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Cervical Spine
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Windlass Mechanism Test
Purpose: To test for the presence of fascial and ligamentous impairments of the foot.
Test position: Part 1: Sitting
Part 2: Standing
Performing the Test:
Part 1: In sitting, the examiner stabilizes the ankle in neutral with 1 hand just proximal to the 1st metatarsal head. Next, the examiner extends the first phalange while allowing the IP joint to flex. A positive test is considered if passive extension is continued to end range or until the patient's pain is reproduced.
Part 2: The patient stands on a stool with the metatarsal heads just off the edge of the stool. The patient is instructed to place equal weight on both feet. Again, the examiner passively extends the first phalange while allowing the IP to flex. A positive test is considered if passive extension is continued to end range or until the patient's pain is reproduced.
Diagnostic Accuracy: Unknown.
Importance of the Test: The windlass effect is the primary mechanism that lifts the medial longitudinal arch during toe off. As the toes extend, the plantar fascia lengths and increases tension on the medial longitudinal arch. This increased tension pull the arch together, raises, and stabilizes the foot during toe-off. Decreased tension would limit the effectiveness of the windlass mechanism and less toe-off would be noted. Clients that have pain or excessive toe extension motion should be examined more thoroughly. Additionally it would be important to check foot type, intrinsic muscle strength, and resting foot position.
Note: these tests should only be performed by properly trained health care practitioners
Test position: Part 1: Sitting
Part 2: Standing
Performing the Test:
Part 1: In sitting, the examiner stabilizes the ankle in neutral with 1 hand just proximal to the 1st metatarsal head. Next, the examiner extends the first phalange while allowing the IP joint to flex. A positive test is considered if passive extension is continued to end range or until the patient's pain is reproduced.
Part 2: The patient stands on a stool with the metatarsal heads just off the edge of the stool. The patient is instructed to place equal weight on both feet. Again, the examiner passively extends the first phalange while allowing the IP to flex. A positive test is considered if passive extension is continued to end range or until the patient's pain is reproduced.
Diagnostic Accuracy: Unknown.
Importance of the Test: The windlass effect is the primary mechanism that lifts the medial longitudinal arch during toe off. As the toes extend, the plantar fascia lengths and increases tension on the medial longitudinal arch. This increased tension pull the arch together, raises, and stabilizes the foot during toe-off. Decreased tension would limit the effectiveness of the windlass mechanism and less toe-off would be noted. Clients that have pain or excessive toe extension motion should be examined more thoroughly. Additionally it would be important to check foot type, intrinsic muscle strength, and resting foot position.
Note: these tests should only be performed by properly trained health care practitioners
References:
Neumann, Donald. Kinesiology of the Musculoskeletal System. 2nd Edition. Mosby Printing Inc. Print.
Neumann, Donald. Kinesiology of the Musculoskeletal System. 2nd Edition. Mosby Printing Inc. Print.
