Special test for the alignment of the ankle :

• Alignment tests are used to determine the relation of the leg to the hindfoot & the relation of the hindfoot to the forefoot.
• These tests are orthopedic or clinical.
• These tests are applied to the clinic by the therapist or doctor.
• These tests applied the check the alignment of the ankle

Name of the special test of the alignment of the ankle :

1. Coleman block test
2. Forefoot – heel alignment
3. Leg-heel alignment

Purpose of the three alignment tests :

• These tests are used to differentiate functional from anatomical means structural deformities or asymmetries.

Coleman block test :-

• This Coleman block test differentiates a hindfoot Varus which is resulting from a forefoot valgus from a hindfoot Varus which is resulting from a tight tibialis posterior.

• If the examiner is found to have a hindfoot Varus in standing into the patient, then the examiner places a lift/block under the lateral side of the forefoot.

• Result = if the hindfoot Varus is corrected, it indicates the hindfoot is flexible & the hindfoot Varus is due to a plantarflexed first ray or a valgus forefoot.
• If the hindfoot Varus is not correct, it is indicated to the tightness of the tibialis posterior muscle.

Forefoot – heel alignment :-

Technique :

• The patient position for the test is supine with the feet extending at the end of the examining table.
• The examiner positions the subtalar joint in the supine neutral position.
• While maintaining this position, the examiner pronates the midtarsal joints maximally & then observes the relationship between the vertical axis of the heel & the plane of the second thought fourth metatarsal heads.

Result :

• Normally, this alignment plane is perpendicular to the vertical axis.

• If the patient’s medial side of the foot is raised, it is indicated to the patient has a forefoot varus.
• If the patient’s lateral side of the foot is raised, it is indicated to the patient has a forefoot valgus.

Leg-heel alignment :-

Technique :

• In this test patient’s position for the test is the prone position with the foot is extending over the end of the examining table.
• The examiner puts a mark on the midline of the calcaneus bone at the insertion of the Achilles tendon.
• The examiner makes a second mark approximately 1 cm distal to the first mark & as close to the midline of the calcaneus as possible.
• A calcaneal bone line is made when to join the two marks which are drawn by the therapist.
• Then the examiner draws two marks in the midline on the lower third of the leg.
• When these two marks are joined, which is forming the tibial line & it represents the longitudinal axis of the tibia.
• The examiner then places the subtalar joint is held in neutral, the examiner looks at the two lines.

Result :

• If these two lines are parallel/in slight Varus means 2′ to 8′, in this situation the leg-to-heel alignment is considered normal.
• If the heel is everted, the patient is suffering from hindfoot valgus.
• If the heel is inverted, the patients suffer from hindfoot Varus.