Ankle and Lower Leg PRT Quiz

Positional Release Therapy for Ankle and Lower Leg: Anterior and Medial Structures

• The tibialis anterior muscle assists in slowing foot and ankle pronation during the initial phases of gait.

• The extensor digitorum longus muscle extends the second through fifth toes and assists with ankle dorsiflexion and foot eversion.

• The anterior talofibular ligament is the weakest and one of the most commonly torn lateral collateral ligaments of the ankle.

• The deltoid ligament is composed of four ligaments that fan distally from the medial malleolus to their respective insertion sites.

• The tibialis posterior muscle helps to stabilize the arch during ambulation.

• The palpation procedure for the tibialis anterior muscle involves finding its belly at the upper two thirds of the tibia and tracing its tendon medially across the ankle joint.

• The palpation procedure for the extensor digitorum longus muscle involves locating it between the tibialis anterior and peroneal muscles and having the patient extend the lesser toes against resistance.

• The palpation procedure for the anterior talofibular ligament involves moving anteriorly off the anterior portion of the lateral malleolus toward the neck of the talus.

• The palpation procedure for the deltoid ligament involves strumming across the thickening of the tibiocalcaneal ligament and determining the location of any tender points or fasciculatory response of the ligament and its origin and attachment.

• The deep palpation procedure for the tibialis posterior muscle and tendon involves tracing the tendon just medial to the medial malleolus upward along the shaft of the tibia and rolling the fingers upward against the posterior lateral shaft of the tibia to apply indirect pressure to the posterior tibialis musculature.

• PRT clinician procedures for these structures involve various combinations of ankle movements and compressions to produce joint glides and affect corollary tissues.

• Patient self-treatment procedures involve grasping the heel and moving the ankle and foot into specific positions while feeling for the most relaxed tissue position and also the presence of a fasciculation, followed by external rotation of the ankle and compression toward the knee by pushing upward against the calcaneus until the fasciculation has subsided or abated.Positional Release Therapy for Ankle and Lower Leg Structures

• Positional Release Therapy (PRT) is a technique used to alleviate pain and tension in specific muscles and ligaments in the ankle and lower leg.

• PRT involves the use of gentle pressure and positioning to achieve a relaxed state in the targeted tissue.

• PRT is effective for treating medial and posterior structures in the ankle and lower leg, including the tibialis posterior muscle and tendon, Achilles tendon, soleus muscle, and gastrocnemius muscle.

• PRT can be performed by a clinician or self-administered by the patient.

• For medial structures, the clinician or patient can use the calcaneus as a fulcrum and move the lower leg and ankle into marked internal rotation and plantar flexion with the far hand.

• For posterior structures, the clinician or patient can palpate the Achilles tendon and slide the fingers off its borders to locate the lower portions of the soleus muscle.

• Gastrocnemius muscle can be isolated from the soleus muscle by having the patient plantar flex the ankle while the knee is flexed.

• The calcaneofibular ligament, which limits ankle inversion, can also be targeted with PRT.

• PRT can be performed by placing the involved side on the opposite thigh and moving the ankle into maximal plantar flexion and inversion while feeling for the most relaxed tissue position and fasciculation.

• Once the most relaxed position or strong fasciculation is found, inversion and internal rotation of the ankle can be applied, followed by cephalad calcaneal compression toward the knee.

• PRT can be used to treat a variety of conditions, such as ankle sprains, tendinitis, and muscle strains.

• PRT is a non-invasive technique that can be used as a standalone treatment or in conjunction with other therapies.Positional Release Therapy Procedure for Peroneus Longus and Brevis Muscles

• Peroneal muscles are commonly strained with ankle sprains and can produce avulsion fractures.

• The brevis muscle is deep to the longus and can be felt on either side of the longus tendon at the lower third of the ankle.

• The peroneus longus muscle assists with foot eversion, ankle plantar flexion, and supports the longitudinal and transverse arches.

• The palpation procedure involves locating the fibular head and strumming across the peroneus longus muscle belly to its tendinous aspect, then sliding fingers off either side of the tendon onto the muscle belly of the brevis and repeating the strumming procedure.

• Tender points or fasciculatory response of the muscles and their tendons and attachment sites should be noted for PRT treatment.

• The PRT clinician procedure involves the patient being prone with the knee flexed to 90° and the shin supported, moving the ankle through its range of motion to find the optimal treatment position.

• The clinician applies marked ankle eversion coupled with heavy calcaneal compression, external tibial rotation, and forefoot eversion for fine-tuning.

• Corollary tissues treated include peroneal tendons, peroneus tertius, and extensor digitorum brevis.

• The procedure is for use only in Positional Release Therapy Course 2-Sport Medics.

• The procedure is described in T. Speicher's Clinical Guide to Positional Release Therapy.

• A video (5.7) is available for the peroneus longus and brevis PRT procedure.

• The procedure is used to treat lateral structures of the ankle and lower leg.

Positional Release Therapy for Ankle and Lower Leg: Anterior and Medial Structures

• The tibialis anterior muscle assists in slowing foot and ankle pronation during the initial phases of gait.

• The extensor digitorum longus muscle extends the second through fifth toes and assists with ankle dorsiflexion and foot eversion.

• The anterior talofibular ligament is the weakest and one of the most commonly torn lateral collateral ligaments of the ankle.

• The deltoid ligament is composed of four ligaments that fan distally from the medial malleolus to their respective insertion sites.

• The tibialis posterior muscle helps to stabilize the arch during ambulation.

• The palpation procedure for the tibialis anterior muscle involves finding its belly at the upper two thirds of the tibia and tracing its tendon medially across the ankle joint.

• The palpation procedure for the extensor digitorum longus muscle involves locating it between the tibialis anterior and peroneal muscles and having the patient extend the lesser toes against resistance.

• The palpation procedure for the anterior talofibular ligament involves moving anteriorly off the anterior portion of the lateral malleolus toward the neck of the talus.

• The palpation procedure for the deltoid ligament involves strumming across the thickening of the tibiocalcaneal ligament and determining the location of any tender points or fasciculatory response of the ligament and its origin and attachment.

• The deep palpation procedure for the tibialis posterior muscle and tendon involves tracing the tendon just medial to the medial malleolus upward along the shaft of the tibia and rolling the fingers upward against the posterior lateral shaft of the tibia to apply indirect pressure to the posterior tibialis musculature.

• PRT clinician procedures for these structures involve various combinations of ankle movements and compressions to produce joint glides and affect corollary tissues.

• Patient self-treatment procedures involve grasping the heel and moving the ankle and foot into specific positions while feeling for the most relaxed tissue position and also the presence of a fasciculation, followed by external rotation of the ankle and compression toward the knee by pushing upward against the calcaneus until the fasciculation has subsided or abated.Positional Release Therapy for Ankle and Lower Leg Structures

• Positional Release Therapy (PRT) is a technique used to alleviate pain and tension in specific muscles and ligaments in the ankle and lower leg.

• PRT involves the use of gentle pressure and positioning to achieve a relaxed state in the targeted tissue.

• PRT is effective for treating medial and posterior structures in the ankle and lower leg, including the tibialis posterior muscle and tendon, Achilles tendon, soleus muscle, and gastrocnemius muscle.

• PRT can be performed by a clinician or self-administered by the patient.

• For medial structures, the clinician or patient can use the calcaneus as a fulcrum and move the lower leg and ankle into marked internal rotation and plantar flexion with the far hand.

• For posterior structures, the clinician or patient can palpate the Achilles tendon and slide the fingers off its borders to locate the lower portions of the soleus muscle.

• Gastrocnemius muscle can be isolated from the soleus muscle by having the patient plantar flex the ankle while the knee is flexed.

• The calcaneofibular ligament, which limits ankle inversion, can also be targeted with PRT.

• PRT can be performed by placing the involved side on the opposite thigh and moving the ankle into maximal plantar flexion and inversion while feeling for the most relaxed tissue position and fasciculation.

• Once the most relaxed position or strong fasciculation is found, inversion and internal rotation of the ankle can be applied, followed by cephalad calcaneal compression toward the knee.

• PRT can be used to treat a variety of conditions, such as ankle sprains, tendinitis, and muscle strains.

• PRT is a non-invasive technique that can be used as a standalone treatment or in conjunction with other therapies.Positional Release Therapy Procedure for Peroneus Longus and Brevis Muscles

• Peroneal muscles are commonly strained with ankle sprains and can produce avulsion fractures.

• The brevis muscle is deep to the longus and can be felt on either side of the longus tendon at the lower third of the ankle.

• The peroneus longus muscle assists with foot eversion, ankle plantar flexion, and supports the longitudinal and transverse arches.

• The palpation procedure involves locating the fibular head and strumming across the peroneus longus muscle belly to its tendinous aspect, then sliding fingers off either side of the tendon onto the muscle belly of the brevis and repeating the strumming procedure.

• Tender points or fasciculatory response of the muscles and their tendons and attachment sites should be noted for PRT treatment.

• The PRT clinician procedure involves the patient being prone with the knee flexed to 90° and the shin supported, moving the ankle through its range of motion to find the optimal treatment position.

• The clinician applies marked ankle eversion coupled with heavy calcaneal compression, external tibial rotation, and forefoot eversion for fine-tuning.

• Corollary tissues treated include peroneal tendons, peroneus tertius, and extensor digitorum brevis.

• The procedure is for use only in Positional Release Therapy Course 2-Sport Medics.

• The procedure is described in T. Speicher's Clinical Guide to Positional Release Therapy.

• A video (5.7) is available for the peroneus longus and brevis PRT procedure.

• The procedure is used to treat lateral structures of the ankle and lower leg.