Here is a test I learned as one of the breakouts of the SFMA to test for ankle dorsiflexion. After using it more, I realized there are easy ways to make this an easy MWM and self treatment as well.
Dr. Mike Voight, who taught the SFMA course pointed me to this article. For normals, very good reliability for intra rater and inter-rater. He also stated the test has gone through other test-retest reliability testing. With mostly very repeatable results.
The test is as follows
- start in half kneel with the toes 5" away from the wall
- the other knee should be on a pad
- WNL is touching the patella to the wall
- the heel should remain on the ground
limiting factors (from most obvious to least)
- talocrural restrictions
- posterior tissue restrictions
- knee flexion
- opposite hip extension
- ipsilateral tibial IR
- fibular head anterolateral glide
Alternate test to take contralateral hip flexors out of the equation
With the testing foot on a chair you take the opposite hip flexors out of the equation but having the knee less flexed.
Self tibial IR
- while making sure the foot stays flat, the patient may grasp their tibia proximally
- turn your tissues until they stop, add a little extra pressure (to make sure you wind up to end range and not just tissue transverse play)
- hold the IR while you try to make your knee touch the wall
- repeat on and off with only a slight hold at the end range
- you can try pushing your foot toes down into the ground for an eccentric load (heel still remains flat)
- the tibial IR most likely gets some anterior gliding of the fibular head, which arthrokinematically also should help with ankle df
|Medial border of 2nd MCP blocking talar translation|
- While the patient is self mobilizing the tibia for IR use your 2nd MCP to block the talus from translating anteriorly
- this mobilizes both the tibia internally and the talus posteriorly, BAM, more functional WB MWM!
- this often gets more knees to the wall quite a bit faster making some previously slow responders into rapid responders