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Minnesota State University, Mankato
Minnesota State University, Mankato

Manual Muscle Testing

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

Abductor Hallucis

Origin
Medial process of tuberosity of calcaneus, flexor retinaculum, plantar aponeurosis and adjacent intermuscular septum
Insertion
Medial side of base of proximal phalanx of great toe. Some fibers are attached to the medial sesmoid bone
Action
Abducts and assists in flexion of the metatarsophalangeal joint of the great toe
Nerve
Tibial, L4–5 & S1
Patient
Sitting or supine
Fixation
Grasps heel firmly
Test
Abduction of great toe from axial line of foot
Pressure
Against medial side of the first metatarsal and proximal phalanx
See Test

Flexor Digitorum Brevis

Origin
Medial process of the calcaneal tuberosity, central part of plantar aponeurosis and adjacent intermuscular septa
Insertion
Middle phalanx of digits two through five
Action
Flexes the proximal interphalangeal joints and assists in flexion of the metatarsophalangeal joints of second through fifth digits
Nerve
Tibial, L4–5 & S1
Patient
Sitting or supine
Fixation
Stabilization of proximal phalanges with foot and ankle in neutral position
Test
Flexion of the proximal interphalangeal joints of the second through fifth digits
Pressure
Against the plantar surface of the middle phalanx of digits two through five in direction of extension
See Test

Flexor Hallucis Longus

Origin
Posterior surface of distal two thirds of fibula, interosseus membrane and adjacent intermuscular septa and fascia
Insertion
Base of distal phalanx of great toe on plantar surface
Action
Flexes the interphalangeal joint of the great toe and assists in flexion of the metatarsophalangeal joint, plantar flexion of the ankle and inversion of the foot
Nerve
Tibial, L5 & S1–2
Patient
Sitting or supine
Fixation
Stabilization of metatarsophalangeal joint with foot and ankle in neutral position
Test
Flexion of the interphalangeal joint of the great toe
Pressure
Against the plantar surface of the distal phalanx in direction of extension
See Test

Flexor Digitorum Longus

Origin
Middle three fifths of the posterior surface of the tibia from the fascia covering the tibialis posterior
Insertion
Bases of the distal phalanges of digits two through five
Action
Flexes the proximal and distal interphalangeal joints and metatarsophalangeal joints of second through fifth digits and assists in plantar flexion of the ankle and inversion of the foot
Nerve
Tibial, L5 & S1–2
Patient
Sitting or supine, knee flexed if gastrocnemius is tight
Fixation
Stabilization of metatarsals with foot and ankle in neutral position
Test
Flexion of the distal interphalangeal joints of the second through fifth digits the flexor digitorum is assisted by the quadratus plantae
Pressure
Against the plantar surface of the distal phalanx of digits two through five in direction of extension
See Test

Extensor Digitorum Longus

Origin
Lateral condyle of the fibula, proximal three fourths of the anterior surface of the body of the fibula, proximal part of the interosseous membrane, adjacent intermuscular septa and deep fascia
Insertion
Bbases of the middle and distal phalanges of digits two through five
Action
Extends the metatarsophalangeal joints and assists in extension of the interphalangeal joints of second through fifth digits and assists in dorsiflexion of the ankle and eversion of the foot
Nerve
Peroneal, L4–5 & S1
Patient
Sitting or supine
Fixation
Stabilization of foot in slight plantarflexion
Test
Extension of all joints of the second through fifth digits
Pressure
Sgainst the dorsal surface of the toes in direction of flexion
See Test

Extensor Digitorum Brevis

Origin
Distal portion of superiolateral portion of the calcaneus, lateral talocalcaneal ligament and apex of the inferior extensor retinaculum
Insertion
On the proximal phalanx of the great toe and the distal phalanges of toes two through four
Action
Extends the metatarsophalangeal joints and assists in extension of the interphalangeal joints of first through fourth digits and assists in extending the interphalangeal joints of toes two through four
Nerve
Deep Peroneal, L4–5 & S1
Patient
Sitting or supine
Fixation
Stabilization of foot in slight plantarflexion
Test
Extension of all joints of the second through fifth digits
Pressure
Sgainst the dorsal surface of the toes in direction of flexion
See Test

Extensor Hallucis Longus & Brevis

Origin of Longus
Middle half of anterior surface of the fibula and adjacent interosseous membrane
Origin of Brevis
Distal part of superior and lateral surfaces of the calcaneus, lateral talocalcaneal ligament and apex of the inferior extensor retinaculum
Insertion
Dorsal surface of base of proximal phalanx of great toe
Action
Extends the metatarsophalangeal joint of the great toe
Nerve
Deep Peroneal, L4–5 & S1
Patient
Sitting or supine
Fixation
Stabilization of foot in slight plantar flexion
Test
Extension of the metatarsophalangeal and interphalangeal joints of the great toe
Pressure
Against the dorsal surface of the distal and proximal phalanges in direction of flexion
See Test

Tibialis Anterior

Origin
Lateral condyle and proximal half of the lateral surface of the tibia, interosseous membrane, deep fascia & lateral intermuscular septum
Insertion
Medial and plantar surface of medial cuneiform bone, base of the first metatarsal bone
Action
Dorsiflexes the ankle joint & assists in inversion of the foot
Nerve
Deep peroneal, L4–5 & S1
Patient
Sitting or supine
Fixation
Examiner supports leg just above ankle
Test
Dorsiflexion of the ankle with inversion of the foot
Pressure
Against the medial side, dorsal surface of the foot, in direction of plantarflexion of the ankle & eversion of the foot
See Test

Tibialis Posterior

Origin
Most of the interosseous membrane, lateral portion of the posterior surface of the tibia, proximal 2/3 of the medial surface of the fibula, adjacent intermuscular septa & deep fascia
Insertion
Tuberosity of the navicular & by fiberous expansions to the sustentaculum tali, three cuneiforms, cuboid & bases of the second through fourth metatarsals
Action
Inversion of the foot & assists with plantarflexion of the ankle
Nerve
Tibial, L4–5 & S1
Patient
Sitting or supine with extremity in lateral rotation
Fixation
Examiner supports leg just above ankle
Test
Inversion of the foot with plantarflexion of the ankle
Pressure
Against the medial side & plantar surface of the foot, in direction of dorsiflexion of the ankle & eversion of the foot
See Test

Peroneus Longus

Origin
Lateral condyle of the tibia, head & proximal 2/3 of the lateral surface of the fibula, intermuscular septa & adjacent deep fascia
Insertion
Lateral side of the base of the first metatarsal
Action
Eversion of the foot, depresses the first metatarsal & assists with plantarflexion of the ankle
Nerve
Superficial peroneal, L4–5 & S1
Patient
Sitting or supine with extremity in medial rotation
Fixation
Examiner supports leg just above ankle
Test
Eversion of the foot with plantarflexion of the ankle
Pressure
Against the lateral border & plantar surface of the foot, in direction of inversion of the foot & dorsiflexion of the ankle
See Test

Peroneus Brevis

Origin
Distal 2/3 of the lateral surface of the fibula & adjacent intermuscular septa
Insertion
Lateral side of the base of the fifth metatarsal
Action
Eversion of the foot & assists with plantarflexion of the ankle
Nerve
Superficial peroneal, L4–5 & S1
Patient
Sitting or supine with extremity in medial rotation
Fixation
Examiner supports leg just above ankle
Test
Eversion of the foot with plantarflexion of the ankle
Pressure
Against the lateral border & plantar surface of the foot, in direction of inversion of the foot & dorsiflexion of the ankle
See Test

Soleus

Origin
posterior surfaces of the head of the fibula and proximal 1/3 of its body, soleal line and middle 1/3 of the medial border of the tibia & tendinous arch between the tiia and fibula
Insertion
With the tendon of the gastrocnemius (achilles tendon), into the posteior surface of the calcaneus
Action
Plantarflexion of the ankle
Nerve
Tibial, L5 & S1–2

Soleus 1

Patient
Prone with knee flexed to 90°
Fixation
Examiner supports leg just proximal to ankle
Test
Plantarflexion of the ankle
Pressure
Against the plantar surface of the foot, in direction of dorsiflexion of the ankle
See Test

Soleus 2

Patient
Prone with knee flexed to 90°
Fixation
None
Test
Plantarflexion of the ankle
Pressure
Against the plantar surface of the foot, in direction of dorsiflexion of the ankle & cupping the calcanues, providing resistance in the direction of dorsiflexion
See Test

Gastrocnemius

Origin of Medial Head
Proximal & posterior part of the medial epicondye and adjacent part of the femur, capsule of knee joint
Origin of Lateral Head
Lateral condyle and posterior surface of femur, capsule of knee joint
Insertion
Into the middle part of the posteior surface of the calcaneus
Action
Plantarflexion of the ankle
Nerve
Tibial, & S1–2

Gastrocnemius

Patient
Standing on two feet
Fixation
None
Test
Plantarflexion of the ankle bilaterally
Pressure
Body weight and gravity
See Test

Gastrocnemius 2

Patient
Standing on two feet
Fixation
None
Test
Plantarflexion of the ankle bilaterally
Pressure
Against shoulders bilaterally in the direction of dorsiflexion, body weight and gravity
See Test

Gastrocnemius 3

Patient
Single leg stance
Fixation
None
Test
Plantarflexion of the ankle
Pressure
Body weight and gravity
See Test