Joint Mobilization of the Foot and Ankle

Anteroposterior and Posteroanterior Glides

Joint - proximal tibiofibular

Indications - restricted ankle dorsiflexion, plantar flexion

Clinician/Hand Position - For AP, the tibia is stabilized with the medial hand over the proximal tibia, the lateral hand is over the fibular head and the proximal fibula; for PA, the mobilizing hands is against the fibular head, while the stabilizing hand prevents motion of the tibia 

Mobilization Application - For AP, the mobilizing hand is on the fibular head and a posterior force is applied perpendicular to the fibular shaft. For PA, the lateral hand glides the fibular head anteriorly

Distraction (Talocrural Joint)

Joint - Talocrural joint

Indications - To increase general joint play in the ankle

Clinician/Hand Position - facing the foot; grasping the top of the ankle with both hands

Mobilization application - Clinician leans forward to apply a distraction force 

Anterior Glide

Joint - Talocrural

Indications - Restricted plantar flexion

Clinician/Hand Position - facing the foot; stabilizing hand is placed anteriorly around the distal leg, the mobilizing hand is placed around the superior aspect of the heel

Mobilization Application - The talus is glided anteriorly in the plane of the joint

Weight Bearing Anterior Glide

Joint - Talocrural

Indications - Restricted dorsiflexion

Clinician/Hand Positions - The web of the thumb and index finger of the stabilizing hand is around and anterior ankle joint around the malleoli; the clinician's hands in a forward-backward stride position

Mobilization Application - Knees are flexed, the hips pull a strap forward, which moves the body weight from the front to the back leg

Posterior Glide

Joint - Talocrural

Indications - Restricted dorsiflexion

Clinician/Hand Position - facing the foot; stabilizing hand is placed posteriorly around the distal leg at the malleoli, the mobilizing hand is placed around the proximal dorsal foot

Mobilization Application - Talus is glided posteriorly in the plane of the joint

Medial Glide

Joint - Subtalar

Indications - To increase eversion

Clinician/Hand Position - Distal leg is stabilized with the stabilizing hand over the lateral leg proximal to the ankle, the mobilizing hand is cupped around the calcaneus on the medial/lateral calcaneus

Mobilization Application - A downward medial glide is applied; slight traction makes it more comfortable

Lateral Glide

Joint - Subtalar

Indications - Increase subtalar inversion

Clinician/Hand Position - Stabilizing hand is placed over the medial distal extremity proximal to the malleoli, the mobilizing hand is cupped around and calcaneus on the lateral and medial side

Mobilization Application - Force applied occurs directly downward and parallel to the joint surface