mike boisselle geared towards athletic training students
TRANSCRIPT
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Special Tests For the Lower Leg and Ankle
Mike BoisselleGeared Towards Athletic Training Students
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Special Tests
Specific procedures applied to determine the presence of pathomechanics
Unique to each structure, joint, or body part
Bilateral Comparison
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Keep In Mind While Performing Special Tests
AnatomyIsolateStabilizeBilateral comparisonPatient positionPositive signsMedical Emergencies
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Homan’s Sign
•Patient is in supine position, in knee extension
•Dorsiflex patient and squeeze gastroc
•Positive sign-pain
•Pain indicating thrombophlebitis MEDICAL
EMERGENCY
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Anterior Drawer TestPatient seated legs over
tableStabilize distal tibia and
fibulaApply anterior force to
calcaneusPositive test: pain
and/or laxityIndicating anterior
talofibular ligament sprain
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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
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Talar Tilt (Eversion)Patient sitting with legs
over tableStabilize distal tibia, and
grasp calcaneusTilt the calcaneus into
abductionPain and/or laxity
indicates deltoid ligament damage
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Thompson TestPatient prone on table with
heels off edgeExaminer squeezes muscle
belly of gastrocnemius-soleus complex
Normal response is slight plantar flexion
Absence of plantar flexion indicates Achilles tendon rupture
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Tap or Percussion TestPatient sitting with feet
over tables edgePassively dorsiflex patientApply a firm tap to
patients heelPain is indicative of
possible fracture
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Feiss LinePatient 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
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Feiss Line (continued)Non weight bearing
navicular dropIndicates congenital
pes planus
Weight bearing navicular drop
Indicates functional pes planus
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Interdigital Neuroma TestPatient seated with legs
over tableSqueeze the metatarsal
heads together 3 minutes
Pain, tingling, numbness in the foot, toe or ankle
Positive test indicating interdigital neuroma
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Compression TestPatient sitting feet just
over edge
Compress the tibia and fibula
Start away from pain, work towards
Pain may indicate fracture
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That cannot be right…
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Kleiger’s TestPatient sitting at edge of
table
Stabilize distal tibia and fibula
Grasp calcaneus
Dorsiflex and externally rotate
Pain or laxity indicates syndesmosis sprain
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Tinel’s SignPatient sits with feet at edge
of tableTap posterior tibial nerve on
medial sidePositive test- radiating pain
and tinglingIndicative of tarsal tunnel
syndrome