Diagnosing lower limb somatic dysfunction

Page created: March 15, 2021

Notes

Lower limbs

Diagnosing lower limb somatic dysfunction

See the “Special tests for the lower limb” page for discussion of hip and knee dysfunctions and the related diagnostic tests.
FIBULAR HEAD SOMATIC DYSFUNCTION
Anterior fibular head
  • Prefers anterior movement
  • Restricted posteromedial glide
  • Caused by external rotation of the tibia with dorsiflexion and eversion (pronation) of the foot
    • Eversion ankle sprain

Posterior fibular head
  • Prefers posterior movement
  • Restricted anterolateral glide
  • Caused by internal rotation of the tibia with plantar flexion and inversion (supination) of the foot
    • Inversion ankle sprain
Figure 1. Fibular head mechanics. Left image: pronation at the ankle causes the fibular head to move anteriorly. Right image: supination at the ankle causes the fibular head to move posteriorly.
TALUS SOMATIC DYSFUNCTION
Anterior talus
  • Ankle prefers plantar flexion
  • Ankle restricted in dorsiflexion
  • Tibia is posterior on the talus

Posterior talus
  • Ankle prefers dorsiflexion
  • Ankle restricted in plantar flexion
  • Tibia is anterior on the talus
CUBOID AND NAVICULAR SOMATIC DYSFUNCTION
Cuboid
  • Prefers eversion with plantar flexion
  • Longitudinal arch of foot is flattened
  • Tenderness at cuboid with palpable protrusion of medial edge

Navicular
  • Prefers inversion with plantar flexion
  • Medial arch of foot is flattened
  • Tenderness at navicular with palpable protrusion of medial edge
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Illustrator: Aileen Lin, MScBMC
Editor: Robyn Hughes, MScBMC