The Half Kneel Ankle DF Test | Modern Manual Therapy Blog

The Half Kneel Ankle DF Test

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 Treatment

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
Treatment Combo
  • 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


  1. Sheena Whitmire, PTASeptember 26, 2012 at 6:49 PM

    I have a patient who had an ORIF s/p 4 months. I can get 20 degrees of DF with the knee bent but 5-8 at best with the knee straight. I have done every stretch and manual technique in the book but I can not get more DF with the knee straight. He also has about 15 degrees of genu recruvatum. Any ideas as to what may improve DF with full extension of the knee?


  2. What is every technique in the book? Have you tried measuring df like above? It's more functional. What is the patient doing for HEP? Strict compliance is key with manual therapy, it's mostly up to the patient, we just get them moving a bit better.

  3. Sheena Whitmire, PTASeptember 26, 2012 at 11:00 PM

    Yes I did measure as above. He is limited. He reports compliance with HEP and works out at the gym 5x a week in addition. He has a benign bone tumor as well. Not sure if this complicates the condition

  4. Janath Samira KasthuriarachchiOctober 23, 2013 at 8:41 AM

    Quick Question, but by using this test, how can you differentiate between a joint restriction, and a muscular restriction?
    If you measured ankle ROM in supine, you could compare AROM and PROM, and have some sort of idea of what the restriciton is a result of. But, as probably highlighted already, ankle ROM in supine isnt functional

  5. I do not differentiate as when we make rapid changes in any area, it's not true tissue or capsular restriction, but neurophysiologic changes centrally that releases the ROM peripherally. I call it motion dysfunction. When something really is capsular or needs true tissue deformation (think frozen shoulder or status post immobilization) no amount of mobilization will improve ROM rapidly. This is just a test for movement compentency, not to rule in a out tissues. Over the weekend, I took a course where the speaker just asked patients, "Where do you feel the tightness?" - If it was posterior, he would work on tissues, if around the talocrural area, he would work on the joint. I think that's fair, but perception again is dictated by and large of the CNS perception of the area.