Lab 16 - Ankle Ax & Mx

Your patient presents to your clinic with lateral ankle pain. Ask your patient 4 subjective questions.

- Any gait aids?- Specific mechanism?- Current or past orthotics experience?- Footwear? Recent change in footwear?- Pain patterns?- Really important: have you sprained your ankle before?- Ottawa ankle rules: ask about location of pain- Pain at night?

You perform an objective postural assessment on your patient. Name 4 things you are looking for.

pronation/supination, ER or IR of the foot, valgus or varus, deformities,

Palpate the following structures on your patient.Talus, styloid process of 5th MT, talocrural joint line, subtalar joint, tibio-fibular ligament (ant & post component).


Perform AROM of the ankle in both OKC and CKC positions.

OKC: AROM in supine in all motions CKC: DF - knee-to-wall PF - calf raise Pron/sup/inv/ev - standing torso twist

Your patient comes into the clinic with pain and feeling of "giving way" over the L lateral ankle. Perform 2 special tests to assess the anterior stability of the ankle.

Anterior drawer, Talar tilt (CFL).

Your patient comes into the clinic with pain and feeling of "giving way" over the L postero-lateral ankle. Perform 2 special tests to assess the postero-lateral stability of the ankle.

Posterior drawer, talar tilt (PTFL)

Your patient was playing basketball when they landed on their R leg with their foot in excessive dorsiflexion and eversion resulting in significant pain in the ankle region. What is your hypothesis for their injury? Perform a test to rule in your hypothesis.

External rotation test (TFL)

Your patient has been experiencing numbness and tingling in their foot. Perform a test to rule in/out tarsal tunnel syndrome.

Tinel's/percussion test

Your patient was a playing in a soccer game when they feel a snap and heard a pop in the back of their ankle. Perform a test to rule out an achillies tendon rupture.

Thompson test

Perform a test to rule out a syndesmosis injury

hop test (do max 10x) pos if pain

Perform 2 functional tests to assess the biomechanics of the soleus muscle.

deep squat and lunge

Perform 2 tests to assess balance and neuromuscular control of the ankles

star-excursion balance test, Romberg test, single leg balance,

Your patient experienced a grade 2 lateral ankle sprain 3 months ago and continues to experience decreased dorsiflexion. Perform a treatment technique to increase DF range and prescribe one exercise to improve DF ROM.

Mulligan glides, distraction, tib ant contract-relax with DF mobExercise: knee to wall, self mob with band, soleus stretching