Proximal Tibiofibular Non-Thrust Manipulation (Supine)
Purpose: To increase mobility of the tibiofibular joint and to increase terminal knee extension.
Procedure: With the patient in hooklying, the therapist can palpate the patient’s fibular head. The therapist can use one hand to stabilize the patient’s tibia, then use the other hand to grasp the patient’s fibular head between the palm and the fingers. The therapist can then provide either A-P or P-A forces to the proximal tibia.
Comments: P-A glides can help restore ankle plantarflexion while A-P glides can help restore ankle dorsiflexion. Be cautions not to irritate the common peroneal nerve when palpating for the head of the fibula.
Proximal Tibiofibular Non-Thrust Manipulation (Prone)
Purpose: To increase mobility of the tibiofibular joint and to increase terminal knee extension.
Procedure: With the patient in prone, slightly flex the knee and place a towel roll under the mid-tibia. The therapist can use the palm of their hand to provide a P->A glide to the patient’s proximal fibula.
Comments: P-A glides can help restore ankle plantarflexion while A-P glides can help restore ankle dorsiflexion. Be cautions not to irritate the common peroneal nerve when palpating for the head of the fibula.