FUNCTIONAL OBSERVATION ■ Walk on toes – check heel alignment ■ Walk on heels – check forefoot position ■ Squat and rise – is weight evenly distributed ■ Stand on each foot in turn – does the patient appear equally easy on each foot
■ Balance on each foot in turn with eyes open and eyes closed – again look for bias to one side
■ Hop on each foot in turn – look for preference to one side or whether there is a marked improvement on one side
■ Kneel down with feet in plantar flexion and sit back on heels - look for bias to one side or inability to perform at all.
OBJECTIVE MEASUREMENT Joint mobility – Dorsiflexion - 15 to 20o – Plantarflexion – 40 to 60o – Inversion (ankle/subtalar movement) – 20 to 30o – Eversion (ankle/subtalar movement) – 10 to 25o
Ligament muscle strength tests There are many tests which can be performed on and around the ankle joint. As this article is specifically looking at the ankle, the following tests are to show ankle joint disruption and not foot or lower limb problems – see Boxes 1&3.
Always perform all tests on both ankles, and be aware many peo- ple may have history of frequent ankle sprains affecting one or
both legs. It can be difficult to establish a norm in such cases and is best to look at range of non presenting injured joint and assume the involved joint was near to that range as well. If all else fails examine both joints passively and note your findings of end range pain free and check strength of muscles and compare. Never be afraid to send for further testing or Xray.
Further reading/references 1. Watt J. What’s Your Problem? A Ready Reckoner to Patient Assessment. sportEX dynamics 2007;(Jan)11:8-9 2. Watt J. Knee Joint Assessment. sportEX dynamics 2007;(Apr)12:14-15
THE AUTHOR Joan Watt, MCSP, MSMA is a chartered physiotherapist and sports massage practitioner. She has worked at numerous Olympic and Commonwealth games, continues to travel widely as both a practi- tioner as well as a manager and is currently manager of the GB Shooting team.
ASSESSMENT TIP
It’s always a good idea to compare right to left ankles when measuring to ensure accuracy and hopefully establish the norm for that person. Also check active movement first and then passive range as well. In the ankle joint it is not uncommon to discover the patient is loath to go into end range because of previous injury