Orthopedic Exam / Special Tests for Physical Therapy: Ankle and Foot
Special Test: Neutral Position of the Talus
PURPOSE:
- Test for Neutral Position of the Talus
Procedure, Positive Test, Video:
Special Test: Neutral Position of the Talus: PROCEDURE:
[1] (Weight- Bearing Position) – Test for Neutral Position of the Talus
PROCEDURE:
- The patient stands with the feet in a relaxed standing position.
- The examiner palpates the head of the talus on the dorsal aspect of the foot with the thumb and forefinger of one hand.
- The patient is asked to slowly rotate the trunk to the right and then to the left, which causes the tibia to medially and laterally rotate so that the talus supinates and pronates.
Neutral Position of the Talus Test:
POSITIVE SIGN [1]:
- If the foot is positioned so that the talar head does not appear to bulge to either side, then the subtalar joint will be in its neutral position in weight bearing
[2] (Supine) – Test for Neutral Position of the Talus PROCEDURE:
- The patient lies supine with the feet extending over the end of the examining table.
- The examiner grasps the patient’s foot over the fourth and fifth metatarsal heads, using the thumb and index finger of one hand.
- The examiner palpates both sides of the head of the talus on the dorsum of the foot with the thumb and index finger of the other hand.
- The examiner then gently, passively dorsiflexes the foot until resistance is felt.
- While the examiner maintains the dorsiflexion, the foot is passively moved through an arc of supination (talar head bulges laterally) and pronation (talar head bulges medially).
Neutral Position of the Talus Test:
POSITIVE SIGN [2]:
- If the foot is positioned so that the talar head does not appear to bulge to either side, the subtalar joint will be in its neutral nonweight- bearing.
[3] (Prone) = Test for Neutral Position of the Talus
PROCEDURE:
- The patient lies prone with the foot extended over the end of the examining table.
- The examiner grasps the patient’s foot over the fourth and fifth metatarsal heads with the index finger and thumb of one hand.
- The examiner palpates both sides of the talus on the dorsum of the foot, using the thumb and index finger of the other hand.
- The examiner then passively and gently dorsiflexes the foot until resistance is felt.
- While maintaining the dorsiflexed position, the examiner moves the foot back and forth through an arc of supination (talar head bulges later-ally) and pronation (talar head bulges medially).
Neutral Position of the Talus Test:
POSITIVE SIGN [3]:
- As the arc of movement is performed, there is a point in the arc at which the foot appears to “falloff” to one side or the other more easily. This point is the neutral, non-weight-bearing position of the subtalar joint.