Special Tests For the Lower Leg and Ankle

  • Slides: 20
Download presentation
Special Tests For the Lower Leg and Ankle Mike Boisselle Geared Towards Athletic Training

Special Tests For the Lower Leg and Ankle Mike Boisselle Geared Towards Athletic Training Students

Special Tests �Specific procedures applied to determine the presence of pathomechanics �Unique to each

Special Tests �Specific procedures applied to determine the presence of pathomechanics �Unique to each structure, joint, or body part �Bilateral Comparison

Keep In Mind While Performing Special Tests ²Anatomy ²Isolate ²Stabilize ²Bilateral comparison ²Patient position

Keep In Mind While Performing Special Tests ²Anatomy ²Isolate ²Stabilize ²Bilateral comparison ²Patient position ²Positive signs ²Medical Emergencies

Homan’s Sign • Patient is in supine position, in knee extension • Dorsiflex patient

Homan’s Sign • Patient is in supine position, in knee extension • Dorsiflex patient and squeeze gastroc • Positive sign-pain • Pain indicating thrombophlebitis MEDICAL EMERGENCY

Anterior Drawer Test �Patient seated legs over table �Stabilize distal tibia and fibula �Apply

Anterior Drawer Test �Patient seated legs over table �Stabilize distal tibia and fibula �Apply anterior force to calcaneus �Positive test: pain and/or laxity �Indicating anterior talofibular ligament sprain

Talar Tilt (Inversion) �Patient sitting with legs over table �Stabilize distal tibia, and grasp

Talar Tilt (Inversion) �Patient sitting with legs over table �Stabilize distal tibia, and grasp talus �Tilt the talus into adduction �Pain and/or laxity indicates calcaneofibular ligament damage

Talar Tilt (Eversion) �Patient sitting with legs over table �Stabilize distal tibia, and grasp

Talar Tilt (Eversion) �Patient sitting with legs over table �Stabilize distal tibia, and grasp calcaneus �Tilt the calcaneus into abduction �Pain and/or laxity indicates deltoid ligament damage

Thompson Test �Patient prone on table with heels off edge �Examiner squeezes muscle belly

Thompson Test �Patient prone on table with heels off edge �Examiner squeezes muscle belly of gastrocnemius-soleus complex �Normal response is slight plantar flexion �Absence of plantar flexion indicates Achilles tendon rupture

Tap or Percussion Test �Patient sitting with feet over tables edge �Passively dorsiflex patient

Tap or Percussion Test �Patient sitting with feet over tables edge �Passively dorsiflex patient �Apply a firm tap to patients heel �Pain is indicative of possible fracture

Feiss Line �Patient seated legs over table �Draw a dot on medial malleolus, and

Feiss Line �Patient seated legs over table �Draw a dot on medial malleolus, and first MTP joint �Draw a line connecting dots �Observe the navicular tubercle �Weight bearing and non weight bearing

Feiss Line (continued) �Non weight bearing navicular drop �Indicates congenital pes planus �Weight bearing

Feiss Line (continued) �Non weight bearing navicular drop �Indicates congenital pes planus �Weight bearing navicular drop �Indicates functional pes planus

Interdigital Neuroma Test �Patient seated with legs over table �Squeeze the metatarsal heads together

Interdigital Neuroma Test �Patient seated with legs over table �Squeeze the metatarsal heads together 3 minutes �Pain, tingling, numbness in the foot, toe or ankle �Positive test indicating interdigital neuroma

Compression Test �Patient sitting feet just over edge �Compress the tibia and fibula �Start

Compression Test �Patient sitting feet just over edge �Compress the tibia and fibula �Start away from pain, work towards �Pain may indicate fracture

That cannot be right…

That cannot be right…

Kleiger’s Test �Patient sitting at edge of table �Stabilize distal tibia and fibula �Grasp

Kleiger’s Test �Patient sitting at edge of table �Stabilize distal tibia and fibula �Grasp calcaneus �Dorsiflex and externally rotate �Pain or laxity indicates syndesmosis sprain

Tinel’s Sign �Patient sits with feet at edge of table �Tap posterior tibial nerve

Tinel’s Sign �Patient sits with feet at edge of table �Tap posterior tibial nerve on medial side �Positive test- radiating pain and tingling �Indicative of tarsal tunnel syndrome

The Ankle Lower Leg Bones Ankle joint isThe Ankle Lower Leg Bones Ankle joint is
FOOT AND ANKLE SPECIAL TESTS SPECIAL TESTS UsedFOOT AND ANKLE SPECIAL TESTS SPECIAL TESTS Used
FOOT ANKLE AND LOWER LEG Care and PreventionFOOT ANKLE AND LOWER LEG Care and Prevention
Chapter 19 The Ankle and Lower Leg FunctionalChapter 19 The Ankle and Lower Leg Functional
Chapter 15 The Ankle and Lower Leg BonesChapter 15 The Ankle and Lower Leg Bones
Ankle and Lower Leg Rehabilitation 2010 Mc GrawHillAnkle and Lower Leg Rehabilitation 2010 Mc GrawHill
Lower Leg and Ankle Injuries Shin Splints MedialLower Leg and Ankle Injuries Shin Splints Medial
The Ankle and Lower Leg Injuries Prevention HeelThe Ankle and Lower Leg Injuries Prevention Heel
Unit 23 The Ankle and Lower Leg 2005Unit 23 The Ankle and Lower Leg 2005
Injuries to the Lower Leg Foot and AnkleInjuries to the Lower Leg Foot and Ankle
Lower Leg and Ankle Walking Gait l StanceLower Leg and Ankle Walking Gait l Stance
Chapter 15 The Ankle and Lower Leg InjuriesChapter 15 The Ankle and Lower Leg Injuries
The Foot Ankle and Lower Leg FALL UnitThe Foot Ankle and Lower Leg FALL Unit
Chapter 19 The Ankle and Lower Leg 2011Chapter 19 The Ankle and Lower Leg 2011
The Ankle and Lower Leg Injuries Prevention HeelThe Ankle and Lower Leg Injuries Prevention Heel
Ankle and Lower Leg Do Now What doAnkle and Lower Leg Do Now What do
Injuries to the Lower Leg Foot and AnkleInjuries to the Lower Leg Foot and Ankle
THE FOOT ANKLE AND LOWER LEG CHAPTER 17THE FOOT ANKLE AND LOWER LEG CHAPTER 17
Lower Leg and Ankle Injuries Shin Splints MedialLower Leg and Ankle Injuries Shin Splints Medial