title: Diagnosis of Musculus Gastrocnemius Tightness - Key Factors for the Clinical Examination.
abstract: Common foot and ankle pathologies have been linked to isolated Musculus gastrocnemius tightness (MGT). Various examination techniques have been described to assess MGT. Still, a standardized examination procedure is missing. Literature argues for weightbearing examination but the degree of knee flexion needed to eliminate the restraining effect of the M. gastrocnemius on ankle dorsiflexion (ADF) is unknown. This manuscript investigates the effect of knee flexion on ankle dorsiflexion and provides a detailed description of a standardized examination protocol. Examination on 20 healthy individuals revealed, that 20° of knee flexion is sufficient to fully eliminate the influence of the M. gastrocnemius on ADF. This builds the prerequisite for a standardized examination for MGT. Non-weightbearing and weightbearing examination of ADF has to be conducted with the knee fully extended and at least 20° flexed. Two investigators should conduct non-weightbearing testing with the subject in supine position. In order to obtain reliable results, the axis of the fibula should be marked. One examiner can conduct weightbearing examination with the subject in lunge stance. Isolated MGT is present if ADF is impaired with the knee fully extended and knee flexion results in a significant ADF increase. The herein presented standardized examination is the prerequisite for future studies aiming at establishing norm values.
authors: Foot and Ankle Surgery, Munich University Hospital; Department of Trauma Surgery, Munich University Hospital.
authors: Sebastian F
authors: SF
authors: Baumbach
authors: Foot and Ankle Surgery, Munich University Hospital; Department of Trauma Surgery, Munich University Hospital.
authors: Mareen
authors: M
authors: Braunstein
authors: Foot and Ankle Surgery, Munich University Hospital; Department of Trauma Surgery, Munich University Hospital.
authors: Markus
authors: M
authors: Regauer
authors: Department of Trauma Surgery, Munich University Hospital.
authors: Wolfgang
authors: W
authors: Böcker
authors: Foot and Ankle Surgery, Munich University Hospital; Department of Trauma Surgery, Munich University Hospital; hans.polzer@med.uni-muenchen.de.
authors: Hans
authors: H
authors: Polzer
mesh_terms: D000843:Ankle Joint; D006801:Humans; D007719:Knee Joint; D018482:Muscle, Skeletal; D016059:Range of Motion, Articular; D016474:Weight-Bearing