1. Knee & Ankle Goniometry
By: Dr. Gehan Shaalan
Physical Therapy Lecturer BMC

2. 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

3. Knee Flexion
Precaution
 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.

4. 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.

5. Knee Extension
Precaution
 Prevent hip rotation and flexion.
Factors limiting motion
 Tension of knee flexor muscles.
 Tension of cruciate ligament.
 Tension collateral ligament

6. Ankle Dorsi Flexion
Starting 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.

7. Ankle Dorsi Flexion
Precaution
 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

8. 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

9. Ankle Plantar Flexion
Precaution
 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

10. Subtalar Inversion
Starting 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

11. Subtalar Inversion
Precaution
 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.

12. Subtalar Eversion
Starting 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

13. Subtalar Eversion
Precautions
 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.