Manual Muscle Testing: Ankle Inversion

Muscles Involved:

Tibialis Posterior

Patient Positioning

Side lying with test-side ankle off the edge of the plinth

For grades 0 to 2 patient can be supine or short sitting ('gravity minimal' position)

Therapist Position

Sit on stool/chair in front of patient

  • Palpation over tibialis posterior
  • Other hand resistance over dorsum & medial foot

To Test

  • Patient actively inverts
  • Grades 4 and 5: Therapist provides resistance towards eversion + slight dorsiflexion[1]
  • To satisfy grade 5 'normal muscle' performance criteria, the patient must have the ability to move through complete range of motion (active resistance testing) OR maintain an end point range (break testing) against maximum resistance.

References

  1. Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing. Elsevier Health Sciences; 2013 Sep 27.