Posterior Lower Leg

Question 1

Observation for lower leg

Answer 1

• Gait analysis
• Foot mechanics

Question 2

AROM/PROM for lower leg

Answer 2

• PF, DF
• Inversion, Eversion

Question 3

Strength test for lower leg

Answer 3

• PF, DF
• Inversion, Eversion

Question 4

Strength test for soleus

Answer 4

• Lay on stomach, bring knee to 90 degrees, stabilize lower leg and push down on foot while they PF

Question 5

Strength test for gastroc

Answer 5

• Lay on stomach, stabilize lower leg and push down on foot while they PF

Question 6

What are the special tests for the lower leg?

Answer 6

Thompson’s test

Question 7

Thompson’s test

Answer 7

• Patient lays flat on stomach, squeeze the calf, looking for plantar flexion of foot

Question 8

Palpation of lower leg

Answer 8

• Achilles tendon
• Gastroc, soleus

Question 9

What are the injuries for the lower leg?

Answer 9

• Achilles tendon rupture –> acute
• Achilles tendinopathy –> chronic
• Calf strain –> acute

Question 10

History for achilles tendon rupture

Answer 10

• Push off acute injury with feeling of being kicked in the heel

Question 11

Assessment for achilles tendon rupture

Answer 11

• No active PF, no movement with thompson’s test, execessive passive DF

Question 12

Treatment for achilles tendon rupture

Answer 12

• Immediate referral to hospital
• POLICE, use boot or cast in plantar flexed position to protect, once pain and inflammation subsides introduce isometric single raise calf raises, ice and compression to reduce swelling

Question 13

History for achilles tendinopathy

Answer 13

• Chronic condition over training, biomechanical issues, pain worse in morning

Question 14

Assessment for achilles tendinopathy

Answer 14

• Pain with active PF, no weakness, mild pain with passive DF, tenderness on palapation above calcanues

Question 15

Treatment for achilles tendinopathy

Answer 15

• Biomechanical correction of feet
• Eccentric loading –> stand on platform with heels hanging off edge, perform calf raises with both legs, slowly lower the injured leg
• Achilles tape job

Question 16

History for calf strain

Answer 16

• Acute injury, feeling of being hit in calf, can occur in either gastroc or soleus

Question 17

Assessment for calf strain

Answer 17

• Pain and weakness with active PF, pain with palpation over gastroc or soleus

Question 18

Treatment for calf strain

Answer 18

• POLICE
• No stretching for first 1-2 weeks depending on severity
• Isometric exercises –> seated calf raises, progress to standing calf raises
• Concentric exercises –> calf raises on an elevated step or block, do both legs and then progress to injured leg
• Eccentric exercise –> calf raises on an elevated step or block with emphasis on a slow eccentric, do both legs and then progress to injured leg
• Taping, KT tape