Ankle/Foot Mobilization Techniques Case Study Using ankle/foot joint mobilizationtechniques in rehabilitation of a talar fracture
Fracture of the Talar Body• Patient is 28 year old male• Mechanism of Injury – Motor Vehicle -High Impact Injury• Patient is six weeks post op.• Cast remove one day ago.
Orthopedic Procedure• Internal Fixation with lag screws across the talar body facture to produce anatomic reduction• Fracture of the talar body must be stably fixed to restore subtalar joint congruity
Rehabilitation Objectives• Range of Motion • Muscle Strength – Restore ROM to the • Tibialis posterior ankle • Pernoneus longus & brevis Restore ROM to the • Tibialis anterior subtalar joint • Extensor hallucis longus• Restore ROM to the • Gastrocnemius metatarsophalangel • Soleus joints • Flexor digitorum
Important ConsiderationIntraarticular fracture of the talar body involving the subtalar joint may have residual loss of range motion.
Mobilization TechniquesTalocrural Subtalar Joint Anterior glide of • Inversion of Calcaneus Talus • Eversion of Calcaneus Posterior glide of • Calcaneus Distraction
Ankle Joint• Ankle Distraction good start to restore general motion at the ankle.
AnkleAnterior glide of talus restore the component motion for ankle plantar flexion & STJ supination
Ankle Joint• Posterior glide of talus• To restore component motion for ankle dorsi flexion & STJ• pronation.• Position similar to distraction except you do posterior glide of talus. See lab disc
Subtalar Joint• Calcaneal distraction – General technique to restore all motion in the STJ .
Sub Talar JointCalcaneal inversion subtalar joint inversion useful to help in restoring push of the foot
Subtalar JointCalcaneal eversion subtalar joint eversionuseful to help in storing pronation at the foot.
Mobilization Techniques• Mid- tarsal joints – Plantar& Dorsal glides of • Metatarsophalangel the cuboid & cuneiforms – Distraction Dorsal & plantar glide of – Plantar glide-flexion the navicular on talus – Dorsal glide-extension
Mid-tarsal Joint• Plantar& Dorsal glides of the cuboid & cuneiforms – Restore general mobility of the mid foot Plantar & Dorsal glides of the cuboid & cuneiforms
Mid-tarsal JointsDorsal & plantar glide of the navicular on talus. Used to improve ankle dorsi flexion and general motion at the mid foot.
Metatarsophalangel Joints• Distraction of toes restore joint play• Good initial technique for pain& movement.
Metatarsophalangel Joints• Plantar glide of the MTP, PIP and DIP – To increase flexion of the toes
Metatarsophalangel Joints• Dorsal Glide of the MTP, PIP and DIP – Useful to increase toe extension ( push off) Plantar Glide of the MTP, PIP and DIP MTP Plantar glide shown