Abstract
Background: A restricted tibio-fibular joint can result in decreased internal and external rotation of the ankle and feet. This decreased range of motion disrupts musculoskeletal function. The musculoskeletal function of the tibio-fibular joint promotes ankle stability and shock absorption during weight bearing activities. The leg tug technique (LTT) technique will be used to promote restoring the normal range of motion of this tibio-fibular joint.
Methods: This study focuses on restoring the loss of range of motion in the proximal tibio-fibular joint, with an application of an HVLA adjacent technique. Referred to as the leg tug technique (LTT), this manipulation involves a practitioner grasping the calcaneal region (heel) and applying a quick caudal thrust. To evaluate LTT efficiency on foot/ankle rotation a sample of 20 participants (ten male and ten female) from a southeastern osteopathic medical school participated in a quasi-experimental study. Range of motion at the ankle and foot was measured prior to and directly after the manipulation. To maintain measurement consistency, each measured leg was stabilized at the proximal tibio-fibular joint at the knee and assessed for external and internal rotational motion at the ankle with a goniometer. LTT was performed with the participant’s leg stabilized in neutral positioning.
Results: Measurements taken before and after the LTT performance indicated statistically significant improvement in the passive range of motion. Internal rotation before and after comparison in females had a p-value of 0.01 and males had a p-value of 0.001 and for external rotation, females had a p-value of 0.02 and males had a p-value of 0.001. External range of motion showed a mean improvement of 10.2 degrees in females and 6.3 degrees in males and internal range of motion showed a mean improvement 9.2 degrees in females and 12.9 degrees in males.
Conclusion: The LTT improved the tibio-fibular range of motion at the knee among the current sample of participants. The limitations of the current study preclude declaring the LTT as a universal method for improving tibio-fibular range of motion at the knee. However, this limited study offers an effective manual manipulative technique to restore loss of range of motion due to a tibio-fibular restriction.
Keywords
Manual medicine, Muscle and joint injuries, Osteopathic manipulative medicine