Ankle: Pathology, MMT, ST, Structures

Tibia

Weight Bearing Bone, forms medial ankle jt wall

Fibula

Forms lateral ankle joint wall;
common fracture site

Tib Ant MMT

Pt Pos: SS

Stabilization: Lower Leg

Pt Movement: Up In

Clinician Resistance: Down Out

Tib Post MMT

Pt Pos:SS

Stabilization: Lower Leg

Pt Movement: Down Out

Clinician Resistance: Up In

Peroneus Longus/Brevis MMT

Pt Pos: SS

Stabilization: Lower Leg

Pt Movement: Down Out

Clinician Resistance: Up In

Gastroc MMT

Pt Pos: Standing

Stabilization: None

Pt Movement: BW Calf Raises

Clinician Resistance: None

Soleus MMT

Pt Pos: Standing

Stabilization: None

Pt Movement: BW Calf Raises

Clinician Resistance: None

Ant Drawer Test

Tested Structure: ATFL

Pt Pos: long sit knee partially flexed

Clinician Action: Pull calcaneus forward

(+): excess ant glide, pain, clunk

Indication: lat ankle sprain

Talar Tilt (IN)

Tested Structure: CFL

Pt Pos: log sit

Clinician Action: IN foot

(+): excess motion, pain

Indication: lat ankle sprain

Talar Tilt (EV)

Tested Structure: deltoid ligament

Pt Pos: long sit

Clinician Action: EV foot

(+): excess motion, pain

Indication: med ankle sprain

Kleiger’s Test (ER)

Tested Structure: syndesmosis, deltoid ligament

Pt Pos: SS

Clinician Action: ER ankle

(+): pain

Indication: syndesmotic ankle sprain

Squeeze Test

Tested Structure: interosseous membrane

Pt Pos: supine, SS

Clinician Action: squeeze tib and fib together

(+): pain

Indication: syndesmotic ankle sprain

Fibular Translation Test

Tested Structure: syndesmosis, distal fib

Pt Pos: side lying

Clinician Action:apply translation force to fib

(+): excess fib movement, pain

Indication: syndesmotic ankle sprain

DF Compression Test

Tested Structure: high ankle sprain

Pt Pos: long sit, knee flexed

Clinician Action: squeeze ankle on lat and med sides

(+): pain relief w/ compression

Indication: high ankle sprain

Cotton Test (Lat Talar Glide)

Tested Structure: syndesmotic ankle sprain

Pt Pos: long sit

Clinician Action: apply lat force from med side of foot/ankle

(+): excess lat translation

Indication: syndesmotic ankle sprain

Thompson Test

Tested Structure: achilles tendon

Pt Pos: prone

Clinician Action: squeeze calf

(+): no PF reflex

Indication: achilles tendon rupture

Flexor Digitorum Longus

O: Med post tib

I: Digits 2-5

A: Flex digits 2-5, PF

Ext Digitorum Longus

O: Ant tib

I: Digits 2-5

A: Ext digits 2-5, DF

Flexor Hallicus Longus

O: Post fib

I: Plantar surface of big toe

A: Flex big toe, PF

Ext Hallicus longus

O: Ant fib

I: Big Toe

A: Ext big toe

Ext Digitorum Brevis

O: Calcaneus

I: Base of big toe

A: Ext digits 2-4, EXT big toe

Peroneus Longus

O: lat condyle of tib and lat fib

I: base of 1st MT and med cuneiform

A: EV PF

Peroneus Brevis

O: lat fib

I: 5th MT

A: EV PF

Gastroc

O: lat condyles of femur

I: achilles tendon @ calcaneus

A: PF

Soleus

O: Post fib and med tib

I: calcaneus

A: PF

Tib Ant

O: lat condyle and lat surface of tib

I: med cuneiform, base of 1st MT

A: DF IN Add

Tib Post

O: prox posterolateral tib

I: navicular and med cuneiform

A:PF IN

Plantaris

O: lat condyle of femur

I: calcaneus

A: weak PF

ATFL

connects lat mal to talus

resists IN PF

CFL

connects calcaneus to fib

stabilizer

PTFL

connects lat mal to talus

stabilizer

Deltoid Ligament

connects tibia to navicular and calcaneus and talus

stabilizer

Syndesmosis

connects distal tib and fib

stabilizer

Interosseous Membrane

connects tib and fib

separates ant and post leg muscles

Extensor Hallicus Longus MMT

Pt Pos: SS

Stabilization: midfoot

Pt Movement: big toe up

Clinician Resistance: push big toe down

Extensor Digitorum Longus MMT

Pt Pos: SS

Stabilization: ankle

Pt Movement: toes up

Clinician Resistance: push toes down

Flexor Hallicus Longus MMT

Pt Pos: SS

Stabilization: midfoot

Pt Movement: big toe down

Clinician Resistance: push big toe up

Flexor Digitorum Longus MMT

Pt Pos: SS

Stabilization: ankle

Pt Movement: push toes down

Clinician Resistance: push toes up