Maitland knee and ankle

joint
 Learning outcomes

By the end of the lecture, students will be able to:

• Apply various assessment and treatment techniques at knee and

ankle joint as per Maitland’s approach
KNEE JOINT
PASSIVE MOVEMENT TESTS OF VARIOUS KNEE
COMPONENTS
 Tibiofemoral joint Physiological
movements
• Extension variations:
1. extension
2. extension/adduction
3. extension/abduction
4. extension/adduction, including anteroposterior movement extension/abduction,
including anteroposterior movement
• Flexion variations:
5. flexion
6. flexion/adduction, including rotations
7. flexion/abduction, including rotations
8. medial rotation, lateral rotation
 Accessory movements at Tibiofemoral
Joint
• abduction, adduction
• posteroanterior movement, anteroposterior movement
• longitudinal caudad, longitudinal cephalad
• transverse medially, transverse laterally
• medial rotation, lateral rotation.
The accessory movements are most frequently applied to the tibia;
however, they can be carried out on the femur as well.
 PATELLOFEMORAL JOINT
• longitudinal movement caudad and cephalad, including inclinations
• transverse movement medially and laterally, including inclinations
• distraction
• compression
• rotation around the sagittal axis and around the longitudinal axis
TIBIOFEMORAL POSTEROANTERIOR
GLIDE
Tibiofemoral anteroposterior movement:
(a) grade I; (b) grade II.
Tibiofemoral movements: (a) lateral; (b)
media
Rotation around longitudinal axis/sagittal
axis
Treatment example: in 60' flexion, do longitudinal
movements of patellofemoral joint: (a) caudad; (b)
cephalad; (c) transverse medial.
ACCESSORY MOVEMENTS OF THE SUPERIOR
TIBIOFIBULAR JOINT: EXAMINATION AND TREATMENT
TECHNIQUES
Superior tibiofibular joint: (a) anteroposterior movement;
(b) anteroposterior movement with compression
Superior tibiofibular joint: (a) posteroanterior movement;
(b) posteroanterior movement with compression
ANKLE JOINT
Which ankle movement/s will improve the application of
following glides to distal end of the fibula?
• Cranial
• Posterior
• Caudal
• Anterior
• Caudal movement
• Cranial movement
Metatarsophalangeal joints: active testing
including overpressure
Why inferior tibiofibular joint assessment
is more important in ankle pain?
INFERIOR TIBIOFIBULAR JOINT
The inferior tibiofibular joint is more often the cause of symptoms than the
superior tibiofibular joint and should be examined routinely when ankle pain is
present. Movement is described in relation to the movement of the fibula on the
larger, more stable tibia. The movements are:
• Posteroanterior movements (PA)
• Anteroposterior movements (AP)
• Compression
• Longitudinal movement caudad (with leverage of hind-foot)
• Longitudinal cephalad (with leverage of the foot)
• Strong rotation of the talus (produced via the foot); this also produces movement
at the tibiofibular joint, as well as dorsiflexion of the hind-foot, by compression of
the talus into the mortise.
Differentiation of plantar flexion: (a) whole foot plantar flexion; (b) as in (a)
but without MTP joints.
Summarize which ankle movement/s will improve the
application of following glides to distal end of the fibula
• Cranial
• Posterior
• Caudal
• Anterior
• Caudal movement
• Cranial movement