The Brookbush Institute (BOC AP# P10038) is approved by the Board of Certification, Inc. to provide continuing education to Athletic Trainers (ATs). This program is eligible for a maximum of {{credits}} hours/ Category A CEUs. ATs should claim only those hours actually spent in the educational program.

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Joint manipulations for the ankle, midfoot, and tibiofibular joint. Types of manipulations, manipulations vs. mobilizations of the cuboid, talonavicular, and proximal tibiofibular joint. Optimal intervention for chronic ankle instability, balance, ankle sprains, vertical jump height, heel pain, knee bow in, knee bow out, feet flatten, feet turn out, excessive forward lean, and asymmetrical weight shift. The risk of adverse events, accuracy vs sensitivity, screening, reliability, and validity of ankle, midfoot, and tibiofibular manips.

Joint Manipulation: Ankle, Midfoot and Tibiofibular Joint

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I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

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Integrated Manual Therapist

This course describes joint manipulation techniques for the ankle (tibiotalar or talocrural joint, and talocalcaneal or subtalar joint), midfoot (cuboid, talonavicular, cuneonavicular, etc.), and proximal tibiofibular joints. Various synonyms and definitions have been used to describe the term "manipulation". The Brookbush Institute uses one conventional definition of the term "manipulations;" implying low-amplitude (relatively small motions), high-velocity (quick) techniques, intended to target and reduce the stiffness of specific joints or segments, that exhibit a decrease in passive accessory range of motion (a.k.a. stiffness during arthrokinematic motion; specifically glide). Research does imply that manipulations affect multiple joints simultaneously; however, the Brookbush Institute asserts that efforts to target the stiffest joints or segments will increase the likelihood that the stiffest segments are included in the "multiple joints" affected.

The Brookbush Institute has carefully selected manipulation techniques with the intent to increase the probability of practitioner success. That is, techniques have been chosen that are relatively easy to teach, reliably improve outcomes, and are the most commonly used. The Brookbush Institute does not wish to assert that these manipulation techniques are the only techniques that are effective, and/or that these are the best techniques for every outcome measure. It is possible that a highly complex, and/or advanced technique, may result in better outcomes, or that a particular pathology is better addressed with a rarely used technique.

Note, that the term "mobilization" is reserved for low-velocity techniques that are taught in a separate set of courses.

This course includes manipulation techniques that intend to reduce excessive stiffness of the tibiofibular joints, ankle joints, and transverse tarsal joints, improve dorsiflexion range of motion, medial longitudinal arch height, and normalize altered lower extremity muscle activity. For example, research demonstrates that ankle sprain may result in long-term loss of posterior glide of the talus on the tibia (anterior position fault), resulting in failure to regain optimal dorsiflexion, loss of invertor strength, and chronic ankle instability, and ankle manipulation are an effective treatment for improving arthrokinematic dysfunction. These techniques may also be used in an integrated approach for improving 

 including Achilles tendinopathy, plantar fasciitis, pes planus, knee valgus, iliotibial band syndrome (ITBS), patellofemoral pain syndrome (PFPS), etc. Additionally, due to the relationship between ankle motion and hip internal rotation during gait, these techniques may aid in the treatment of femoroacetabular impingement (FAI), psoas tendinitis, hip osteoarthritis, etc.

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) to develop an evidence-based, systematic, integrated, patient-centered, patient-centered, and outcome-driven approach.

Talonavicular and Cuneonavicular Joint Manipulation

Sample Intervention - "Feet Flatten (Functional Pes Planus)

Gastrocnemius and Soleus Static Manual Release

Extensor Hallucis Longus (EHL) and Extensor Digitorum Longus (EDL) Static Manual Release

Flexor Hallucis Longus (FHL) and Flexor Digitorum Longus (FDL) Static Manual Release

Instrument Assisted Soft Tissue Mobilization

Joint Manipulation: Lumbar Spine, Sacroiliac Joint, and Pubic Symphysis

Joint Manipulation: Elbow (Radial Head) and Wrist

Joint Manipulation: Ankle, Midfoot, and Tibiofibular Joint

For an introduction to joint mobilizations and manipulations:

Joint Mobilization and Manipulation: Introduction

Joint Mobilization and Manipulation: Reliability

Joint Mobilizations and Manipulations: Effects

Joint Mobilization and Manipulation: Risk of Adverse Effects

Joint Mobilizations and Manipulations: Evidence-based Teaching and Learning

Course Description: Ankle, Midfoot, and Tibiofibular Joint Manipulation

Introduction

Tibialis Anterior Manual Muscle Test (MMT)

Tibialis Posterior Manual Muscle Test (MMT)

Research Summary

Efficacy

Comparing Interventions

Combining Interventions

Systemic Effects

Research Corner: Ankle Joint (tibiotalor/talocrural) Manipulation

Tibiofibular Joint Manipulation

Midfoot Manipulations/Mobilizations

Calcaneus Mobilization/Manipulation

Research Corner: Additional Manipulations

Proximal Tibiofibular Joint Manipulation

Cuboid Manipulation

Talonavicular and Cuneonavicular Manipulation

Talocalcaneal Manipulation

Video Demonstrations

Nield, S., Davis, K., Latimer, J., Maher, C., & Adams, R. (1993). The effect of manipulation on range of movement at the ankle joint. Scandinavian journal of rehabilitation medicine, 25(4), 161-166.

Fryer, G. A., Mudge, J. M., & McLaughlin, P. A. (2002). The effect of talocrural joint manipulation on range of motion at the ankle. Journal of manipulative and Physiological Therapeutics, 25(6), 384-390.

Andersen, S., Fryer, G. A., & McLaughlin, P. (2003). The effect of talo-crural joint manipulation on range of motion at the ankle joint in subjects with a history of ankle injury. 

Köhne, E., Jones, A., Korporaal, C., Price, J. L., Brantingham, J. W., & Globe, G. (2007). A Prospective, Single-Blinded, Randomized, Controlled Clinical Trial of the Effects of Manipulation on Proprioception and Ankle Dorsiflexion in Chronic Recurrent Ankle Sprain. 

Journal of the American Chiropractic Association

Pellow, J. E., & Brantingham, J. W. (2001). The efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and grade II ankle inversion sprains. 

Journal of manipulative and physiological therapeutics

Whitman, J. M., Cleland, J. A., Mintken, P., Keirns, M., Bieniek, M. L., Albin, S. R., … & McPoil, T. G. (2009). Predicting short-term response to thrust and nonthrust manipulation and exercise in patients post inversion ankle sprain. 

journal of orthopaedic & sports physical therapy

Hedlund, S., Nilsson, H., Lenz, M., & Sundberg, T. (2014). Effect of chiropractic manipulation on vertical jump height in young female athletes with talocrural joint dysfunction: a single-blind randomized clinical pilot trial. Journal of manipulative and physiological therapeutics, 37(2), 116-123.

Kamali, F., Sinaei, E., & Bahadorian, S. (2017). The immediate effect of talocrural joint manipulation on functional performance of 15–40 years old athletes with chronic ankle instability: A double-blind randomized clinical trial. Journal of bodywork and movement therapies, 21(4), 830-834.

Dananberg, H. J., Shearstone, J., & Guillano, M. (2000). Manipulation method for the treatment of ankle equinus. 

Journal of the American podiatric medical association

Joseph, L. C., de Busser, N., Brantingham, J. W., Globe, G. A., Cassa, T. K., Korporaal, C., & Bonello, R. (2010). Research & Science. The Comparative Effect of Muscle Energy Technique vs. Manipulation for the Treatment of Chronic Recurrent Ankle Sprain. Journal of the American Chiropractic Association, 47(7).

Marrón-Gómez, D., Rodríguez-Fernández, Á. L., & Martín-Urrialde, J. A. (2015). The effect of two mobilization techniques on dorsiflexion in people with chronic ankle instability. Physical Therapy in Sport, 16(1), 10-15.

Lubbe, D., Lakhani, E., Brantingham, J. W., Parkin-Smith, G. F., Cassa, T. K., Globe, G. A., & Korporaal, C. (2015). Manipulative therapy and rehabilitation for recurrent ankle sprain with functional instability: a short-term, assessor-blind, parallel-group randomized trial. Journal of manipulative and physiological therapeutics, 38(1), 22-34.

Shim, Y. S., & Song, H. S. (2013). Effect of manipulation complex therapy on ankle sprain with ankle pain. Journal of Acupuncture Research, 30(2), 65-71.

Eisenhart, A. W., Gaeta, T. J., & Yens, D. P. (2003). Osteopathic manipulative treatment in the emergency department for patients with acute ankle injuries. The Journal of the American Osteopathic Association, 103(9), 417-421.

Truyols-Domínguez, S., Salom-Moreno, J., Abian-Vicen, J., Cleland, J. A., & Fernández-De-Las-Peñas, C. (2013). Efficacy of thrust and nonthrust manipulation and exercise with or without the addition of myofascial therapy for the management of acute inversion ankle sprain: a randomized clinical trial. 

Heggannavar, A., & Gupta, R. K. (2015). Effectiveness of Subtalar Joint Mobilization in Plantar Heel Pain. 

Indian Journal of Physiotherapy and Occupational Therapy

López-Rodríguez, S., de-las-Penas, C. F., Alburquerque-Sendín, F., Rodríguez-Blanco, C., & Palomeque-del-Cerro, L. (2007). Immediate effects of manipulation of the talocrural joint on stabilometry and baropodometry in patients with ankle sprain. Journal of manipulative and physiological therapeutics, 30(3), 186-192.

Fisher, B. E., Piraino, A., Lee, Y. Y., Smith, J. A., Johnson, S., Davenport, T. E., & Kulig, K. (2016). The effect of velocity of joint mobilization on corticospinal excitability in individuals with a history of ankle sprain. 

Beazell, J. R., Grindstaff, T. L., Sauer, L. D., Magrum, E. M., Ingersoll, C. D., & Hertel, J. (2012). Effects of a proximal or distal tibiofibular joint manipulation on ankle range of motion and functional outcomes in individuals with chronic ankle instability. 

Chae, Y. W., Park, J. W., & Nam, K. S. (2017). The Effect of a Proximal and Distal Tibiofibular Joint Manipulation on Dorsiflexion and Balance in Individuals with a History of Lateral Ankle Sprain. 

Grindstaff, T. L., Beazell, J. R., Sauer, L. D., Magrum, E. M., Ingersoll, C. D., & Hertel, J. (2011). Immediate effects of a tibiofibular joint manipulation on lower extremity H-reflex measurements in individuals with chronic ankle instability. Journal of Electromyography and Kinesiology, 21(4), 652-658.

Govender, N., Kretzmann, H., Price, J. L., Brantingham, J. W., & Globe, G. (2007). A Single-Blinded Randomized Placebo-Controlled Clinical Trial of Manipulation and Mobilization in the Treatment of Morton's Neuroma. Journal of the American Chiropractic Association, 44(3).

Cashley, D. G., & Cochrane, L. (2015). Manipulation in the treatment of plantar digital neuralgia: a retrospective study of 38 cases. Journal of chiropractic medicine, 14(2), 90-98.

Shashua, A., Flechter, S., Avidan, L., Ofir, D., Melayev, A., & Kalichman, L. (2015). The effect of additional ankle and midfoot mobilizations on plantar fasciitis: a randomized controlled trial. journal of orthopaedic & sports physical therapy, 45(4), 265-272.

Fraser, J. J., Saliba, S. A., Hart, J. M., Park, J. S., & Hertel, J. (2020). Effects of midfoot joint mobilization on ankle-foot morphology and function following acute ankle sprain. A crossover clinical trial. Musculoskeletal Science and Practice, 46, 102130.

Melkersson, C., Nasic, S., Starzmann, K., & Boström, K. B. (2017). Effect of foot manipulation on pregnancy-related pelvic girdle pain: a feasibility study. Journal of chiropractic medicine, 16(3), 211-219.

Chevutschi, A., D'Houwt, J., Pardessus, V., & Thevenon, A. (2015). Immediate effects of talocrural and subtalar joint mobilization on balance in the elderly. 

Smila, B., Fernāte, A., & Zaļaiskalna, V. (2016, May). THE EFFECT OF ANKLE AND SUBTALAR JOINT SOMATIC DYSFUNCTION CORRECTION TO IMPROVE ORIENTEER STATIC BALANCE. In Proceedings of the International Scientific Conference. Volume III (Vol. 553, p. 562).

Bibliography

Questions, comments and critiques welcomed and encouraged

Joint Manipulation: Ankle, Midfoot and Tibiofibular Joint

Related Courses:

Course Description: Ankle, Midfoot, and Tibiofibular Joint Manipulation

Introduction

Research Summary

Research Corner: Ankle Joint (tibiotalor/talocrural) Manipulation
4 Sub Sections

Research Corner: Additional Manipulations
3 Sub Sections

Video Demonstrations
4 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Joint Manipulation: Ankle, Midfoot and Tibiofibular Joint

Related Courses:

Course Description: Ankle, Midfoot, and Tibiofibular Joint Manipulation

Introduction

Research Summary

Research Corner: Ankle Joint (tibiotalor/talocrural) Manipulation4 Sub Sections

Research Corner: Additional Manipulations3 Sub Sections

Video Demonstrations4 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Research Corner: Ankle Joint (tibiotalor/talocrural) Manipulation
4 Sub Sections

Research Corner: Additional Manipulations
3 Sub Sections

Video Demonstrations
4 Sub Sections