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      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
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      • Resisted Supination External Rotation Test
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        • Hyperabduction Test
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      • Yergason's Test
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    • Knee >
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      • McMurray Test
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      • Posterior Sag Sign
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      • Thessaly Test
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    • Foot/Ankle >
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Assessing Hip Extension Mobility with Ankle/Foot Pain

6/9/2019

6 Comments

 
Hip extension mobility and anterior chain extensibility are assessments that should often be considered in patients with ankle/foot pain. Often, we see that ankle DF and hip ext ROM are limited simultaneously in patients and one can impact the other. When we are assessing gait, a patient will have difficulty with terminal stance phase due to either of these issues. The ankle and hip must each achieve 10-20 deg of DF and ext accordingly. A limitation in either of these may lead to compensation: early heel rise, excessive lumbar extension, shorter stride length, etc.
Picture
In the case of Lumbar Extension or Extension-Rotation Movement Impairment Syndromes (MIS), typically we see loss of hip extension mobility leading to excessive lumbar extension motion in standing, walking, or supine positioning. Anything that requires the hip to move into extension will instead move in the lumbar spine, due to flexibility deficits. Over time, this may lead to a painful state. Increasing hip extension mobility may help the local motion, but if the functional pattern (gait) and associated impairments aren’t address as well, the patient may continue to have difficulty with an activity like walking. A patient may have gained enough hip extension mobility to achieve normal terminal stance positioning; however, the restricted ankle DF motion must be also be improved to see the change in gait.

So how do we make sure that we don’t miss these impairments in our exam? The answer is simple: make sure you do a thorough exam that is efficient and a standardized procedure. My exam sequence for strength and mobility looks identical in >95% of my lower quarter patients (minus adding/subtracting a few special tests each time). If you make it a habit, you will be much less likely to miss it. So make sure in your foot/ankle patients, you are assessing hip ext mobility as well looking at ankle DF mobility for your low back/hip patients.

Dr. Chris Fox, DPT, OCS



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6 Comments
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6/24/2020 01:20:04 am

Ankle foot pains are worse, if not the worst. Glad you highlighted some important points. Thank You for this article.

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When it comes to evaluating hip extension mobility, individuals experiencing ankle or foot pain may face unique challenges. Proper hip extension is crucial for various activities, such as walking, running, and performing functional movements. However, discomfort in the lower extremities can restrict the range of motion and hinder accurate assessments. To overcome these limitations, it is essential to consider specialized techniques and modifications that accommodate individuals with ankle or foot pain.

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  • Home
  • About Us
  • TSPT Academy
  • Resources
    • Newsletter
    • Orthopedic Blog
    • Featured Articles
    • Research Articles
    • Residency Corner
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test