Download Ankle Plantar flexion

Data Collection for LE
Ankle Plantar flexion
 Gastrocnemius
 Plantaris
 Soleus
 Tibialis Posterior
 Flexor Digitorum Longus
 Flexor Hallucis Longus
 Fibularis Brevis
 Fibularis Longus
o Goniometer: Position pt supine with towel roll under knee. While stabilizing the distal tibia and
fibula, use other hand to pull foot into plantar flexion. Stabile arm= head of fibula. Moveable
arm= parallel to sole of the heel. Axis= inferior to lateral malleolus.
o End Feel: Firm or hard
o MMT= Pt prone with ankles dangling off end of plinth. Gastrocnemius or soleus can be
emphasized by extending or flexing the knee. Place one hand on calcaneus and other hand on
calf. Push calcaneus downward and anterior to cause dorsiflexion.
o MMT Gravity eliminated= Sidelying.
Ankle Dorsiflexion
 Anterior Tibialis
 Extensor Digitorum Longus
 Extensor Hallucis Longus
 Fibularis Tertius
o Goniometer: Position pt supine with towel roll under knee. While stabilizing the distal tibia and
fibula, use other hand/forearm to pull foot into dorsiflexion. Stabile arm= head of fibula.
Moveable arm= parallel to sole of the foot. Axis= inferior to lateral malleolus.
o End Feel= Hard or firm
o MMT= Position pt in sitting with legs over plinth. Rest test leg on your leg and place foot in mid
arch of muscles strength. (Note: to test Tibialis Anterior place foot into slight eversion and
plantar flexion) Stabilize distal fibula and tibia with one hand while providing resistance with
other hand.
o MMT Gravity Eliminated= Sidelying.
Ankle Inversion
 Tibialis Anterior
 Tibialis Posterior
o Goniometer: Position pt in supine with ankles off edge. Put a dot in the middle of the lateral and
medial malleolli. Stabile arm= tibial tuberosity. Moveable arm= parallel to 2nd metatarsal. Axis=
On dot. (Note: If done this way, you must document as inversion, adduction, and plantar flexion.
OR Position pt prone with ankles off plinth. Place a dot between head of fibula and head of tibia.
Another dot medial and superior to calcaneus and another dot medial and inferior to calcaneus.
Stabilize distal tibia and fibula.
o End Feel= Hard or firm
o MMT= Position pt side-lying with test leg down and stabilize distal tibia while providing
resistance to foot.
o MMT gravity eliminated= Supine
Ankle Eversion
 Fibularis Tertius
 Fibularis Brevis
 Fibularis Longus
o Goniometer: Same as inversion
o End Feel= Hard or firm
o MMT= Position pt side-lying with test leg up and stabilize distal tibia while providing resistance
to foot.
o MMT gravity eliminated= Supine
Knee Flexion
 Gastrocnemius
 Plantaris
 Sartorius
 Gracilis
 Biceps Femoris
 Semitendinosus
 Semimembranosus
o Goniometer: Place pt in supine (optional: place towel under distal thigh) Stationary arm:
Pointing towards the greater trochanter. Moveable arm: pointing towards the lateral mallelous.
Axis= lateral epicondyle of the femur. Stabilize the femur and ensure no rotation occurs.
o End Feel= firm/soft
o MMT= pt prone with knee bent around 45 stabilize femur while providing resistance to tibia.
o MMT gravity eliminated= side-lying
Knee Extension
 Rectus Femoris
 Vastus Intermedius
 Vastus Medialis
 Vastus Lateralis
o Goniometer: Same as Flexion.
o End feel= hard
o MMT= pt sitting with knees over plinth with a towel under thigh. Stabilize femur and provide
resistance to tibia.
o MMT gravity eliminated= side-lying
Hip Flexion
 Psoas Major
 Iliacus
 Rectus Femoris
 Sartorius
 Pectineus
 Tensor Fascia Lata
o Goniometer= Pt supine. Stabilize the pelvis. Stationary arm= parallel to the supporting surface.
Moveable arm= pointing towards the lateral epicondyle. Axis= greater trochanter of femur.
o End feel= soft
o MMT= Pt sitting while focusing on sitting up tall. Provide resistance to femur while other hand
stabilizes pelvis
o MMT gravity eliminated= Side-lying
Hip Extension
 Gluteus Maximus
 Biceps Femoris (long head)
 Semitendinosus
 Semimembranosus
o Goniometer= Same as flexion but patient is prone.
o End Feel= firm
o MMT= Pt prone. Stabilize pelvis and provide resistance to femur.
o MMT gravity resistance= Side-lying
Hip Abduction
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Gluteus Medius
Gluteus Minimus
Tensor Fasica Lata
Sartorius
o Goniometer= Pt supine with stabile arm along line between two ASIS’s. Moveable arm=
pointing between lateral and medial epicondyles. Axis= one ASIS of test side. Stabilize opposite
hip.
o End Feel=firm
o MMT= Side-lying stabilize pelvis and provide resistance to femur
o MMT gravity eliminated= supine
Hip Adduction
 Adductor Magnus
 Adductor Longus
 Adductor Brevis
 Pectineus
 Gracilis
o Goniometer= same as abduction however, you stabilize the same hip
o End feel= firm
o MMT= Side-lying with test leg on bottom. Bend top leg and provide resistance to femur while
stabilizing hip
o MMT gravity eliminated= same as abduction
Hip External rotation
 Deep Six
o Gemellus Superior
o Gemellus Inferior
o Obturator Externus
o Obturator Internus
o Pirifomis
o Quadratus Femoris
 Sartorius
 Gluteus Maximus
o Goniometer= pt sitting on edge of plinth sitting up tall put towel under test thigh. Pull leg in
while stabilizing pelvis. Stationary arm= perpendicular to floor. Moveable arm= pointing
towards medial and lateral malleoli. Axis= medial patella
o End Feel= firm
o MMT= same position as goni measurement. Stabilize femur.
o MMT gravity eliminated= pt supine with leg bent.
Hip Internal rotation
 Tensor Fascia Lata
 Pectineus
 Gluteus Medius
 Gluteus Minimus
o Goniometer= Same as ER.
o End Feel= firm
o MMT= same as goni measurement. Stabilize femur
o MMT Gravity eliminated= pt supine with leg bent
Special Tests:
 Ankle:
o Anterior Drawer: Tests for ATF laxity
 Pt in slight plantar flexion in NWB position. Stabilize distal fibula/tibia. Grasp calcaneus.
o Talar Tilt: Test for ATF, CF, PTF laxity
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 NWB position. ATF=plantar flexion. CF=neutral. PTF=dorsiflexion.
Squeeze test: Assess for syndesmotic sprain
 Supine with knee extended. Compress tibia and fibula together.
ER Stress/Kleiger’s test: Assess for deltoid or syndesmotic sprain
 ER and Plantar flexion while grasping calcaneus= deltoid ligament
 ER and dorsiflexion= syndesmotic sprain
Windlass test: assess for planar fasciitis
 NWB or WB. Lift great toe
Thompson’s test: assess for Achilles rupture
 Prone
Homan’s sign: assess for thrombophlebitis of lower leg
 Passively dorsiflex leg while squeezing the calf
Knee:
o Lachman’s test: assess for ACL laxity.
 Supine with knee in 0-30 flexion. Stabilize femur and anteriorly translate tibia on femur
 Prone: apply anterior force to slightly flexed knee.
o Anterior Drawer: Assess for ACL laxity
 Supine with knee flexed at 80-90 flexion. Translate tibia anteriorly on femur.
o Posterior Drawer: Assess for PCL laxity
 Same as anterior but with posterior translation
o SAG or Godfrey’s test: Assess for PCL laxity
 Supine with knee and hip flexed.
o Clarke’s/Grind/Zohler’s test: Assess for chondromalacia or patellar malacia
 Supine-pt contracts quads against patellar resistance
o Varus test: Assess for LCL laxity
 Supine while applying a varus stress to the knee
o Valgus test: assess for MCL laxity
 Supine while applying a valgus stress to knee
o Apleys test: assess meniscus
 Prone with knee flexed at 90 apply downward force and rotate
o Patella Apprehension: assess for subluxing patella
 Push patella laterally and medially
o Nobles: Assess for IT band irritation
 Extend the knee while compressing IT band
o Ober’s: Assess for tight IT band
 Side lying while stabilizing the pelvis
Hip:
o Thomas test: assess for tight hip flexors
 Pull leg into trunk while laying supine
o Ely’s test: assess for tight rectus femoris
 Side-lying or prone pull heel towards buttocks
o Scour test: Assess for labral tear
 Flex hip to 90. IR and ER the hip while ABD and ADD
o Faber’s test: assess for hip/SI and labral pathology
 Cross leg and stretch adductors
o Trendelenburg: assess for weak gluteus medius
 Stand on one leg
o Piriformis: assess for tight piriformis
 70-80 flexion of knee and adduct while compressing downwards