Term
What is the draw sign?
What is a positive and what does it mean? |
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Definition
It is a drawer test of the ankle.
Positive: Excess motion
Indicates: Instability of the anterior talofibular ligament. |
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Term
| How would you verify an anterior talofibular ligament tear? |
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Definition
| Utilize the Lateral Stability Test. |
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Term
Lateral Stability Test
Positive:
Indication: |
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Definition
Excess motion at the lateral aspect of the ankle upon inversion.
Indication: Instability of the primarily the anterior talofibular ligament, also the calcaneal fibular ligament, and the posterior talofibular ligament. If there is an increase in pain the ligaments are still attached, if there is no increase in pain there is a complete tear. |
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Term
| What ROM does the Dr stress the patient’s ankle in for the Lateral Stability Test? |
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Definition
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Term
| What does a positive Lateral Stability test most often indicate? |
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Definition
| Ligament tears from front to back. The first one would be the anterior talofibular ligament sprain or tear. The second one would be the Calcaneofibular ligament sprain or tear, and then the Posterior Talofibular ligament sprain or tear. |
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Term
| How would you verify an anterior talofibular ligament tear? |
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Definition
| Utilize the Draw sign for the ankle. |
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Term
Medial Stability Test
Positive:
Indication: |
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Definition
| Positive: Excess motion at the lateral aspect of the ankle upon eversion. Indication: Instability of the Deltoid ligament. If there is an increase in pain the ligaments are still attached, if there is no increase in pain there is a complete tear. |
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Term
| What ROM does the Dr stress the patient’s ankle in for the Medial Stability Test? |
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Definition
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Term
| What does a positive Medial Stability Test indicate? |
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Definition
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Term
| Talus A Fluid Motion of the Ankle: |
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Definition
| One hand of the Dr holds underneath the distal end of the tibia for stabilization. The other hand (the hand used should correspond to the foot being palpated) will be on the anterior aspect of the talus. Press A-P on the talus to feel for loss of motion. |
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Term
| Calcaneus L Fluid Motion of the Ankle: |
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Definition
| Upon performing the Medial Stability Test you note loss of motion upon eversion of the calcaneus. |
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Term
| Calcaneus M Fluid Motion of the Ankle: |
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Definition
| Upon performing the Lateral Stability Test you note loss of motion upon inversion of the calcaneus. |
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Term
| Navicular AM Fluid Motion of the Ankle: |
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Definition
| Stand on the lateral side of the foot, reach across to the medial aspect grasping the navicular. Stabilize the segments around the navicular (the talus and the cuneiforms) and attempt to rotate the navicular in relationship to those segments (one group at a time, ie. Navicular to talus, then navicular to cuneiforms). |
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Term
| Cuboid AL Fluid Motion of the Ankle: |
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Definition
| Stand on the medial side of the foot, reach across to the lateral aspect grasping the cuboid. Stabilize the segments around the cuboid (the calcaneus and the 4th and 5th metatarsals) and attempt to rotate the cuboid in relationship to those segments, |
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Term
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Definition
| Listing them 1st, 2nd, 3rd according to the metatarsals they articulate with. Stabilize the surrounding bones (metatarsals, navicular) one at a time and shear them P-A and A-P past each other. The cuneiforms will have loss of motion P-A. |
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Term
| Which ankle adjustments MUST have 3rd party stabilization? |
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Definition
| Talus A, Navicular AM, and Cuboid AL. |
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Term
| Which ankle adjustments May have 3rd party stabilization? |
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Definition
| Talus traction and cuneiform posterior. |
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Term
| Indications for Talus A adjustment? |
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Definition
| o Usually a history of inversion ankle sprain. o Pain or tenderness across the anterior aspect of the ankle (talotibial joint). o Edema at the anterior ankle. o Loss of dorsiflexion ROM. o Loss of fluid motion from A-P. o Failure of talus traction to improve fluid motion. |
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Term
| Indications of a Calcaneus L? |
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Definition
o History of an inversion ankle sprain.
o Tenderness below the lateral malleolus.
o Loss of eversion ROM.
o Restricted fluid motion on the medial stability test.
o Possibly edema below the lateral malleolus. |
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Term
| What is the CP for a Calcaneus L? |
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Definition
| The thenar of the hand opposite the side of involvement. |
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Term
| What does the SH do to the ankle for Calcaneus L? |
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Definition
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Term
| The Calcaneus L has restricted fluid motion during which orthopedic test? |
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Definition
| The medial stability test. |
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Term
| Indications for Calcaneus M? |
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Definition
o Usually a history of eversion ankle sprain.
o Tenderness below the medial malleolus.
o Loss of eversion ROM.
o Restricted fluid motion on the lateral stability test.
o Possibly edema below medial malleolus. |
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Term
| What is the CP for a Calcaneus M? |
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Definition
| The thenar of the hand corresponding to the side of involvement. |
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Term
| What does the SH do to the ankle for Calcaneus M? |
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Definition
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Term
| The Calcaneus M will have restricted fluid motion during which orthopedic test? |
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Definition
| The lateral stability test. |
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Term
| Indications that Navicular AM adjustment is needed? |
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Definition
o Usually a history of kicking injury.
3
o Pain or tenderness over the navicular tuberosity.
o Edema over the navicular.
o Loss of fluid motion of the navicular bone. |
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Term
| What is the LOD of the thrust for the Navicular AM? |
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Definition
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Term
| Indications for a Cuboid AL? |
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Definition
o Loss of fluid motion.
o Point tenderness over the cuboid AND deep in the calf. 2 Pain Points!
o Dull ache referred deep in the posterior calf musculature. |
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Term
| Where should the thumbs be for the Cuboid AL? |
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Definition
| One under the 4th & 5th metatarsals and one under the cuneiforms and navicular. |
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Term
| What is the CH for the Cuboid AL? |
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Definition
| The CH is the hand opposite the side of involvement. |
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Term
| Indications for a Cuneiform P? |
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Definition
o Visually see a fallen arch.
o Pain and swelling on the plantar surface of the foot (plantar fasciitis).
o Loss of fluid motion P-A. |
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Term
| Where should the stabilization fingers be for the Cuneiform P? |
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Definition
| On the dorsum of the foot. In particular over the proximal end of the metatarsals, navicular and cuboid. |
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Term
What is part 1 of Morton's Test?
What is a positive?
What does it indicate? |
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Definition
Palpate between the metatarsal heads and shafts.
Positive: A palpable mass/cyst (like a gummy worm or soft eraser.
Indication: a Morton's Neuroma |
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Term
What is part 2 of mortons test?
What is a positive?
What does it indicate? |
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Definition
Compress the medial and lateral sides of the metatarsal heads together. Positive: Pain between the metatarsal heads.
Indication: A Morton’s Neuroma. |
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Term
| Where is Morton’s Neuroma most commonly found? |
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Definition
| Between the 3rd & 4th metatarsal heads. However it can be located between any of them. |
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Term
| What would you want to differentiate Morton’s Neuroma from? |
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Definition
| Differentiate it from a stress fracture, subluxation (MT-P), and plantar fasciitis. |
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Term
| What does a positive Morton’s test indicate? |
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Definition
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Term
What is Strunsky's test?
Positive?
Indication? |
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Definition
| Rapid plantar flexion of the metatarsal phalange joints Positive: If pain in the metatarsal arch. Indication: Metatarsalgia. |
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Term
| T-MT A Fluid motion of the foot |
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Definition
| One hand of the Dr holds underneath the distal end of the tibia for stabilization. The other hand (the hand used should correspond to the foot being palpated) will be on the anterior aspect of the talus. Press A-P on the talus to feel for loss of motion. |
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Term
| MT-P P fluid motion of the foot |
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Definition
| One hand stabilizes the metatarsal(s). The other hand grasps the phalange (toe). Move the phalange P-A, A-P, M-L, L-M, and check rotation. |
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Term
| I-P fluid motion of the foot |
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Definition
| One hand stabilizes the proximal phalange. The other hand grasps the distal phalange. Move the phalange P-A, A-P, M-L, L-M, and check rotation. |
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Term
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Definition
o Pain point over the joint space.
o Loss of fluid motion. |
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Term
| What are possible causes of T-MT A? |
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Definition
| Hard shoes that don’t allow the foot to flex, disuse, and the foot being stepped on. |
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Term
| What is the PP for T-MT A? |
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Definition
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Term
| What is the CP for T-MT A? |
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Definition
| The chiropractic index finger. #5. |
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Term
| What is the thrust LOD for T-MT A? |
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Definition
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Term
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Definition
o Pain point over the joint space.
o Loss of fluid motion.
o Callus build up over the metatarsal head. |
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Term
| What ways are there to adjust the MT-P joint? |
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Definition
| MT-P Traction and MT-P P thrusting move. |
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Term
| What types of pathologies may MT-P traction take care of? |
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Definition
| MT-P P, DJD, Bunion, and arthridities. |
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Term
| What is the CP for MT-P P? |
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Definition
| The CP is #9 of the hand corresponding to the side of involvement. |
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Term
| Indications for a Bunion adjustment: |
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Definition
o Valgus deformity of the great toe.
o Callus at the medial portion of the first MT-P joint.
o Fixation in the joint in most directions.
o X-ray shows a Bunion formation. |
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Term
| What is the PP for Bunion? |
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Definition
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Term
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Definition
| Patient is prone. With the knee bent at 90 stabilize the 1st metatarsal. Grasp the 1st phalange and traction it S-I and plantar flex at the joint. Repeat until most aberrant motion is removed from the joint and until the patient can tolerate the Bunion Part II maneuver (may take one or several visits). |
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Term
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Definition
| Patient is in the same position at Bunion Part I. Stabilize the foot against the Dr’s hip. The hand on the metatarsal will pre-stress it in rotation away from the Dr’s body. The hand on the phalange will traction it S-I and the thrust will take the phalange away from the other toes (L-M in relationship to the foot) pivoting at the MT-P joint. |
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Term
| What is Bunion Part II intended to do? |
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Definition
| It is intended to align the proximal phalange onto the metatarsal head. |
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Term
| What pathology may I-P Traction (in the foot) take care of? |
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Definition
| Hammertoes, DJD, subluxation, and jammed toes. |
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