Triceps surae; Gastrocnemius

Action Flex the knee, plantar flex

the ankle

Origin Condyles of the femur,

posterior surfaces

Insertion Calcaneus via calcaneal

tendon

Innervation Tibial (S1-2)

Triceps surae; soleus

Action Plantar flex the ankle

Origin Soleal line, post. surface of

tibia and prox. post. surface of fibula

Insertion Calcaneus via calcaneal

tendon

Innervation Tibial (S1-2)

Gastrocnemius and Soleus- standing

Ask pt. to stand on her toe

Palpate the posterior leg, sculpting out the gastrocnemius’s oval head

Move distal to the gastrocnemius and palpate the distal portion of soleus

Both muscles blend into the calcaneal tendon

( Triceps surae)

Gastrocnemius and Soleus- standing

Accessible from an

anterior direction

Locate tibial shaft

Slide medially off the

shaft and feel the

wad of muscle

Gastrocnemius and Soleus- prone

Bend the knee to 90°

When the knee is flexed, gastronemius muscle is ineffectual as a plantar flexor

Isolate the soleus by asking pt. to gently plantar flex against your resistance

Plantaris

Action Weak plantar flexion of the

ankle, weak flexion of the knee

Origin Lateral condyle of the femur

Insertion Calcaneus via calcaneal

tendon

Innervation Tibial (S1-2)

Plantaris

Prone with knee flexed

Locate the head of fibula

Move thumb medial into

the popliteal space b/w

gastrocnemius heads

Slowly sink into the tissue

of the posterior knee

Test for gastrocnemius and plantaris

• Patient:Patient: Standing

• Test:Test: Rising on toes,

pushing the body

weight directly

upward

• Pressure:Pressure: Body

weight

Test for soleus

Test for soleus

• Patient:Patient: Prone with the knee flexed at least 90°

• Fixation:Fixation: The examiner supports the leg, proximal to the ankle

• Test:Test: Plantar flexion of the ankle, without inversion or eversion of the foot

• Pressure:Pressure: Against the calcaneus, pulling the heel in a caudal direction.

Popliteus

Prone with knee

flexed

Explore the posterior

surface of the tibia by

pushing the overlying

edge of the soleus

and gastrocnemius to

the side

Test for popliteus

• Patient:Patient: Sitting with the knee flexed at a right angle and with leg in lateral rotation of tibia on femur

• Test:Test: Medial rotation of the tibia on femur

• Resistance:Resistance: Seldom is resistance or pressure applied.

Peroneus longus and brevis

Locate the head of

fibula and the lateral

malleolus

Peroneal bellies are

located b/w these

landmarks

Ask pt. to alternately

evert and relax her

foot

Test for peroneus longus & brevis

• Patient:Patient: Supine, with the extremity medially rotated, or side-lying (on the opposite side)

• Fixation:Fixation: The examiner supports the leg, above the ankle joint

• Test:Test: Eversion of the foot, with plantar flexion of the ankle joint

• PressurePressure: Against the lateral border and sole of the foot, in the direction of inversion of the foot and dorsiflexion of the ankle joint

Anterior compartment

1. Tibialis anterior

2. Extensor

digitorum longus

3. Extensor hallucis

longus

Tibialis anterior

Action Invert the foot , dorsifelx

the ankle

Origin Prox. lat. surface of tibia

and interosseous membrane

Insertion Medial cuneiform and

base of 1st metatarsal

Innervation Deep peroneal

Tibialis anterior

Supine

Locate the shaft of

the tibia and slide off

it laterally

Ask pt. to dorsiflex

his ankle and palpate

its long, inch-wide

belly

Test for tibialis anterior

Test for tibialis anterior

• Patient:Patient: Spine or sitting (with knee flexed if any gastrocnemius tightness is present)

• Fixation:Fixation: The examiner supports the leg, just above the ankle joint

• Test:Test: Dorsiflexion of the ankle joint and inversion of the foot, without extension of the great toe

• Pressure:Pressure: Against the medial side, dorsa surface of the foot, in the direction of plantar flexon of the ankle joint and eversion of the foot