MSK LQ Ankle Lab

Anterior Drawer Test (Ankle)

-Tests anterior talofibular ligament (ATFL) stability

-positive if glide is ≥4mm or causes pain.

-move the knee into extension and

ankle into plantar flexion and supination

-norm is 2mm or less

Talar Tilt Test

-Assesses CFL (adduction in neutral)

-ATFL (adduction in PF)

-and deltoid ligament (abduction).

-Pt position: supine with knee flexed

-+ test= pain or laxity

Squeeze Test

-Assesses high ankle sprain

-positive if squeezing syndesmosis above malleoli causes pain in distal ⅓ of leg

-Pt position: supine or sidelying

Kleiger Test (ER Stress Test)

-Assesses syndesmosis (anterolateral pain) or deltoid ligament (medial pain) via foot external rotation.

-Pt position: EOB in short sitting

-Test: stabilize Tib/fib and ER the foot

-pain at anterolateral distal tib/fib (high ankle sprain)

-Pain at medial ankle= possible deltoid ligament tear

Morton's Test

-Assesses stress fracture or neuroma

-squeezing the metatarsal heads together

-+ test= pain (neuroma or stress fx)

Thompson Test

-Assesses Achilles tendon rupture

-positive if squeezing the calf causes no ankle plantarflexion.

-Pt position: prone with feet off the EOB

-Test: squeeze calf and observe for PF

Windlass / Great Toe Extension Test

-Assesses plantar fascia

-positive if medial longitudinal arch fails to raise during hallux extension.

-Test: passively extend Hallux while holding calf to ensure no muscle contraction

-Normal: MLA raises

Navicular Drop Test

-Assesses excessive pronation

-positive if navicular tubercle drops ≥10mm from neutral to standing

-Place STJ in neutral-->Mark Navicular height-->Remeasure navicular tubercle in standing

Homan's Test

-Assesses for deep vein thrombosis (DVT) by passively dorsiflexing the ankle

-+ test= pain in the calf

-Low Sn and SP

Too Many Toes Sign

-Indicates abnormal pronation

-Observe calcaneus from posterior

-Normal: can see 5th and half of 4th toes

-+ test= more toes viewable

Figure 8 Ankle Measurement

• Used for swelling measurements.

• Place tape measure midway between Tibialis anterior and lateral malleolus.

• Pull tape across instep distal to navicular.

• Pull tape across arch and bring it up just proximal to the 5th metatarsal and across tibialis anterior.

• Bring tape around ankle joint distal to medial malleolus, across Achilles and back to starting point.

Lunge Test

-Assesses talocrural joint dorsiflexion ROM

-failure to touch knee to wall from 10cm is positive.

-Watch for compensations-heel comes up, knee valgus/IR/pronation

Hop Tests (Return to Sport)

Four functional tests: single hop, crossover hop, triple hop, and six-meter timed hop.

TC distraction

Distract ankle at talocrural joint→HVLA

Cuboid Whip Manipulation

Pt in prone

Palpate plantar cuboid surface and apply a dorsal glide to the cuboid

Knee flexed to 70º

DF ankle to end range

move the knee into extension and ankle into plantar flexion and supination

Manual Mobilization with Movement (Talus)

Therapist applies posterior talocrural glide while patient lunges forward with knee/hip flexed 90º.

Belt-Assisted Mobilization with Movement (Distal Tibia)

Therapist applies sustained anterior glide to distal tibia while patient lunges forward.

LOW DYE TAPING

Used to off-load the plantar fascia and provide medial arch support