Subtalar, Midfoot and Knee-to-Wall Tests for the Stiff Ankle

For the subtalar joint, Dave stabilizes the midfoot and cups the calcaneus, rocking it in the transverse plane and then the frontal plane. A patient who moves well on the prone tests but still has a stiff ankle may be missing subtalar pronation. The table torsion test, credited to Seattle physiotherapist Christopher Johnson, assesses the midfoot. With the foot flat in crook lying, the clinician stabilizes the bases of the first and fifth metatarsals while the patient pushes the knee out to the side. Limited range on the affected side points to midfoot stiffness. A foot that drifts toward midline when the first ray is pressed down suggests poor medial stability, which may affect the knee and hip. The knee-to-wall test is done in half kneeling to reduce rotating over the leg. The patient moves back about a centimeter at a time while keeping the heel down, with a square pelvis and the knee over the second toe. Dave compares sides and looks at how the range is achieved, not only the number.