Metatarsolphalangeal Joint

Question 1

MTP Toe Flexion

Answer 1

0-45
Patient Position:
• Supine at edge of table, hip neutral, knee extended, heel on the table to help stabilize foot (Norkin and White show the heel off the table but stabilization is easier with the heel on the table).
• Opposite leg in hip and knee flexion with foot on table to allow access to medial aspect of foot/great toe. If this is not possible, opposite leg could also be abducted to allow access to medial aspect of foot/great toe.
• Normal End Feel: Firm (due to tissue tension on the dorsal aspect)

Question 2

Goniometer- MTP Toe Flex

Answer 2

USE Short, metal finger goniometer or ‘Stubby’ broad-arm goniometer
• Fulcrum/ Axis: over dorsal aspect at midpoint of MTP joint
• Stationary Arm: dorsal midline of first metatarsal
• Moving Arm: dorsal midline of the proximal phalanx of great toe

Question 3

MTP Extension

Answer 3

• Patient position and goniometer alignment are the same as for flexion
• Goniometer: ‘Stubby’ broad-arm goniometer
• Normal End Feel: Firm (due to tissue tension on the plantar aspect)