Lower Extremity Adjusting

Phalanxes- 3 joints to check.

LAE, AP/PA, Int/Ext Rotation, Med/Lat Glide
Foot- Metatarsals, Cuneiforms, Navicular, Cuboid
Metatarsals- AP/PA glide- Plantar surface bil thumbs
Rotation of Tarsal/Meta – Figure 8
Cuneiforms- Medial, Middle, Lateral- Assess- Thumb/index assess A/P while stabilizing
with other hand. Dorsal to Plantar adjust with medial hand chiro index on cuneiform to be
adjusted, stabilize with lateral hand. DF and Evert foot with inferior LOD (Pt. BRACES) Plantar
to Dorsal- Pt prone, knee bent to 45 degrees- medial thumb over cuneiform to be adjusted
braced with lateral thumb impulse superior
A/P Glide of Cuboid- assess at base of 5th metatarsal- Dorsal to Plantar adjust with chiro index
on cuboid, other hand stabilize foot. Plantar to Dorsal- Thumb on cuboid and other stabilizes,
Both thrusts are bilateral rotations
A/P Glide of Ankle- Heel on foot rest. Tarsal/Metatarsal Impulse from test postision
Navicular/Cuneiform
Navicular/Talus
Mortise
Med/Lat tilt of Sub Talar joint- Hold distal foot with one hand Calcaneus with other. Impulse
from test positions
LAE of Mortise- Pt. prone. Knee at 90 degrees doctor knee on back of leg
Inferior Shear of Sub Talar- Same position as above- Hand on heel and shear with other hand
A/P Distal Tib/Fib- Assess with foot flat on table- Adjust sidelying
Patella- move the in all directions
A/P Glide of Fem/Tib- Knee at 90 degrees- palpate joint line – impulse at tibial tub-
P/A prone patient. Hand in popliteal space- flex leg over hand
Int/Ext Rotation of Fem Tib- Rotate at ankle/ palpate in joint space for tibial condyle- Impulse
with bilateral hand on tibia
Med/Lat tilt of knee- knee in between leg at 20 degrees- palpate below joint line for motion.
Adjust with hand at ankle and on joint line motion from flex to ext with impulse before ext.
A/P Glide of Prox Tib/Fib- Foot on foot piece in DF. Assess A/P- Prone adjustment on opposite
side- Hand is in pop space, knee flexed and impulse Ant/Lat
Sup Glide Prox Tib/Fib- Leg extended check with DF of foot. If fixated impulse thru DF.

HIP LAE- PT BRACE- Traction at distal tib/fib

Hip Int/Ext Rot- Pt prone- Ext to opposite thigh, Int laterally. Block at SI for assess- Int adjust-
pick up hip into extension. Take to end range and impulse on trochanter. Same for External rot.
Hip Extension- Lift leg and impulse thru trochanter.