History

• Past history
• Present history

Inspection

• Deformity
• Swelling

Palpation

• Medial malleolus

  (Deltoid ligament)

  Tibialis posterior tendon

  Flexor digitorum longus tendon

  (Tibial nerve)

  Posterior tibial artery

  (Flexor hallucis longus tendon)

• Lateral malleolus

  (Anterior talofibular ligament)

  (Calcaneofibular ligament)

  (Posterior tibiofibular ligament)

  Sinus tarsi

  Peroneus longus tendon

  Peroneus brevis tendon

  Peroneal tubercle

• Anterior

  Distal tibiofibular joint area

  Dome of talus

  Tibialis anterior tendon

  Extensor digitorum longus tendon

  Extensor hallucis tendon

  Dorsalis pedis

  Sensation distribution for deep peroneal nerve

• Posterior

  Achilles tendon

  Retrocalcaneal bursa

  Calcaneus

Testing

• AROM

  Dorsiflexion - changes...depends on what?

  Plantarflexion

  Inversion

  Eversion

  Forefoot adduction

  Forefoot abduction

  Supination (combination of which movements?)

  Pronation (combination of which movements?)

• RROM

  Dorsiflexion

  Plantarflexion

  Eversion

  Inversion

• PROM

  Dorsiflexion (20°)

  Plantarflexion (50°)

  Eversion (5°)

  Inversion (5°)

• MMT

  Tibialis anterior

  Extensor digitorum longus

  Extensor hallucis longus

  Peroneus brevis/longus

  Gastrocnemius

  Soleus

  Tibialis posterior

  Flexor digitorum longus

  Flexor hallucis longus

• Neurological exam

  “Break” tests

  Dermatome (L4-S1)

  Achilles tendon reflex (S1)

• Vascular exam

  Posterior tibial pulse

  Dorsalis pedis pulse

• Orthopedic tests

  Percussion

  Malleolar compression

  Anterior drawer

  Talar tilt

  Rotation drawer

  Tibial torsion