Ankle Assessment Standing- 4 Lefts Looking for Hallux Valgus, bunion, hyper extended knees, scars, symmetrical muscle

e definition, Achilles tendon and the arch of the feet.

Plinth Check temp- inside/inside outside/outside Swelling (behind malleolus) Tissue slide- across front of ankle (Talus)

Active Movements Dorsiflexion/Plantarflexion Inversion/Eversion

Passive Movements- Joints (Always moving prox->distal) Ankle Joint Plantar Flexion Throttle grip around neck of talus and pull towards you with hand on calcaneus pushing up. Dorsi Flexion Hand remains on calcaneus, heel of other hand on MT heads. Push up on MT heads and pull down on calcaneus. When you reach limit ask pt to slightly unlock knee to check gastrocs is intact and then flex knee to approx 45*.

Subtalar Joint Inversion & Eversion- Knee remains flexed to keep dorsiflexion and sole of foot placed on chest for support. Hands under Calcaneus and elbows @ 9+3 position to start. Then move to 8+2 position for Inversion and 10+4 for Eversion. Support knee when returning leg back to plinth.

Midtarsal Joint One hand under calcaneus, other pincher grip to lateral border of base of 5 th metatarsal of foot with finger across foot pointing to medial malleolus. Foot is clamped in web space of hand. Stabilise rear foot by pulling down on calcaneus. Carry out longitundinal Caudad + Cephaplat, Inversion + Eversion, Abduction + Adduction. *Checking capsular pattern

Passive Movements- Ligaments Ankle Ligaments Plantar flex + invert (throttle grip on anterior talus) Testing Anterior TaloFibular Ligament Plantar flex + Evert (throttle grip on anterior talus) Dorsiflex + Invert (pincher grip) Dorsiflex + evert (pincher grip) Other hand always under calcaneus

Test for Calcaneocuboid ligament Find base of 5th MT, pincher grip around foot. Apply traction-> Caudad, Inversion and adduction

Resisted Movements Dorsiflexion- hand pushing on calcaneus and pulling on mid foot Plantarflexion- hand pulling on calcaneus and pushing on plantar side of head of MT Eversion- handing under calcaneus and pincher grip on mid foot. Try to turn sole in. Inversion- swop hands, under calcaneus and pincher on mid foot. Try to turn sole out.