1. Foot & Ankle Examination

2. Subjective Age Occupation & Sport – sports, shoes, dominant foot Site - localised Spread - little Onset – overuse, trauma, insidious Duration – recent, longstanding, intermittent Behaviour – agg/ ease Symptoms – clicking, crepitus, locking, swelling, p+ns PMSH

3. Observation Gait Posture Deformity Colour Wasting Swelling Site of pain State at rest

4. Palpation Heat Swelling Synovial Thickening Pulses

5. Ankle Joint Capsular pattern = more loss of plantar flex Pain, range and end feel Passive plantar flex Passive dorsi-flex (knee flexed)

6. Ankle Joint Ligaments Passive plantar flexion and inversion Stresses lateral ligaments Passive plantar flexion and eversion Stresses deltoid ligament

7. Talo-calcaneal Joint Capsular pattern = loss of varus Heel varus Heel valgus

8. Mid tarsal Joint Capsular pattern = loss of adduction, inversion and dorsi-flexion Pain, range and end feel Passive plantar flexion Passive dorsi- flexion Passive abduction Passive adduction Passive medial rotation Passive lateral rotation

9. Muscles Pain and power Resisted dorsi-flexion Resisted plantar flexion Resisted eversion Resisted inversion

10. Additional Tests Instability test – draw test Differentiation of ligaments: Anterior talo-fibular – plantar flex with inv Calcaneo-fibular – ankle in DF with varus of heel Calcaneo-cuboid – midtarsal inv with add Proprioception tests