Knee & Ankle Goniometry

By: Dr. Gehan Shaalan

Physical Therapy Lecturer BMC

Knee Flexion Starting Position: Patient should be supine with

both legs flat on the table. The fulcrum is aligned with the

lateral epicondyle of the femur. The stationary arm is in line with

the greater trochanter and midline of the femur, the moving arm with the lateral malleolus and midline of the fibula.

Ending Position: Goniometer positioning is same

as above. Normal ROM is 135

Knee Flexion

Precaution 1-Prevent hip rotation, adduction and

abduction. 2-Hip flexed to 90 degrees only to prevent

stretching of the rectus femoris muscle. Factors limiting motion Tension of muscles of knee extension

( quadriceps muscles) Contact of bulk of calf muscles of posterior leg

with posterior thigh.

Knee Extension

Starting and Ending Position:

The patient should be lying prone with both legs flat on the table.

The goniometer positioning for knee extension is the same as it is for knee flexion.

Normal ROM for knee extension is between 0 and –10 degrees. The patient has –3 degrees of knee extension.

Knee Extension

Precaution Prevent hip rotation and flexion.

Factors limiting motion Tension of knee flexor muscles. Tension of cruciate ligament. Tension collateral ligament

Ankle Dorsi Flexion

Starting Position Patient is supine with legs off the

table. The fulcrum is aligned with the

lateral malleolus. The stationary arm is in line with the

midline of the lower leg; use the head of the fibula for reference. The moving arm is parallel to the fifth metatarsal.

Note: Once again remember that the goniometer will be at 90 degrees and to adjust for that when recording the angles.

Ending Position:    Same as above Normal ROM for dorsiflexion is

between 0 and 20 degrees.

Ankle Dorsi Flexion

Precaution Avoid eversion and inversion. Avoid motion of hip and knee.

Factors limiting motion Tension of peroneus muscles. Contact of lateral bones medially. Tension of the lateral tarsal ligaments

Ankle Plantar Flexion

Starting Position and Ending Position:

  Patient is sitting with legs off table.

  Goniometer alignment is the same as for dorsiflexion.

Normal ROM is 45 degrees

Ankle Plantar Flexion

Precaution Prevent hip rotation Avoid forefoot flexion. Prevent inversion and eversion of the foot.Factors limiting motion Tension of the dorsiflexor muscles of ankle. Contact of posterior portion of talus with tibia. Tension of ligaments: a) anterior talofibular.b) Anterior fiber of deltoid ligament

Subtalar Inversion

Starting and Ending Position: The patient should be lying

prone with foot hanging off the table.

The fulcrum is placed between the two malleoli. The stationary arm is aligned with the midline of the leg and the moving arm with the midline of the calcaneus

The ROM is from 0 - 30 degrees

Subtalar Inversion

Precaution Prevent medial rotation of the knee. Prevent lateral rotation and abduction of the

hip. Allow ankle joint plantar flexion. Factors Limiting ROM Contact of tarsal bones medially. Tension of eversion muscles ( peroneal

group) Tension of lateral tarsal ligament.

Subtalar Eversion

Starting and Ending Position: The patient should be lying

prone with foot hanging off the table.

The fulcrum is placed between the two malleoli. The stationary arm is aligned with the midline of the leg and the moving arm with the midline of the calcaneus.

The ROM is from 0 - 25 degrees

Subtalar Eversion

Precautions Prevent lateral rotation of knee. Prevent medial rotation and abduction of the hip. Allow dorsiflexion at the ankle.

Factors Limiting ROM Contact of tarsal bones laterally. Tension of muscles of inversion tibialis posterior. Tension of medial tarsal ligaments.