The Talar Tilt Test: Lateral Ankle Sprain

 In Foot

Talar Tilt Test:

If you’ve been keeping up with our series this month on the Knee and Foot, you’ll have seen loads of new videos with Bonnie on various screens and landmark demo’s! In particular, the bones of the foot…If you haven’t watched this yet, and you’re interested in the details of the Talar Tilt Test then we recommend you pop on over to our YouTube channel and subscribe first of all – and then watch the Ligaments of the Foot video! It will help to understand the videos which proceed it!

If you’re already up to date with our videos then welcome to the latest addition! Today we’re looking at the Talar Tilt Test for Lateral Ankle Sprains. We’ve covered a few screens on ankle sprains lately, but as there is more than one way to sprain your ankle, we feel it’s important to have a few screens in your toolbox which can help you to accurately locate the source of trauma or pain and then be able to adequately assist your client to rehab and then strengthen that joint.

 

The Talar Tilt Test as mentioned above is used for testing someone who’s recently suffered from an inversion ankle sprain. This screen aims to target the lateral ligaments of the foot, specifically the Anterior Talofibular Ligament, the Calcaneofibular Ligament and the Posterior Talofibular Ligament.

Anterior Talofibular Ligament: 

The Anterior Talofibular Ligament is often abbreviated to the ATFL (much easier to say!) and it’s the most anterior ligament on the lateral side of the ankle. It runs from the anterior surface of the fibula to the talus and therefore it is named the anterior talofibular ligament. This ligament’s function is to restrict  the foot from excessively sliding forward in relation to the tibia…Did you know, it’s the most commonly injured ligament in an inversion ankle sprain!

Calcaneofibular Ligament:

Also referred to as the CFL – This ligament runs from the fibula to the calcaneus and is therefore called the calcaneofibular ligament. This ligament’s primary function is to restrict excessive inversion at the subtalar joint

Posterior Talofibular Ligament:

If you haven’t guessed it by now, the Posterior Talofibular Ligament is also known as the PTFL. It spans from the fibula to the talus on the posterior aspect. This ligament’s primary function is to prevent excessive inversion at the subtalar joint.

How to Screen: 

Integrity of the ATFL: 

Take the foot into a slight plantar flexion, then take hold of the calcaneus and then take the foot into inversion. This test would be positive if you felt excessive gapping the joint when inverting the foot or if the client reported any pain during this test.

Integrity of the CFL: 

Take the foot into a neutral position, again taking hold of the calcaneus and taking the foot into inversion. As above, this test would be positive if the client had pain during this movement or if you felt excessive gapping in the joint.

Integrity of the PTFL:

Take the foot into full dorsiflexion, hold the calcaneus and take the foot into inversion. If you feel excessive gapping of the joint or your client felt any pain during this movement then you know this is a positive screen and the integrity of the ligament has been compromised.

What about the Deltoid Ligaments?

Don’t worry – We’re looking at those too! The deltoid ligaments are situated on the medial side of the ankle as opposed to the preceding 3 which are all located on the lateral side. The deltoid ligaments are a group of ligaments which are all there to restrict excessive eversion at the subtalar joint.

To screen these, all you’ll need to do is take the foot into the neutral position, hold the calcaneus and then take the foot into eversion. If there’s pain or excessive gapping in the joint here, then the deltoid ligaments will need to be looked at.

All of these screens are really helpful when you need to narrow down the source of a sprain – But what we look at on our courses is then how you would help your client to effectively strengthen and rehab the joint using Pilates based exercise. Pilates is all about optimal movement so if we know which area of the body is preventing that and we can work on correctly and strengthening the weak link then we’ll have happy, pain free clients! Winners all round!

If any of these screens test positively, then it’s best to be safe and refer your client onto their GP or physiotherapist for further investigation before allowing them to participate in your class.

Once your client has seen a medical practitioner and has been cleared for Pilates exercise, there are many things you can do to help and potentially improve their condition. We delve deeper into this on our Knee and Foot courses and we still have a few spaces free should you wish to join us and learn more! So if you’re interested, please feel free to visit our Courses page or why not drop us an email at info@pilatestherapy.co.uk

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