Evaluation-Ankle and Lower Leg

1. Evaluation-Ankle and Lower Leg Ms. Bowman

2. Anatomy Review-Bones • Talus • Tibia • Fibula • Tibia and Fibula are connected by a syndesmosis

3. Anatomy Review-Ligaments • Anterior tibiofibular ligament • Posterior tibiofibular ligament • Anterior talofibular ligament • Posterior talofibular ligament • Calcaneofibular ligament • Deltoid Ligament • Anterior tibiotalar ligament • Posterior tibiotalar ligament • Tibionavicular ligament • Tibiocalcaneal ligament

4. Anatomy Review-Muscles • Muscles of the lower leg are divided into compartments • Anterior Compartment • Tibialis anterior • Extensor hallucislongus • Extensor digitorumlongus • Lateral Compartment • Peroneus longus • Peroneus brevis • Deep Posterior Compartment • Tibialis posterior • Flexor digitorumlongus • Flexor hallucislongus • Superficial Posterior Compartment • Gastrocnemius • Soleus

5. Anatomy Review-Muscles

6. History • Onset-acute, chronic • Type of pain-how are symptoms affecting athletic participation or ADLs • MOI • Changes in activity or conditioning regimen • Pmhx

7. Inspection • Weight bearing vs. non-weight bearing • Edema • Redness • Deformity • Discoloration • Bilateral comparison • Muscle tone

8. Palpation • When palpating, check for deformity, alignment, edema, crepitus, and pain • Bones • Muscles • Ligaments • Tendons • Pulses • Posterior tibial artery • Dorsalispedis artery

9. ROM Testing • Measured with goniometer • AROM, PROM, and RROM • Dorsiflexion, Plantar Flexion, Inversion, and Eversion

10. Ligamentous Testing • Anterior Drawer Test-anterior talofibular ligament • Talar Tilt Test-Calcaneofibular ligament, anterior talofibular ligament, posterior talofibular ligament • Kleiger’s Test-Deltiod ligament, syndesmosis pathology

11. Neurological Testing • Lower quarter screen (will learn once we get to the hip) • Dermatomes • Myotomes

12. Special Testing • Bump Test • Squeeze Test • Thompson Test