Ankle and Lower Leg
History
Location of the pain
Nature of the pain
Onset
Injury mechanisms
Level of activity and conditioning regimen
Prior history


Inspection
General Inspection
WTB status

  General bilateral comparison
  Swelling
Lateral Structures
  Peroneal muscle group
  Distal one-third of the fibula
  Lateral malleolus
Anterior Structures
  Appearance of the anterior lower leg
  Contour of the malleoli
  Talus
  Sinus tarsi
Medial Structures
  Medial malleolus
  Medial longitudinal arch
Posterior Structures
  Gastrocnemius-soleus complex
   Atrophy (S1 or S2 nerve root or tibial or sciatic nerves are impaired)
   Deep vein thrombophlebitis (Unexpected redness and swelling of the posterior calf)
  Achilles tendon
  Bursae
  Calcaneus

Palpation
Lateral Structures

  Fibula shaft
  Interosseous membrane
  Anterior and posterior tibiofibular ligaments
  Calcaneofibular ligament
  Anterior talofibular ligament
  Posterior talofibular ligament
  Peroneal tubercle
  Cuboid
  Base of the fifth metatarsal
  Peroneus longus and brevis
  Peroneal retinaculum
Anterior Structures
  Anterior tibial shaft
  Dome of the talus
  Extensor retinacula
  Sinus tarsi
  Tibialis anterior
  Long toe extensors
  Peroneus tertius
Medial Structures
  Medial malleolus
  Deltoid ligament
  Sustentaculum tali
  Spring ligament
  Navicular and Navicular tubercle
  Talar head
  Tibialis posterior
  Long toe flexors
Posterior Structures
  Gastrocnemius-soleus complex
  Achilles tendon
  Subtendinous calcaneal bursa
  Subtaneous calcaneal bursa
  Dome of the Calcaneus
Palpation of pulses
  Posterior tibial artery
  Dorsalis Pedis artery

Range of Motion Tests
AROM/PROM/RROM (Dorsiflexion, Plantarflexion, Inversion, Eversion)

Ligamentous Tests
Anterior Talofibular Ligament Instability

  Anterior drawer test
Calcaneofibular Ligament Instability
  Inversion stress test (talar tilt)
Ankle Syndesmosis Instability
  Kleiger’s Test (External rotation test)
  Squeeze test
Deltoid Ligament Instability
   Eversion stress test (talar tilt)
  External rotation test

Neurological Tests
Anterior compartment syndrome
Peroneal nerve involvement
Sciatic nerve involvement
Lumbar nerve root involvement

Special Tests
Lower Leg Fractures
  Squeeze test
Stress Fracture
  Bump test
Achilles Tendon Pathology
  Thompson test
Neurovascular Pathology
  Homan’s sign (Test for Deep Vein Thrombophlebitis)