FM2 - ankle

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  1. What is the evaluation procedure for the ankle?
    Observation - alignment of femur, tibia, patella

    Tracing - circumferential assessment of calf/thigh

    Knee tracking - palpate tracking at knee and at proximal ankle

    Calcaneus - Position and medial/lateral mobility ( in efficient state, calcaneus is mobile med/lat in standing with neutral WB). calcaneal weight bearing - fingers under medial/lateral calcaneus then knee bending. 

    Tibia, fibula and talus mobility during knee tracking

    Plantar surface weight bearing including during knee tracking (efficient state: no tension during palpation)

    mid foot - width

    first ray and big toe position

    first and 5th met weight bearing during knee tracking

    squatting - ability to keep heeps on floor

    balance - single leg/heel/toe

    gait assessment

    • foot posture and mobility evaluation
    • - sitting: apply VCT to confirm foot type
    • - attempt to mold foot into neutral subtalar and fore foot position
    • - retest VCT

    * note structural limitation to assume this position

    - standing: observe and define normal foot posture
  2. What is the treatment sequence for the calcaneus?
    • Calcaneal distraction:
    • - half foam under knee
    • - full ankle DF with strap
    • - REM or FMP of cranial hip shrugging

    • Calcaneal tilt:
    • - half foam can be under calcaneus to work on relative inversion or eversion, OR
    • - heel slight off edge of table, strap to full DF with strap OR with thigh
    • - FMP of resisted DF/PF
    • - FMP of resisted invert/evert
    • - STM along joint line
  3. What is the treatment sequence for posterior chain STM?
    • Fat pad:
    • - prone

    • Plantar fascia:
    • - prone with foot off EOB
    • - supine with foot off EOB
    • - acute pain; treat in shorted ROM, then progress
    • - FMP Of ankle DF/PF
    • - make sure to assess bony contour

    • achilles tendon:
    • - assess for verticality and mobility and free tendon play:
    • - sheath
    • - medial/lateral play
    • - AP/PA mobility

    - calf

    - FMP of foot circles, PROM/AROM DF/PF

    • gastroc/soleus play:
    • - bend knee and grasp gastroc
    • - hold foot in DF and extend knee to mob interface

    • soleus, posterior tib, toe flexor:
    • - with knee flexion
    • - FMP of AROM DF/PF

    • interosseous membrane:
    • - prone with knee ext with f. roll under ankle
    • - FMP fo active DF/PF
    • - sink fingers vertical then unlock
  4. What is the treatment sequence for anterior chain STM?
    • evaluate through FMP of foot circles (back porch doodling):
    • - NMC
    • - excursion
    • - muscle play
    • - bony contour of tibia¬†

    • Other evaluation for tx include:
    • - PROM DF (ease?)
    • - AROM DF/PF + foot invert/evert + toe flex/ext
    • - resisted ankle DF/PF (NMC?)
    • - bone flexibility (tibia supported by 2 f. roll. assess/tx through AP)
  5. What are the additional STM positions for foot/ankle?
    • sidelying:
    • - FMP of ankle DF/PF
    • - FMP of leg tracking

    • sitting/hooklying:
    • - FMP of armadillo
    • - goot for posterior tib

    • standing/half kneeling:
    • - gastrocsoleus, posteiror tib, TA etc
    • - patella, politeus, plantaris, fibular head
    • - FMP of knee tracking
    • - FMP of foot inevert/evert
    • - can use circumferential
    • -

Card Set Information

Author:
toshimoshi
ID:
318325
Filename:
FM2 - ankle
Updated:
2016-04-02 17:53:16
Tags:
IPA
Folders:
FM2
Description:
FM2 ankle
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