Ankle and foot special tests
- Anterior drawer test
- Patient supine with foot off the edge of the mat; ankle in 20 degrees of plantarflexion; therapist translates the talus anteriorly while stabilizing the lower leg
- Tests the integrity of the anterior talofibular ligament
- Positive: excessive anterior talar translation and/or pain
- Patient supine with foot off the edge of the mat; ankle in 20 degrees of plantarflexion; therapist translates the talus anteriorly while stabilizing the lower leg
- Talar tilt
- Patient sitting with the knee bent and ankle relaxed in neutral to 20 degrees plantarflexion; therapist stabilizes the distal tibia and moves the foot into adduction (calcaneofibular ligament) and abduction (deltoid ligament)
- Tests the integrity of the calcaneofibular and deltoid ligaments
- Positive: laxity and/or pain
- Patient sitting with the knee bent and ankle relaxed in neutral to 20 degrees plantarflexion; therapist stabilizes the distal tibia and moves the foot into adduction (calcaneofibular ligament) and abduction (deltoid ligament)
- Thompson’s test
- Patient prone with foot off the edge of the mat; therapists squeeze calf muscle (ankle should plantarflex)
- Tests the integrity of the Achilles tendon
- Positive: no movement of the foot
- Red flag: suggests Achilles tendon rupture - stop and report to the supervising PT for prompt physician or orthopedic referral
- Patient prone with foot off the edge of the mat; therapists squeeze calf muscle (ankle should plantarflex)
- Windlass test
- Weight bearing: patient stands with toes over the edge of a step while the examiner passively dorsiflexes the first metatarsophalangeal (MTP), or big toe, joint
- Non-weight bearing: patient seated with knee flexed to 90 degrees while the examiner stabilizes the ankle and passively dorsiflexes the first MTP joint
- Both positions test for the presence of plantar fasciitis
- Positive: reproduction of plantar surface pain, or the joint does not extend
The pathophysiology, clinical presentation, and intervention considerations for these lower extremity conditions are covered in the next chapter, Comparing clinical presentation and interventions of lower extremity.