ANKLE and TOE MMT

Gravity Resisted Instructions: Ask the client to sit in a chair or on edge of treatment table with legs hanging over the edge with hips and knees at 90° of flexion, and the ankle in plantar flexion. The practitioner will stabilize proximal to the ankle and then ask the client to "Bend your ankle and point your foot up toward the ceiling." The client will move the ankle into dorsiflexion, and the practitioner applies resistance to the anterior portion of the foot in the direction of plantar flexion.  

Grades: Normal (5), Good (4), Fair (3) 

Gravity Minimized: No resistance is applied, and the practitioner or the table supports the testing extremity. (Not pictured) 

Instructions: Client is side-lying on the side not being tested with the tested extremity having the hip in neutral, knee flexed, and ankle plantar flexed.   The practitioner will support the extremity being tested.  The practitioner will ask the client to "point your foot up toward your knee." The practitioner will palpate the ankle dorsi flexor muscle (tibialis anterior).

Grades: Poor (2), Trace (1), No contraction (0)

Gravity Resisted Instructions: Ask the client to lie prone on a table with the foot and ankles over the edge, with the ankle in dorsiflexion. The practitioner will stabilize proximal/posterior to the ankle and then ask the client to "Move the bottom of your foot up toward the ceiling."  The client will move the ankle into plantar flexion, and the practitioner applies resistance to the posterior aspect of the heel/calcaneus in the direction of dorsi flexion.  

Grades: Normal (5), Good (4), Fair (3) 

Gravity Minimized: No resistance is applied, and the practitioner or the table supports the testing extremity. (Not pictured) 

Instructions: Client is side-lying on the side not being tested with the tested extremity having the hip in neutral, knee flexed, and ankle dorsi-flexed.   The practitioner will support the extremity being tested.  The practitioner will ask the client to "point your foot as far as you can go."  The practitioner will palpate the ankle plantar flexor muscles (gastrocnemius & soleus).

Grades: Poor (2), Trace (1), No contraction (0)

Gravity Resisted Instructions: Ask the client to sit in a chair or on the edge of the treatment table with legs hanging over the edge with hips and knees at 90° of flexion, and the ankle in slight eversion. The practitioner will stabilize proximal to the ankle and then ask the client to "Bend your ankle and point your foot inward toward your other leg, as if looking at the bottom of your foot." The client will move the ankle into inversion, and the practitioner applies resistance to the medial aspect of the foot in the direction of ankle eversion.  

Grades: Normal (5), Good (4), Fair (3) 

Gravity Minimized: No resistance is applied, and the practitioner or the table supports the testing extremity. (Not pictured) 

Instructions: Client is seated on the treatment table, with the ankle and foot supported and in neutral. The practitioner will support the ankle and foot being tested.  The practitioner will ask the client to "point your foot inward toward your other leg as if you are looking at the bottom of your foot." The practitioner will palpate the ankle inversion muscles (tibialis anterior, gastrocnemius, soleus, flexor digitorum longus, flexor hallucis longus, and tibialis anterior).

Grades: Poor (2), Trace (1), No contraction (0)

Gravity Resisted Instructions: Ask the client to sit in a chair or on the edge of the treatment table with legs hanging over the edge with hips and knees at 90° of flexion, and the ankle in slight inversion. The practitioner will stabilize proximal to the ankle and then ask the client to "Point your foot outward away from your other leg. " The client will move the ankle into eversion, and the practitioner applies resistance to the lateral aspect of the foot in the direction of ankle inversion.  

Grades: Normal (5), Good (4), Fair (3) 

Gravity Minimized: No resistance is applied, and the practitioner or the table supports the testing extremity. (Not pictured) 

Instructions: Client is seated on the treatment table, with the ankle and foot supported and in neutral. The practitioner will support the ankle and foot being tested.  The practitioner will ask the client to "point your foot outward away from your other leg." The practitioner will palpate the ankle eversion muscles (peroneus longus, peroneus brevis, and extensor digitorum longus).

Grades: Poor (2), Trace (1), No contraction (0)

Gravity Resisted Instructions: Ask the client to lie supine with the foot being tested supported by the treatment table.  The knee is extended in 0° of extension, the ankle and foot in neutral, and the toes slightly flexed. The practitioner will stabilize the metatarsals and then ask the client to "Straighten your toes toward the ceiling." The client will move the toes into extension, and the practitioner applies resistance to the dorsal aspect of the toes into flexion.  

Grades: Normal (5), Good (4), Fair (3) 

Gravity Minimized: No resistance is applied, and the practitioner or the table supports the testing extremity. (Not pictured) 

Instructions: Ask the client to lie supine with foot being tested supported by the treatment table.The knee is extended in 0° of extension, the ankle and foot in neutral, and the toes slightly flexed. The practitioner will stabilize the metatarsals and then ask the client to "Straighten your toes toward the ceiling."The practitioner will palpate the MTP/IP toe extensor muscles (extensor hallucis longus, extensor digitorum brevis (toes 2-4), and extensor digitorum longus).

Grades: Poor (2), Trace (1), No contraction (0)

Gravity Resisted Instructions: Ask the client to lie supine with the foot being tested supported by the treatment table.  The knee is extended in 0° of extension, the ankle and foot in neutral (off the table), and the toes in extension. The practitioner will stabilize the metatarsals and then ask the client to "Flex and point your toes toward the floor." The client will move the toes into flexion, and the practitioner applies resistance to the volar aspect of the toes into extension.

Grades: Normal (5), Good (4), Fair (3) 

Gravity Minimized: No resistance is applied, and the practitioner or the table supports the testing extremity. (Not pictured) 

Instructions: Ask the client to lie supine with foot being tested supported by the treatment table. The knee is extended in 0° of extension, the ankle and foot in neutral, and the toes slightly extended. The practitioner will stabilize the metatarsals and then ask the client to "Flex and point your toes toward the floor." The practitioner will palpate the MTP/IP toe flexor muscles (flexor hallucis longus, flexor hallucis brevis, lumbricals, flexor digitorum brevis, & flexor digitorum longus).

Grades: Poor (2), Trace (1), No contraction (0)