Knee Flexion Starting Position: Patient should be supine with both legs flat on the table. The fulcrum is aligned with the lateral epicondyle of the femur. The stationary arm is in line with the greater trochanter and midline of the femur, the moving arm with the lateral malleolus and midline of the fibula. Ending Position: Goniometer positioning is same as above. Normal ROM is 135
Knee FlexionPrecaution 1-Prevent hip rotation, adduction and abduction. 2-Hip flexed to 90 degrees only to prevent stretching of the rectus femoris muscle.Factors limiting motion Tension of muscles of knee extension ( quadriceps muscles) Contact of bulk of calf muscles of posterior leg with posterior thigh.
Knee Extension Starting and Ending Position: The patient should be lying prone with both legs flat on the table. The goniometer positioning for knee extension is the same as it is for knee flexion. Normal ROM for knee extension is between 0 and –10 degrees. The patient has –3 degrees of knee extension.
Knee ExtensionPrecaution Prevent hip rotation and flexion.Factors limiting motion Tension of knee flexor muscles. Tension of cruciate ligament. Tension collateral ligament
Ankle Dorsi FlexionStarting Position Patient is supine with legs off the table. The fulcrum is aligned with the lateral malleolus. The stationary arm is in line with the midline of the lower leg; use the head of the fibula for reference. The moving arm is parallel to the fifth metatarsal. Note: Once again remember that the goniometer will be at 90 degrees and to adjust for that when recording the angles.Ending Position: Same as above Normal ROM for dorsiflexion is between 0 and 20 degrees.
Ankle Dorsi FlexionPrecaution Avoid eversion and inversion. Avoid motion of hip and knee.Factors limiting motion Tension of peroneus muscles. Contact of lateral bones medially. Tension of the lateral tarsal ligaments
Ankle Plantar Flexion Starting Position and Ending Position: Patient is sitting with legs off table. Goniometer alignment is the same as for dorsiflexion. Normal ROM is 45 degrees
Ankle Plantar FlexionPrecaution Prevent hip rotation Avoid forefoot flexion. Prevent inversion and eversion of the foot.Factors limiting motion Tension of the dorsiflexor muscles of ankle. Contact of posterior portion of talus with tibia. Tension of ligaments:a) anterior talofibular.b) Anterior fiber of deltoid ligament
Subtalar InversionStarting and Ending Position: The patient should be lying prone with foot hanging off the table. The fulcrum is placed between the two malleoli. The stationary arm is aligned with the midline of the leg and the moving arm with the midline of the calcaneus The ROM is from 0 - 30 degrees
Subtalar InversionPrecaution Prevent medial rotation of the knee. Prevent lateral rotation and abduction of the hip. Allow ankle joint plantar flexion.Factors Limiting ROM Contact of tarsal bones medially. Tension of eversion muscles ( peroneal group) Tension of lateral tarsal ligament.
Subtalar EversionStarting and Ending Position: The patient should be lying prone with foot hanging off the table. The fulcrum is placed between the two malleoli. The stationary arm is aligned with the midline of the leg and the moving arm with the midline of the calcaneus. The ROM is from 0 - 25 degrees
Subtalar EversionPrecautions Prevent lateral rotation of knee. Prevent medial rotation and abduction of the hip. Allow dorsiflexion at the ankle.Factors Limiting ROM Contact of tarsal bones laterally. Tension of muscles of inversion tibialis posterior. Tension of medial tarsal ligaments.