Immediate effect of a single anteroposterior talus mobilization on dorsiflexion range of motion in participants with orthopedic dysfunction of the ankle and foot.

The authors conducted this study in order to establish the immediate effects of a single anteroposterior mobilization of the talus on the active dorsiflexion range of motion (ROM) in individuals with different orthopedic foot and ankle injuries. Their study consisted of 30 male and female participants aged 18 to 50 years with unilateral orthopedic foot and ankle dysfunction. All participants underwent 3 sets of active dorsiflexion ROM measurement in both ankles. Measurements were baseline, post-first treatment, and post-second treatment values. The participants received either joint mobilization or manual contact (control) on the affected ankle. Active dorsiflexion ROM was assessed using a biplanar goniometer with participants in the prone position and 90° of knee flexion. Both groups (joint mobilization and manual  contact) displayed greater active dorsiflexion ROM. However, the mean difference of dorsiflexion measurements before and after mobilization was greater than before and after control treatment.

The authors concluded that a single session of articular mobilization of the talus didn’t substantially increase dorsiflexion ROM in patients presenting orthopedic dysfunctions of the ankle and foot compared with a manual contact procedure.

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I recall another study with similar results though the precise method not explained. I have observed some clinicians mobilize with direct contact (only) onto the anterior talus, client supine inducing only a glide. Because glide is so limited working only on glide does not gain much whereas a contact with the calcaneus which I call a calcaneal scoop enhances the main motion which is rotational in the sagittal plane. With the scoop coupled with A-P glide (heel of hand on anterior talus) gains can be dramatic, more often than not. I prefer 30 oscillations with moderately firm, pressure. The client is taught a self-mob technique with the anterior part of lower leg on a stool foot hanging off, they scoop the back of the heel and distract coupled with active dorsiflexion, in addition to traditional stretches. The passive treatment is a one-time intervention. Sometimes a more complex pattern exists throughout the foot and ankle, othertimes the subtalar joint gains normative eversion and abduction in response to the above “talocrural” mobilization. I appreciate the post and yes research needed especially re most appropriate mobilization technique, and the reversible muscular inhibition that is clinically observered, etc.

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