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Minnesota State University, Mankato
Minnesota State University, Mankato

Foot/Ankle/Low Leg Evaluation Module

Page address: http://ahn.mnsu.edu/athletictraining/spata/footanklemodule/

Bony Anatomy

Subjective/History

Determine 6: activity, MOI, location of pain, type of pain, severity of pain, onset of pain, unusual sounds/ sensations, actions that increase & decrease pain, S/S, change in S/S over time, prior injury/ surgery, family history & general medical health

Objective

Inspection 1,6:

General: swelling, discoloration, deformity, muscle symmetry/atrophy, foot type (pes cavus, pes planus)

Skin: callus, blisters, discoloration, open wounds, scars& skin infections

Toes: number, Morton's alignment, claw toes, hammer toe, hallux valgus, bunion, corns, ingrown toenail, subungual hematoma

Medial View: medial longitudinal arch

Lateral View: fifth metatarsal

Dorsal View:

Plantar View: plantar warts, transverse metatarsal arch

Foot Alignment: forefoot varus/valgus, rearfoot varus/valgus

Shoe: wear pattern

Postural Assessment:

Gait Assessment:

Foot, Ankle & Lowleg Palpation Rollover: using internet explorer rollover the images to trace some anatomy of the foot, ankle and lowleg

Bony Palpation 1: first– fifth metatarsophalaneal joints, first– fifth metatarsals, first metatarsocunieform, first– third cunieforms, navicular tubercle, head of talus, medial malleolus, sustentaculum tali, medial tubercle of talus, calcaneus, styloid process at base of fifth metatarsal, cubiod tubercle, peroneal tubercle, lateral malleolus, talar dome, inferior tibiofibular joint, medial tubercle, sesamoid bones, metatarsal heads

Soft Tissue Palpation 1: deltoid ligament (anterior tibiotalar ligament, tibionavicular ligament, tibiocalcaneal ligament & posterior tibiotalar ligament), tibialis posterior tendon, flexor digitorum longus tendon, posterior tibial artery, tibial nerve, flexor hallucis longus tendon, tibialis anterior tendon, extensor hallucis longus tendon, extensor digitorum longus tendon, dorsal pedal artery, anterior talofibular ligament, calcaneofibular ligament, posterior talofibular ligament, peroneus longus & brevis tendons, extensor digitorun brevis muscle, retrocalcaneal bursa, calcaneal bursa, plantar fascia (plantar aponeurosis)

Range of Motion 1,5:

AROM: ankle dorsiflexion, ankle plantarflexion, subtalar eversion, subtalar inversion, MTP flexion, MTP extension

PROM: ankle dorsiflexion with knee bent (20°), ankle plantarflexion (50°), subtalar eversion (5°), subtalar inversion (5°), forefoot adduction (20°), forefoot abduction (10°), first MTP flexion (45°), first MTP extension (70–90°)

RROM: ankle dorsiflexion, ankle plantarflexion, eversion, inversion, MTP flexion, MTP extension

Neurovascular Exam

Manual Muscle Testing 2:

Abductor Hallucis, Flexor Digitorum Brevis, Flexor Hallucis Longus, Flexor Digitorum Longus, Extensor Digitorum Longus, Extensor Digitorum Brevis, Extensor Hallucis Longus & Brevis, Tibialis Anterior, Tibialis Posterior, Peroneus Longus, Peroneus Brevis, Sloeus, Gastrocnemius, Popliteus

Special Tests 3,7:

Anterior Drawer, Heel Tap, Squeeze, Varus–Valgus Stress, Tinel's Sign, Thompson's, Supple Pes Planus, Side–to–Side, Percussion, Navicular Drop, Kleiger's, Inversion Talar Tilt, Eversion Talar Tilt, Intermetatarsal Glide, Interdigital Neuroma, Homan's Sign, Fracture, Feiss' Line

Assessment

Identifies examiner's impression of injury & potientally complicating factors based on subjective & objective information

Plan

Explains examiner's goals as well as how the examiner intends on meeting these goals through initial management, treatment, rehabilitation