Ankle Distraction Manipulation

Foot-Ankle Manual Therapy Technique

Body Region: Ankle

Technique Name: Subtalar/Talocrural Distraction Manipulation

Indications: ankle sprain, plantar heel pain

Instructions:

Patient Position:

  • Patient in supine or long sit position with leg to receive treatment fully extended and contralateral leg in slight knee flexion with foot on table

Clinician Position:

  • Standing at foot of patient, facing towards the patient’s head
  • The hands are interclasped over the dorsum of the foot foot, placed just below the neck of the talus
  • The thumbs on the metatarsals provide firm counter-pressure on the plantar side of the foot

Technique Description:

  • The rearfoot is inverted or everted to find the position of less resistance
  • The leg is raised to position ankle at best angle for distraction
  • A long-axis distraction mobilization is imparted on the joint in a caudal direction (can range from slow velocity oscillatory mobilization to high velocity thrust manipulation)

Key Points:

  • Ensuring that the talocrural joint is in a loose-packed position with minimal joint resistance is key to isolating the movement to that joint

Related Techniques

  • Ankle Dorsiflexion
  • Ankle Dorsiflexion MWM
  • Ankle Inversion - Eversion
  • Cuboid Manipulation Prone
  • Cuboid Manipulation Supine
  • Cuneiform Manipulation
  • Distal Tibiofibular A-P/P-A
  • Distal Tibiofibular P-A Prone - ALT
  • Distal Tibiofibular P-A Prone
  • Distal Tibiofibular A-P
  • Distal Tibiofibular Superior Glide
  • Metatarsal Fan Mobilization
  • Navicular A-P Thrust
  • Subtalar Eversion Manipulation
  • Subtalar Medial-Lateral Glides
  • Talocrural Prone A-P
  • Supine Talocrural A-P
  • Talocrural P-A (knee extended)
  • Talocrural P-A (knee flexed)
  • Tarsometatarsal Mobilization
  • Subtalar Eversion Whip