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What bone articulates with the calcaneus to form the lateral longitudinal arch?
Cuboid
What foot posture index score is indicative of a highly pronated foot?
What phase of gait does the calcaneus invert?
heel off, toe off, and swing
Your patient just came in 20 mins late to their appointment and have been complaining about re-injuring their ankle going down the stairs. What intervention could you do?
Talocrural manipulation
Which exercise increases arch support the most? Marble pick up or doming?
doming isolates intrinsics
Which of the 3 talar facets bears majority of the load? What percent?
Posterior; 75% of the load
When performing the ER stress test, you noticed your patient has excessive laxity and pain. Therefore we can rule ____ _______.
RULE IN syndesmosis ankle sprain
Which of the following is NOT an exam finding with PTTD?
A) Progressive flattening of arch
B) Pain posterior to medial malleolus
C) feeling like walking more on the outside of the foot
D) decreased walking distance due to foot
What direction is your joint mobilization when performing on the distal tibfib in order to improve DF?
posterior glide
Which muscle can refer pain to the plantar fascia?
Soleus
Why is DF the closed pack position for the talocrural joint?
the dome of the talus is wider anterior than posterior so when in DF, the talus is wedged into the mortise
How do you perform the triple compression test?
PF, invert, and provide manual compression over the tarsal tunnel for 30 seconds.
What is one of the major risk factors for acute lateral ankle sprain?
Not participating in balance/proprioception prevention program when there is hx of previous injury
What are the parameters of high volt?
-negative polarity (distal) to positive polarity (proximal)
-pulse frequency: 120
-intensity: 90%
-30 min treatment, 30 min rest cycle for 4 hours or a single, continuous 180 min session
What type of treatment would be appropriate for PTTD if the forefoot is abducting and the hindfoot is everting in stance during gait?
reverse 6 treatment
also joint mobilizations, manipulation
If the frontal plane is rotated 14 degrees laterally from the M/L axis, what motion is being introduced to the talocrural joint?
A) PF/DF
B) Inv/Ever
C) Add/abd
C) add/abd
Which achilles tendon special test is the most sensitive?
Thompson's test (also the most specific too)
What are the key findings with achilles tendinopathy?
-pain 2-6 cm prox to insertion
-pain with palpation
- + arc sign
- + royal london
- - lumbar screen
What is one of the best strengthening exercises to improve achilles tendinopathy sx?
gastroc-soleus eccentrics
Which ligament can fail or become lax due to PTTD?
spring ligament
What is the pathoanatomy of a high ankle sprain?
Since the talocrural only has 1 DOF, when WB in DF and a pivot moment is created, it causes the tibia and fibula to separate.
How do you calculate the composite score of the Y balance test?
[(A + PL + PM)/(3 x leg length)] x 100
What is the mean difference with the navicular drop test?
10 mm (1 cm)
What type of manipulation is performed for PTTD?
navicular dorsal glide manipulation
What is important to emphasize to your patient when they are seeing maximal recovery at week 12 and want to discontinue exercise?
Tendons do not have a lot of vascularity, takes a long time to see benefits and to heal. The imaging can still be unchanged during this time even if you feel like you are getting better.