Manual Therapy

11-9-09

"Infamous Ankle"
"You Don't Have Weak Ankles, You Have Stupid Ankles"
-Martyn Matthews

Week 7 in Manual therapy brings us to the ankle joint. Like the previous Monday's in manual therapy, we go over basic anatomy of the joint(i.e. bones, muscles, ligaments and other joints). The ankle joint(talocrural joint) is a synovial hinge joint meaning that it can move in two directions; plantar flexion or dorsiflexion. Another joint within the ankle and foot would be the subtalar joint. This is a plane synovial joint also known as a uniaxial hinge joint. The motion's that come from this joint are eversion and inversion. Next, we look at the mid-tarsal joints: talocalcaneofibular and calcaneocuboid. The functional motion for these joints would be to dorsiflex, plantarflex, invert, evert, abduct and adduct.

Now that we know the different joints within the ankle/foot joint we can go ahead and apply different mobilisations to regain ROM of these joints or help reduce pain.

There are 14 different mobilisations to choose from when dealing with a patient with an ankle problem.

Subtalar eversion mobilisation








Midtarsal supination mobilisation








plantarflexion mobilisation








PA of talus mobilisation








Dorsiflexion mobilisation








Subtalar inversion mobilisation








Intertarsal PA mobilisation








Midtarsal PA mobilisation








Midtarsal pronation mobilisation








Midtarsal AP mobilisation







PA of Tibia mobilisation

Intertarsal AP mobilisation







AP of Talus mobilisation









AP of tibia mobilisation



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We went on to learn 10 deep transverse frictions that were applied to:
-deltoid ligament
-anterior talo-fibular ligament
-calcaneo-fibular ligament
-gastrocnemius muscle
-tendo-calcaneus tendinits
-tendo-calcaneus tendinitis( teno-osseous-calcaneus)
-tendo-calcaneus tenitis(lateral aspect of tendon)
-peroneus longus tendon
-peroneal tendons behind malleolus

Finally, we learn one manipulation that is applied when there is a chronic talo-fibular ligament sprain.