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29 Cards in this Set

  • Front
  • Back
ROM Test:
•Test 8: Straight leg, hip flexion & external rotation
•Test 9: Straight leg, hip flexion, abduction and external rotation
•Test 10: Straight leg, hip flexion, adduction and external rotation

Muscle Test:
•Lie supine, flex the hip 30º, fully externally rotate the leg
•Take tension off of the psoas by having them bend their knee

Tester:
•Stand on involved side
•Stabilize the opposite ASIS
•Action hand on the medial malleolus
•Push straight down (force: hip extension)

Palpation:

Ilium
•Client flexes hip with femur externally rotated
•Get fingers on medial side of ASIS and try to sink down and inside the bowl of ilium
•Find medial aspect of ASIS & sink inside the bowl of the ilium, come down & into the ilium straight down, filling as much as the bowl of the ilium as you can
•Curl fingers into iliac fossa having client exhale
•Confirm through hip flexion

Lesser Trochanter
•Find adductor longus, come up pretty high and slide into the triangle just superior and anterior to adductor longus
•External rotation of thigh, follow above adductor longus tendon, pressure: down and in
Iliacus:
ROM Test:
•Test 7: Straight leg, abduction and external rotation
•Test 9: Straight leg, hip flexion, abduction and external rotation

Muscle Test:
•Supine, very slight hip flexion, 30º abduction, full external rotation

Tester:
•Stand on involved side
•Stabilizing hand on opposite ASIS
•Action hand on medial malleolus
•Push down and out (extension and abduction through the oblique plane)

Palpation:
•For Diaphragmatic, treat L1 - L2 on the left side & L1 - L3 for the right side
•Can be performed on the patients side to move abdominal contents away
•Palpation is lateral to the bodies and anterior to the transverse processes
•Use umbilicus as a landmark. (Umbilicus is about L3)
•Take tension off of the psoas by having them bend their knee, easier to get into the bodies of vertebras

Left Crus: Xyphoid Process
•Come up to L2, then L1, then underneath the ribs
•Come up and under the rib cage, sink down, pull tissue back, and sink under the edge of the rib cage, palpating with the nail bed of our finger
•Start at the side of the xyphoid process and then slide under the rib cage, work way along the ribs until you get to the 11th rib (first floater), then you’re done
•Palpate from xyphoid process rib cage
•Have patient exhale to relax diaphragm and deflate lungs

Right Crus: Xyphoid Process
•Get upper 2 lumbar, then find rectus abdominis, landmark umbilicus work L3, L2, L1 underneath the ribs

Rib Cage
•Sink down under edge of rib cage, work way along ribs until you get to the 11th rib
•Palpate diaphragm down to angle of ribcage
Psoas Major: Diaphragmatic Fibers
ROM Test:
•Test 9: Straight leg, hip flexion, abduction and external rotation

Muscle Test:
•Supine, 45º hip flexion, 30º abduction, full external rotation
•Push down and out

Tester:
•Stand on involved side
•Stabilizing hand on opposite ASIS
•Action hand on medial malleolus
•Push down and out (extension and abduction through the oblique plane)

Palpation:
•If you see Thoracic or Lumbar, treat them as a WHOLE, do L1-T12
•Palpation is lateral to the bodies and anterior to the transverse processes
•Use umbilicus as a landmark. (Umbilicus is about L3)
•Take tension off of the psoas by having them bend their knee, easier to get into the bodies of vertebras

L2 – L5
•Find umbilicus, find rectus abdominis, come lateral, then come down and in at a 45º angle
•Take nice slow movements in as they breathe out, as they breathe out slide in until you feel a hardness
•Get lateral on the bodies of the vertebras and anterior on the transverse processes
•Do palpation, and then slowly come out, move hand, and begin next palpation
•Lies lateral to the abdominal aorta. Feel for pulse and move laterally
•Flex involved hip and have partner exhale.
•Small circles to move abdominal contents to the side
•Active hip flexion to confirm

Lesser Trochanter
•External rotation of thigh, follow above adductor longus tendon, pressure: down and in
•Have them flex adductor longus (pull in), adduct into hand
•After you find adductor longus, have them relax then come superior to adductor longus, slide through and come straight back down towards the table and find the lesser trochanter
•There is a triangle just lateral and anterior to adductor longus, slide into triangle and then down and into the lesser trochanter
Psoas Major: Lumbar Fibers
ROM Test:
•Test 9: Straight leg, hip flexion, abduction and external rotation

Muscle Test:
•Supine, 30º hip flexion, 30º abduction, full external rotation

Tester:
•Stand on involved side
•Stabilizing hand on opposite ASIS
•Action hand on medial malleolus
•Push down and out (extension and abduction through the oblique plane)

Palpation:
•If you see Thoracic or Lumbar, treat them as a WHOLE
•Palpation is lateral to the bodies and anterior to the transverse processes
•Use umbilicus as a landmark. (Umbilicus is about L3)
•Take tension off of the psoas by having them bend their knee, easier to get into the bodies of vertebras

L1 & T12
•Find umbilicus (L3, move up into L2, then L1, and then up and get T12)
•Lies lateral to the abdominal aorta. Feel for pulse and move laterally
•Flex involved hip and have partner exhale.
•Small circles to move abdominal contents to the side
•Active hip flexion to confirm

Lesser Trochanter
•External rotation of thigh, follow above adductor Longus tendon, pressure: down and in
Psoas Major: Thoracic Fibers
ROM Test:
•Test 10: Straight leg, hip flexion, adduction and external rotation

Muscle Test:
•Supine, flex hip with external rotation of the femur to position of posterior pelvic tilt, adduct thigh across midline
•Get on knees, put hand under back, and then flex the hip until the back becomes flat against the table. That’s when you know they are in a posterior pelvic tilt. That’s the amount of hip flexion that person needs for the test. It’s all dependent upon the person. Then adduct their thigh, and externally rotate the femur.
•Pull down and away from opposite shoulder while maintaining that lumbar position.

Tester:
•Stand on involved side
•Stabilize the opposite ASIS
•Action hand on medial malleolus
•Pull down and across toward you from their opposite shoulder.(extend and abduct thigh through oblique plane to create anterior pelvic rotation)
•Resistance always comes in the plane of your forearm.

Palpation:
•Palpation is lateral to the bodies and anterior to the transverse processes
•Use umbilicus as a landmark. (Umbilicus is about L3)

L1 & L2
•L1 & L2
•Take tension off of the psoas by having them bend their knee, easier to get into the bodies of vertebras
•Same processes as psoas major treating lumbar spine at T12 & L1.

Superior Ramus of Pubis
•Find top of the pubic bone, get superior lateral pubic bone, sink down deep and then up and under the edge of the pubic bone
•Attaches on the posterior most lateral aspect
•Move down, palpate deep to superior ramus
•Top of the pubic bone, sink down and into the posterior aspect
Psoas Minor:
ROM Test:
•Test 6: Straight leg, external rotation of the femur

Muscle Test: 12A
•Supine, full external rotation of the femur

Tester:
•Stand at the base of the patient
•Stabilize the opposite ankle medially
•Action hand on back o the ankle to regulate external rotation
•Apply force into abduction away from the midline (pull out)

Palpation:
•Leg on bottom moved back, other leg in front at 90º

Ischial Tuberosity & Ramus of Ischium
•Patient lying on side with uninvolved hip flexed
•Find ischial tuberosity, compress tissue of thigh down, slide down and under the LATERAL aspect of the ramus of the ischium
•Slide under LATERAL aspect of ischium using finger tips
•Most posterior adductor attachment on the ramus of ischium and ramus of pubis

Linea Aspera (Middle 1/3)
•Check to see the position of their leg, so you can tell where you need to go to get to the middle 1/3 of the linea aspera
•Have them contract their hamstring, come off the edge of the hamstring, and slide right down and into the linea aspera getting the most posterior middle 1/3
Adductor Magnus: Oblique Fibers
ROM Test:
•Test 1: Straight Leg internal Rotation of the femur

Muscle Test: 12B
•Supine, full internal rotation of the femur

Tester:
•Stand at the base of the patient
•Stabilize the opposite ankle
•Action hand lateral underside of the ankle
•Apply force into hip flexion (lift up)

Palpation:

•Pectineus, Adductor Longus, Adductor Brevis, Gracilis, & Adductor Magnus = Puny Little Boys Go Masticate
•Adductor Longus is the landmark for everything else, it’s the most medial, then it moves the most superior to Pectineus, then lateral and posterior to Brevis, & lateral and posterior to Gracilis, and then Magnus
•Lie on side of weakness

Ischial Tuberosity & Ramus of Ischium
•Patient lying on side with uninvolved hip flexed 90º
•Find ischial tuberosity, compress tissue of thigh down, slide down and under the LATERAL aspect of the ramus of the ischium
•Slide under LATERAL aspect of ischium using finger tips
•Most posterior adductor attachment on the ramus of ischium and ramus of pubis

Adductor Tubercle
•Go to medial femoral condyle and find adductor tubercle, follow up supracondylar ridge about 1 inch
•Find adductor tubercle and palpate 1 inch upwards
Adductor Magnus: Vertical Fibers
ROM Test:
•None

Muscle Test: 13
•Supine, elevate both legs 1-2 inches
•Don’t abduct both legs, abduct the leg your not testing
•Adduct & externally rotate the leg you are testing
•Full external rotation of involved femur

Tester:
•Stand at the base of the patient
•Stabilize the opposite ankle
•Action hand lateral underside of the ankle
•Apply force into abduction (pull out)

Palpation:
•Overlap each attachment slightly on linea aspera
•Pectineus, Adductor Longus, Adductor Brevis, Gracilis, & Adductor Magnus = Puny Little Boys Go Masticate
•Adductor Longus is the landmark for everything else, it’s the most medial, then it moves the most superior to Pectineus, then lateral and posterior to Brevis, & lateral and posterior to Gracilis, and then Magnus
•Have a guy re-position himself if needed, on a male client get a skeleton and show them “I am going to be touching here; if there is anything in the way it is ok to touch yourself and move it.”

Pubic Tubercle
•Patient supine with slight hip flexion and external rotation
•Externally rotate leg, have them pull into your hand, adducting thigh, follow big tendon of adductor longus, compress into it and follow it all the way up until you hit the side of the pubic bone,
•Sink into the bone, and slightly compress tendon into the bone
•Lateral on pubic bone
•Externally rotate leg, find tendon, slide into side of pubic bone into pubic tubercle
•When palpating, compress the tendon, don’t move it

Linea Aspera (lower portion)
•Palpate at the linea aspera along lower portion of muscle belly
•Medial to hamstrings and posterior to quads, feel the division, have them pull heel towards but, feel hamstrings
•Along same line as adductor magnus but more inferior, and more lateral than vastus medialis
•Similar to Vastus Medialis, but more posterior and inferior
Adductor Longus:
ROM Test:
•Test 5: Straight leg, hip flexion, adduction & internal rotation
•Test 10: Straight leg, hip flexion, adduction and external rotation

Muscle Test: 14
•Supine, flex and adduct involved leg across the midline
•Full internal rotation of involved leg
•Repeat test with full external rotation of involved leg

Tester:
•Stand at the base of the patient
•Stabilize the opposite ankle
•Action hand underside of involved ankle
•Apply force into abduction

Palpation:
•Pectineus, Adductor Longus, Adductor Brevis, Gracilis, & Adductor Magnus = Puny Little Boys Go Masticate
•Adductor Longus is the landmark for everything else, it’s the most medial, then it moves the most superior to Pectineus, then lateral and posterior to Brevis, & lateral and posterior to Gracilis, and then Magnus
•Always stay outside of the triangle

Inferior Ramus of Pubis
•Patient lying supine with slight hip flexion and external rotation
•Have client adduct thigh, find big adductor longus tendon and go inferior and lateral (never medial)
•Come to inferior ramus of the pubis
•Palpate just posterior to the adductor longus attachment

Pectineal Line and middle portion of Linea Aspera
•Overlap with Adductor Magnus
•Find adductor longus tendon, go behind it and go inferior to lesser trochanter/upper 1/3 to upper 1/2
•Palpate along the linea aspera, proximal to the adductor longus
Adductor Brevis:
ROM Test:
•Test 8: Straight leg, hip flexion & external rotation
•Test 10: Straight leg, hip flexion, adduction and external rotation

Muscle Test: 15
•Lie Supine, flex and adduct the femur 30º
•Full external rotation of the femur

Tester:
•Stand at the base of the patient
•Stabilize the opposite ankle
•Action hand on the medial top of the distal tibia
•Apply force into abduction and extension (push down and out)

Palpation:
•Pectineus, Adductor Longus, Adductor Brevis, Gracilis, & Adductor Magnus = Puny Little Boys Go Masticate
•Adductor Longus is the landmark for everything else, it’s the most medial, then it moves the most superior to Pectineus, then lateral and posterior to Brevis, & lateral and posterior to Gracilis, and then Magnus
•Always stay outside of the triangle

Ramus of Pubis (Superior Border)
•Patient supine with slight hip flexion and external rotation
•Find adductor longus, go superior and lateral to superior ramus of pubis, come in front of adductor longus, find lesser trochanter and come about 2 inches down from lesser trochanter on Pectineal line which is just below the lesser trochanter about 2 inches down
•Have client adduct thigh, find most anterior and superior attachment of the adductor group (above adductor longus)

Pectineal Line of the Femur
•Pectineal line is just below lesser trochanter about 2 inches down & is part of the medial aspect of the linea aspera
•Palpate medial posterior surface of femur from lesser trochanter down approximately 2 inches
Pectineus:
ROM Test:
•Test 1: Straight Leg Internal Rotation of the femur
•Test 5: Straight leg, hip flexion, adduction & internal rotation

Muscle Test: 16
•Supine, adduct femur to midline
•Full internal rotation of femur

Tester:
•Stand at base of patient
•Stabilize opposite ankle
•Action hand on medial top of distal tibia
•Apply force into abduction of the involved leg

Palpation:
•Pectineus, Adductor Longus, Adductor Brevis, Gracilis, & Adductor Magnus = Puny Little Boys Go Masticate
•Adductor Longus is the landmark for everything else, it’s the most medial, then it moves the most superior to Pectineus, then lateral and posterior to Brevis, & lateral and posterior to Gracilis, and then Magnus
•Always stay outside of the triangle

Inferior Ramus of Pubis & Ramus of Ischium
•Patient supine with slight hip flexion and external rotation
•Landmark adductor longus & ischial tuberosity, about halfway in between on pubic side
•Have client adduct thigh, follow taut tendon into pubic bone
•Get on adductor longus, sink down and lateral to bone on lateral aspect of the inferior ramus of pubis just behind adductor brevis, on the pubic side of the 40 yard line not the ischium side

Pes Anserine (Upper/Medial Tibia)
•Paint the pes anserine, you will feel a flat spot and a mass of tissue coming in where the Gracilis, Semitendinosus and Sartorius are all blending in
•2 finger widths will paint the whole pes anserine
•Follow tendon into pes anserine attachment on the superior/medial aspect of the tibia
Gracilis:
ROM Test:
•Test 18: Hip External rotation with hip and knee flexion
•Test 20: Hip flexion, abduction, and external rotation

Muscle Test: 20A
•Supine, flex hip 60º, flex knee 110º so that heel is at level of opposite knee
•Putting heel at opposite knee = 60º & 110º
•Externally rotate the femur
•Slightly abduct femur
•Internally rotate tibia and plantarflex the foot

Tester:
•Stand on same side as leg being tested
•Stabilize the lateral side of knee
•Action hand cups the heel
•Forearm slightly upward
•Pull out at the heel applying a force into internal rotation and knee flexion, slight bit of flexion and more rotation

Palpation:
•If weak, treat all divisions

Linea Aspera (Upper 1/3)
•Prone, palpate lesser trochanter and follow down 1/3 of posterior aspect of femur
•Go to ischial tuberosity, then obliquely and find lesser trochanter, have them flex quad and find posterior aspect of quad near the lesser trochanter

Patella (Superior/Medial Border)
•Supine, palpate superior, medial patella

Patellar Tendon (Medial Aspect)
•Supine, palpate medial patella tendon into tibial tuberosity
Vastus Medialis: Upper Fibers
ROM Test:
•None

Muscle Test: 20B
•Supine, flex hip 30º, flex knee 75º so that heel is at opposite mid shin level
•External rotation of femur
•Slightly abduct femur
•Internally rotate tibia and plantarflex foot

Tester:
•Stand on same side as leg being tested
•Stabilize lateral side of knee
•Action hand cups the heel
•Pull out at the heel applying a force into internal rotation

Palpation:
•If weak, treat all divisions

Linea Aspera (Middle 1/3 of Posterior aspect of femur)
•Prone, palpate middle 1/3 of posterior aspect of femur

Patella (Superior-Medial)
•Supine, palpate superior, medial patella

Tibial Tuberosity
•Palpate medial patella tendon into tibial tuberosity
Vastus Medialis: Middle Fibers
ROM Test:
•None

Muscle Test: 20C
•Supine, flex hip 10º, flex knee 20º so that heel is at level of opposite ankle
•Heel is at ankle
•External rotation of femur
•Slightly abduct femur
•Internally rotate tibia and plantarflex foot

Tester:
•Stand on same side as leg being tested
•Stabilize lateral side of the knee
•Action hand cups the heel
•Pull out at the heel applying a force into internal rotation & knee flexion

Palpation:

Linea Aspera
•Supine, palpate lower 1/3 of posterior, medial aspect of femur into adductor tubercle

Patella (Superior Medial)
•Palpate superior/medial patella

Tibial Tuberosity
•Palpate medial patella tendon into tibial tuberosity
Vastus Medialis: Lower Fibers
ROM Test:
•Test 4: Straight leg, hip flexion, abduction and internal rotation
•Test 3: Straight Leg, Hip flexion & Internal Rotation
•Test 17: Hip internal rotation with hip and knee flexion
•Test 24: Hip Internal Rotation

Muscle Test: 21A
•Supine, flex hip 60º, flex knee 110º so that heel is at level of opposite knee
•Full internal rotation of femur
•Slightly adduct femur
•Externally rotate tibia and plantarflex foot

Tester:
•Stand on opposite side of leg being tested
•Stabilize medial side of knee
•Action hand cups the heel
•Pull in at the heel applying a force into external rotation, pull toward you and in

Palpation:
•If weak, treat all divisions

Greater Trochanter
•Supine, palpate anterior inferior border of greater trochanter
•Superior aspect of trochanter, come anterior & inferior, onto the shaft of the femur, once on the femur, work way at a 45º angle down and around to the posterior aspect of the femur through the IT-band, then bend the knee and feel that quad and wrap around to the posterior aspect of the linea aspera

Linea Aspera
•After palpating trochanter, palpate down upper 1/3 of lateral linea aspera posterior to IT-band.
•Work way around posterior aspect of femur all the way down lateral and posterior to IT-Band
•Get in the tunnel between hamstring and quad
•Make sure you aren’t jabbing into back of IT-band and that you are posterior enough, have them tighten quad to make sure you pop off the belly

Patella (Superior/Lateral)
•Palpate superior/lateral patella
•Superior to lateral aspect of patella

Tibial Tuberosity
•Palpate Tendon into tibial tuberosity
Vastus Lateralis: Upper Fibers
ROM Test:
•None

Muscle Test: 21B
•Supine, flex hip 30º, flex knee 75º so that heel is at opposite mid shin level
•Full internal rotation of femur
•Slightly adduct femur
•Externally rotate tibia and plantarflex foot

Tester:
•Stand on opposite side o leg being tested
•Stabilize medial side of knee
•Action hand cups heel
•Pull in at the heel applying a force into external rotation and knee flexion

Palpation:

Linea Aspera (Middle 1/3)
•Supine, palpate middle 1/3 of lateral linea aspera, below IT-band

Patella (Superior-Lateral)
•Palpate superior/lateral patella

Tibial Tuberosity
•Palpate lateral patella tendon into tibial tuberosity
Vastus Lateralis: Middle Fibers
ROM Test:
•None

Muscle Test: 21C
•Supine, flex hip 10º, flex knee 20º, so that heel is at level of opposite knee
•Full internal rotation of femur
•Slightly adduct femur
•Externally rotate tibia and plantarflex foot

Tester:
•Stand on opposite side of leg being tested
•Stabilize the medial side of knee
•Action hand cups the heel
•Pull in at the heel applying a force into external rotation and knee flexion

Palpation:

Linea Aspera (Lower 1/3)
•Supine, palpate lower 1/3 of lateral femur, posterior to IT-band down into lateral condyle

Patella (Superior-Lateral)
•Palpate superior, lateral patella

Tibial Tuberosity
•Palpate lateral patella tendon into tibial tuberosity
Vastus Lateralis: Lower Fibers
ROM Test:
•None

Muscle Test: 22B
•Supine, flex hip and flex knee to 110º
•Internally rotate tibia

Tester:
•Stand on side of leg being tested
•Stabilize anterior femur
•Action hand on anterior tibia
•Apply force into knee flexion

Palpation:

Femur
•Supine, palpate under belly of medial side of rectus femoris on upper anterior 2/3 of medial femur
•Move rectus femoris, same as lateral but about 1 inch more medial and more rectus
•Come on anterior upper 2/3 of anterior surface of femur
•Have them flex quad, medial aspect of rectus, sink to bone, same for lateral

Patella & Tibial Tuberosity
•Palpate superior patella and patella tendon attachment into tibial tuberosity
Vastus Intermedius: Medial Fibers
ROM Test:
•None

Muscle Test: 22A
•Supine, flex hip and knee 120º
•Tibial external rotation

Tester:
•Stand on side of leg being tested
•Stabilize anterior femur
•Action hand on anterior tibia
•Apply force into knee flexion (straight down)

Palpation:

Femur
•Find trochanter, come on anterior surface just below where you were for Vastus Lateralis, come in at a 45º angle from the side and come right down onto the anterior surface
•Supine, palpate under belly of rectus on anterior 2/3 of lateral femur
•Lateral aspect below trochanter, inferior, straight down 2/3

Patella & Tibial Tuberosity
•Palpate superior patella and patella tendon attachment into tibial tuberosity
Vastus Intermedius: Lateral Fibers
ROM Test:
•None

Muscle Test: 23
•Supine, 10º of hip and knee flexion

Tester:
•Stand at the side of patient
•Brace under involved knee
•Action hand on anterior aspect of the ankle
•Apply force into hip extension keeping flexion at knee joint
•Push straight down

Palpation:

Supra-Patellar Tendon
•Supine, palpate 1 – 1 ½ inches above patella feel ridge (below quad), at supra-patellar tendon
•Palpate sides of supra-patellar tendon to the top of the patella (at bottom edge of Vastus Intermedius)
•Making a rectangle

Patella (Superior)
•Palpate across superior patella
Articularis Genu:
ROM Test:
•Test 11: Straight leg, ankle plantar flexion
•Test 19: Knee flexion with hip flexion (add tibial external rotation)None
•Test 12: Straight leg, lower leg, internal rotation
•Test 15: Ankle plantarflexion with adduction and eversion of forefoot (knee flexed)

Muscle Test: 24A
•Supine, flex hip 22.5º, flex knee 45º
•Full Plantarflexion at the ankle
•Full internal rotation of the tibia
•Worry about the 45º at the knee
•Looking for tibia to move upon rotation

Tester:
•Stand at the base of the patient
•Stabilize anterior portion of the knee
•Action hand on the back of the ankle
•Apply force into extension at the knee (pull straight out)

Palpation:

Medial Condyle of Femur
•Prone, palpate into posterior medial condyle of femur
•Go in similar to the hamstring, but instead of tibia, this time it’s the posterior aspect of the femur,

Medial Head of Gastroc
•Have them contract, or flex gastroc, palpate the bottom of the horseshoe line
•Palpate medial head at musculo-tendon junction

Calcaneus (Medial Attachment)
•Hook in and palpate at superior, medial calcaneus
•Pushing the tissue in and getting the superior aspect
Gastrocnemius: Medial Fibers
ROM Test:
•Test 11: Straight leg, ankle plantar flexion
•Test 19: Knee flexion with hip flexion (add tibial external rotation)None
•Test 13: Straight leg, lower leg external rotation
•Test 16: Ankle Plantarflexion with abduction & eversion of forefoot (knee flexed)

Muscle Test: 24B
•Supine, flex hip 22.5º, flex knee 45º
•Full plantarflexion of the foot
•Full external rotation of the tibia

Tester:
•Stand at the base of the patient
•Stabilize the anterior portion of the knee
•Action hand on the back of the ankle
•Apply force in extension at the knee (pull straight out)

Palpation:

Lateral Condyle of Femur
•Prone, palpate into posterior lateral condyle of femur
•Kind of like lateral hamstrings, hook into posterior superior lateral condyle of the femur

Lateral Head of Gastroc
•Contract gastroc, lateral head is not as low as medial head, palpate lateral head at musculo-tendon junction, between belly of muscle
•Lateral gastroc horseshoe line

Calcaneus (Lateral Attachment)
•Palpate at superior, lateral calcaneus
Gastrocnemius: Lateral Fibers
ROM Test:
•Test 11: Straight leg, ankle plantar flexion

Muscle Test: 25
•Prone, knee flexed to 90º
•Full plantarflexion of the foot with toes curled
•Internal Rotation of the Tibia
•Repeat Test with External Rotation of the Tibia
•Calcaneal evert = medial, Calcaneal invert = lateral

Tester:
•Stand on side of leg being tested
•Stabilize back of calcaneus
•Action hand on ball of foot
•Apply force into Dorsiflexion of the ankle (Pushing down and lifting at the heel).

Palpation:

Fibula (Upper 1/3 Posterior/Medial)
•Prone, flex knee, palpate the upper 1/3 of the posterior, medial aspect of the fibula.

Tibia (Middle 1/3 Posterior)
•Palpate medial head along the middle 1/3 of the posterior tibia
•Palpate posterior to anterior on back of tibia by curling lateral

Calcaneus
•Palpate at superior calcaneus
Soleus:
ROM Test:
•Test 12: Straight leg, lower leg, internal rotation
•Test 15: Ankle plantarflexion with adduction and eversion of forefoot (knee flexed)
•Test 16: Ankle Plantarflexion with abduction & eversion of forefoot (knee flexed)

Muscle Test: 26
•Supine, flex hip 22.5º, flex knee 45º, fully internally rotate tibia
•Rotate tibia in, not just the foot
•Foot neutral relative to Dorsiflexion and plantarflexion

Tester:
•Stand at the base of the patient
•Stabilize base of heel
•Action hand on medial aspect of the forefoot
•Palm on side of foot and come across
•Apply force into external rotation of the tibia

Palpation:

Lateral Condyle of Femur
•Prone, knee straight, palpate outer portion of lateral condyle of femur
•Lateral condyle of femur, posterior to Epicondyle.

Posterior Tibia (Upper Medial 1/3)
•Flex knee, palpate upper medial
Popliteus:
ROM Test:
•Test 13: Straight leg, lower leg external rotation
•Test 16: Ankle Plantarflexion with abduction & eversion of forefoot (knee flexed)

Muscle Test: 27A
•Supine, flex hip 22.5º, flex knee 45º
•Full plantarflexion and abduction of the foot
•Do not allow toes to extend

Tester:
•Stand at the base of the patient
•Stabilize the base of the heel
•Action hand on lateral aspect of the forefoot
•Apply force into adduction of the foot, maintaining plantarflexion

Palpation:

Fibula (Upper 1/3 Posterior/Lateral)
•Prone, flex knee, palpate the upper 1/3 of the posterior, lateral aspect of the fibula

1st Cuneiform (Lateral Base)
•Palpate lateral side of base of 1st cuneiform
•(feel bony protrusion that divides these bones)

1st Metatarsal (Lateral Base)
•Palpate lateral side of base of 1st metatarsal
•(feel bony protrusion that divides these bones)
Peroneus Longus:
ROM Test:
•Test 13: Straight leg, lower leg external rotation

Muscle Test: 27B
•Supine, flex hip 22.5º, flex knee 45º
•Neutral foot position relative to Dorsiflexion
•Abduction of the foot
•Do not allow toes to extend

Tester:
•Stand at the base of the patient
•Stabilize the base of the heel
•Action hand on lateral aspect of the forefoot
•Apply force into adduction of the foot

Palpation:

Fibula (Middle 1/3 Posterior-Lateral)
•Prone, flex knee, palpate the middle 1/3 of the posterior, lateral aspect of the fibula

5th Metatarsal
•Palpate at lateral aspect of the base of the 5th met.
Peroneus Brevis:
ROM Test:
•Test 14: Straight leg, ankle Dorsiflexion

Muscle Test: 27C
•Supine, flex hip 22.5º, flex knee 45º
•Full Dorsiflexion & eversion of the forefoot
•Full abduction of the foot
•Curl toes

Tester:
•Stand at the base of the patient
•Stabilize the base of the heel
•Action hand on the lateral aspect of the forefoot
•Apply force into plantarflexion and adduction of the foot

Palpation:

Fibula (Lower Anterior 1/3)
•Prone, flex knee, palpate the lower 1/3 of the anterior aspect of the fibula

4th & 5th Metatarsal
•Palpate union where 4th and 5th metatarsals meet
Peroneus Tertius:
ROM Test:
•Test 14: Straight leg, ankle Dorsiflexion

Muscle Test: 29
•Supine, flex hip 22.5º, flex knee 45º
•Full Dorsiflexion and inversion of the foot
•Curl toes

Tester:
•Stand at the base of the patient
•Stabilize the base of the heel
•Action hand on the dorsal aspect of the forefoot
•Apply force into plantarflexion and eversion of the forefoot

Palpation:

Fibular Head
•Supine, palpate on lateral tibia from anterior fibular head

Tibia (Lateral)
•Palpate from anterior fibular head down the upper ½ of the tibia

Medial Cuneiform
•Palpate plantar medial cuneiform

1st Metatarsal (Base)
•Palpate the base of the 1st metatarsal
Tibialis Anterior:
ROM Test:
•Test 12: Straight leg, lower leg, internal rotation
•Test 15: Ankle plantarflexion with adduction and eversion of forefoot (knee flexed)

Muscle Test: 28
•Supine, flex hip 22.5º, flex knee 45º
•Full plantarflexion and adduction of the foot
•Do not allow toes to extend

Tester:
•Stand at the base of the patient
•Stabilize the base of the heel
•Action hand on medial aspect of the forefoot
•Hand cupping heel and blocking laterally
•Apply force into abduction of the foot, maintaining plantarflexion, sweep the foot across
•Have them drive foot into the table while abducting
•Just looking for subtalar joint motion

Palpation:
•Attaches to 8 different places in the foot
•Deepest muscle, deep to the gastroc and soleus
•Compress foot on rearfoot

Fibula (Upper 1/3 Medial/Posterior)
•Prone, flex knee, palpate the upper 1/3 of the medial, posterior aspect of the fibula
•Get between the bones, sink into the fibula, and then sink across to the tibia

Tibia (Upper 1/3 Lateral/Posterior)
•Palpate lateral posterior aspect of the upper 1/3 of the tibia

Medial Malleoli
•Posterior aspect of the medial malleoli

Navicular
•Palpate the medial and plantar surface of the Navicular, work distal

Cuneiforms
•Palpate across the cuneiforms 1,2,3 (medial aspects)
•Slide anterior and get metatarsals

Metatarsals
•Palpate across the mets. Bases of 4,3 & 2

Cuboid
•Palpate the medial aspect of the cuboid
Tibialis Posterior: