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Ankle Distraction Manipulation

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
  • Evidence

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