Lower Leg / Ankle / Foot Flashcards
Soleus MMT
Patient pos - Patient is in the prone position, knee flexed at 90 degrees.
Fixation - Examiner supports leg just proximal to ankle.
Pressure - Against the platar surface of the foot, pushing in the dirrection of dorsiflexion of the ankle.
Thump Test
Patient Pos - Supine
Force - Thge examiner strikes the heel of the foot, a large vibratory force is sent through the limb that stimulates the injured site.
Positive findings - A positive test is reproduction of the patients worst pain. Stress fracture.
Flexor Hallicus Longus MMT
Patient pos - The patient is in the seated or supine position.
Fixation - Stabilize the metatarsophalangeal joint and ankle in a neutral position.
Test - Flexion of interphalangeal joint of the great toe.
Pressure - Plantar surface of the distal phalanx, in direction of extension
Dorsiflexion Maneuver
Patient pos -Patient sits on the edge of the table.
Force - passively and forcefully dorsiflex the foot by holding onth the heel and using forearm to dorsiflex foot.
Positive Findings - Pain on forced dorsiflexion. Indicates a positive test for syndesmosis problem.
Extensor Hallicus Longus/Brevis MMT
Patient pos - Patient is seated or lying supine.
Fixation - Stabilization of the foot in slight plantar flexion
Test - Extension of the metatarsalphalangeal and interphalangeal joints of the great toe.
Pressure - Against the dorsal surface of the distal and proximal phalanges in the direction of flexion.
Peroneus (Fibularis) Tertius MMT
Patient pos - The patient is in the seated or lying supine
Fixation - examiner supports leg just above the ankle.
Test - Eversion of the foot with plantar flexion of the ankle.
Pressure - Against the lateral border and plantar surface of the foot, in the direction of inversion and dorsiflexion of the ankle.
Stork Test
Patient pos - Standing
Test - Patient plces their hands on their hips. stands on one foot and places the other foot on the medial aspect of the standing leg.
looking for lower kinetic chain disorger with loss of balance.
Tibialis Anterior MMT
Patient pos - Sitting, knees flexed 90 degrees, foot is dorsiflexed and inverted.
Stabilization - Stabilization is provided by holding the patients lower leg still with hand just proximal to the posterior portion of the ankle.
Pressure - Applied on the dorsal surface of the foot in the direction of platarflexion. Eccentric test of the tibialis anterior.
Squeeze Test of the Leg
Patient position - Supine, short sit, prone
Stabilization - the examiner grasps the patient’s leg midway up the calf at the tibia and fibula.
Force - Compression and release
Positive Findings - A positive test is considered if the patient experiences pain in the area of the syndesmosis
Peroneus Longus/Brevis MMT
Patient pos -Sitting, knees flexed to 90 degrees, foot is platarflexed and everted.
Fixation - Stabilization is provided by holding the patient’s lower leg still with the hand just distal to the anterior portion of the ankle.
Pressure - Applied to the platar surface of the foot under the head of the big toe, pushing into dorsiflexion and inversion (return to neutral)
Tibialis Posterior MMT
Patient pos - Sitting, knees flexed at 90 degrees, foot is plantarflexed and inverted.
Fixation - Stabilization is provided by holding the patient’s lower leg still with hand just distal to the anterior portion of the ankle.
Pressure - Applied to the platar surface of the foot in the direction of dorsiflexion. Eccentric test.
Talar Tilt
Patient Pos - Supine or sitting with the legs over the edge of the table.
Stabilization - One hand grasps the calcaneus while the other stabilizes the the lower leg.
Force - The hand holding the calcaneus rolls it laterally, tilting the talus, causing a gap on the medial side of the ankle.
Implications - A positive finding would be if the talus tilts or gaps excessively compared bilaterally. If pain is described during this test it is indicative of the deltoid ligament.
Subtalar Neutral
Patient Pos - Patient is seated or standing with feet on floor and leg to be tested in a non-weight bearing position.
Stabilization - The clinician locates the medial and lateral heads of the talus
Force - The clinician has the patient invert and evert their foot until the medial and lateral heads are equally protruding. this is the neutral position.
Flexor Digitorum Longus MMT
Patient pos - Patient is seated or supine.
Fixation - The Clinician stabilizes the metatarsals and maintains nuetral foot and ankle
Test - Flexion of distal interphalangeal joints 2-5
Pressure - Plantar surface of distal phalanges in direction of extension
Navicular Drop
Patient pos - Patient begins seated with both feet on the floor in a non-weight bearing position. The patient may also be standing with all of their weight on the non-tested leg. the clinician puts the patient in a neutral position.
Stabilization - In this position, the clinician locates and marks the navicular head witha pen and holds a note card or ruler up to the mark to measure the height.
Force - patient then bears weight onto the foot and the clinician mesures again to note any navicular drop that may have occured.
Positive findings - any measurement greater than 10 mm
Tinel’s Sign
Patient pos - Is placed in long sitting with the feet hanging off the table.
Force - The clinician palpates the Deep Peroneal nerve laterally of the medial malleoulus. As well as the Tibial nerve posteriorly of the medial malleolus.
Positive Findings - in both cases, tingling or paresthesia felt distally is a positive sign.
Thompson sign
Squeeze the calf looking for dorsi flexion signifying the achillis tendon is in tact.
Figure 8 Measurement
Patient Pos - Patient is positioned in long sitting with the ankle and lower leg beyond the end of the examining table with the ankle in dorsiflexion.
Fixation - Using a 6mm tape measure. measure in a figure 8 pattern looking for swelling.
Anterior Drawer
Patient pos - Test witht the patient seated on the edge of the table.
Stabilization - The examiner stabilizes the distal part of the leg with one hand while the other hand grasps the heel. (ankle is in 20 degrees of plantarflexion)
Force - An anterior force is applied to the heel while attempting to move the talus anteriorly on the tibia. Allow the foot to rotate slightly medially to relax the deltoid ligament.
Positive finding - A positive finding would be a translation of greater than 1 cm compared bilaterally. It is indicative of a complete talofibular ligament rupture.
Rhomberg Test
Patient pos - standing
Test - patient stands with feet together and arms by sides with eyes open. Next the examiner asks patient to close their eyes
Fiess line
basically navicular drop test draw line from medial malleoulus to base of first metatarsal and draw line. see if line drops or rises when bearing weight.
Flexor Hallicus Bevis MMT
Patient pos - Patient is in the seated or supine position.
Fixation - Stabilize the foot proximal to the metatarsophalangeal joint and maintain neautral foot/ankle
Test - flex metatarsophalangeal joint of great toe
Pressure - Plantar surface of the proximal phalanx in the direction of extension.
Mortons Test
Patient position - Patient is placed in long sitting position.
Force - Clinician grasps the foot around the metatarsal heads and squeezes the heads together.
Positive finds - pain is a positive sign for stress fracture or neuroma.
External Rotation / Kleiger’s Test
Patient pos -patient is seated with the leg hanging over the examining table with the knee at 90
Stabilization - Examiner stabilizes the leg with one hand. with the other hand, the examiner holds the foot in neutral 90 degrees.
Force - Apply passive lateral rotation stress to the foot and ankle.
Positive Findings - If pain is produced over the anterior or posterior tibiofibular ligaments and the interosseous membrane, test is positive for syndesmosis injury. If patient has pain medially and examiner feels talus displace from medial malleolus, it may indicate a tear of the deltoid ligament.
Holman’s Sign
Patient pos - The patient is placed in long sitting with the feet hanging off the table with the knee extended.
Force - The clinician passively dorsiflexes the foot and ankle.
Positive findings - The presence of pain in the calf is positive sign.
Interpretation - Tenderness with palpation is also considered a positive sign. DVT
Distal Tibiofibular Compression test
Patient pos - patient lies supine
test - The examiner applies compression over the malleoli
Positive findings - pain in lower leg indicative of syndesmotic sprain if fracture and anterior compartment syndrome have been ruled out.
