Lab Practical 1 (1-5) Flashcards
Anterior Drawer Test Ankle
Tests: ATFL laxity, pain and endpoint
Notes: position ankle in slight plantar flexion, onfield
Talar Tilt Test
Tests: CFL laxity, pain and endpoint
Notes: only clinical (not on field), knee at 90 degrees, invert foot
Deltoid Ligament Test
Tests: Deltoid ligament laxity, pain and endpoint
Notes: evert foot
Always compare special tests to __
contralateral side
Onfield approach:
1) Approach athlete - life or limb? is the area stable? how to remove?
2) Subjective history - MOI, pain, hear anything, previous injury, contralateral injuries
3) Clear above and below
4) Special tests (ext. rot., ant. drawer.
5) Palpate importan structures
6) Help stand and decide on removal
Open basket taping is for:
Athlete not returning to competition
What to ask before taping?
Shave area
Allergies to tape or adherents (spray)
General steps of open basket taping
Have athlete in neutral
Spray area
Apply prowrap 4x up leg and all the way to toes (starting with leg)
Spray again
Anchor
Stirrup (medial to lateral for inversion sprain) and gimmes
Heel locks (medial first then lateral for inversion sprain)
Repeated gimmes
Four pieces of tape to cover ends of anchors
Apply tensor
What do you always do after taping?
Ask if itchy or irritated
Instructions for wear (how long, can they sleep with it, ice)
Check for capillary refill
Tensor rules
1/2 to 3/4 tension and no more overlap than 1/3 of previous piece
Closed basket taping is for?
Competition
Steps for closed basket taping:
Have athlete in neutral
Spray area
Apply prowrap 2 1/2x up leg and only until metatarsal heads
Spray again
2 anchors at top
1 anchor in middle of longitudinal arch
3 stirrups starting on medial side that go over fat pad of heel
Two heels locks (medial to lateral first for lateral/inversion sprains)
Two combination heel locks (starting on medial side first)
Louisiana figure 8 (1x starting on ATFL, 2x starting on deltoid)
Close tap (proximal to distal leg, then proximal to distal for foot)
Anterior Compartment of Leg
area of pain, stretch, strength, nerve, test sensation
Area of pain: lateral tibia Stretch: plantar flexion Strength: dorsiflexion Nerve: deep peroneal Sensation: between 1st and 2nd toes
Lateral Compartment of Leg
area of pain, stretch, strength, nerve, test sensation
Area of pain: near lateral malleolus Stretch: Dorsiflexion/inversion Strength: Plantar flexion/eversion Nerve: superficial peroneal Sensation: dorsum of foot
Superficial Posterior Compartment of Leg
Area of pain: lower 1/3 posterior medial tibia Stretch: dorsiflexion/eversion Strength: plantar flexion/inversion Nerve: tibial nerve Sensation: Plantar foot, not heel
Thompson Test
Tests: achilles’ rupture
Positive test: no movement because not attached
Longitudinal Arch Taping is for:
Plantar fasciitis and to lift the arch
Steps of Longitudinal Arch Taping:
Athlete in long leg sitting position
Plantar flex the toes between neutral and full plantar flexion and ankle in neutral
Spray plantar, dosrum and heel with adherent
Anchor on the metatarsal heads with 1.5 inch tape
4-5 1 inch trips going from and back to the metatarsal heads medially around the calcaneus
Anchor (1.5 inch) starting at metatarsal heads and working back to middle of arch - watch extensor tendons
Wear for a few days
Low Dye Taping is for:
Excessive pronation (stress fractures, shin splints, patella tendinitis/femoralis)
Steps of Low Dye Taping:
Athlete in long leg sitting position
Neutral ankle (subtalar joint) and plantar flex big toe
Spray foot
Anchor across MT heads using 1 inch tape
Two pieces of tape from 1st to 5th metatarsal head going around calcaneus
Anchor around the metatarsal heads
Arch strips from lateral to medial starting at heel until anchor
Re-do longitudinal strips
Anchor MT heads
How to test MCL?
Valgus test
- approach at 45 degrees angle
- first in extension
- second in 15-30 degrees knee flexion (relax gastrocs)
- compare to contralateral side
How to test LCL?
Varus test
- work in between legs
- only in 15-30 degrees knee flexion
- compare to contralateral side
How to test ACL?
1) Lachman’s gold standard
- 20-30 degrees knee flexion
2) Anterior Drawer
- hip 45 degrees flexed and knee 90 degrees flexed
- sit on foot
- thumbs on joint line, fingers wrap around calf to flatten the gastrocs, using index fingers to ensure hamstring tendons are relaxed
What does a negative lachmans but positive anterior drawer mean?
False positive
PCL is torn and anterior drawer test is just reducing the deformity of the PCL
How to test the PCL?
1) Posterior Drawer
- knee flexed at 90
- sit on foot
2) Sag test
- hips and knees at 90 degrees
- view tibial plateau
How to test the meniscus?
McMurray’s Test
- positive test is painful click/pop or apprehension
- 90 degree hip flexion and knee in max flexion
Medial
- external rotation (heel towards midline)
- VARUS force (knee away from body)
Lateral
- internal rotation (heel away from midline)
- VALGUS force (knee towards body)
What does Apley’s Compression test?
Meniscus
- athlete is prone
- knee bend at 90
- push down with one hand and other hand grabbing malleoli and twisting
What does Apley’s Distraction test?
Anything but meniscus
- with two hands grab around malleoli and pull up and rotate leg
- knee on thigh
