The document describes the procedures for measuring range of motion of the knee, ankle, and subtalar joint using a goniometer, including starting position, ending position, normal range of motion, precautions, and factors that can limit motion. Precautions include preventing unwanted movement at adjacent joints, while factors limiting motion include tension in relevant muscles and ligaments or bone contact. Standard range of motion values are provided for flexion, extension, plantarflexion, dorsiflexion, and inversion/eversion.

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.