may also be reproduced if there is a partial tear of the lateral collateral ligament

Perform the test in…..

1.plantar flexion to test the anterior
band

2.plantargrade (neutral) to
assess the middle band

3. Dorsiflexion posterior band

Question 5

4) Talar tilt for lateral ligament complex

Answer 5

Sitting edge of plinth legs dangling off plinth foot in
slight plantarflexion initially. Test is then repeated in
plantargrade and dorsiflexion

Therapist grasps the forefoot and calcaneous

The foot and ankle are inverted/ adducted
in plantarflexion, plantargrade and then
dorsiflexion to assess for integrity of the
Anterior Talofibular Ligament (ATFL),
Calcaneofibular ligament and Posterior
Talofibular Ligament (PTFL) respectively

positive test= if there is excessive movement present compared to the other ankle, indicating a tear (partial
or complete rupture) of the lateral ligament
complex. Pain may also be elicited if there
is a partial tear

Question 6

5) Simmonds triad

Squeeze
Angle of dangle
Gap

Answer 6

1.Squeeze

prone lying feet dangling off plinth

Squeeze calf gastro/soleus complex = should produce plantar flexion

Positive= no plantar flexion

2.Angle of dangle

prone lying feet dangling off plinth if foot is in dorsi flexion this is a positive test

3. Gap palpation

Palpate along Achilles if you feel a gap = positive