Knee & ankle goiometry

1. Knee & Ankle Goniometry
By: Dr. Gehan Shaalan
Physical Therapy Lecturer BMC

2. 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

3. 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.

4. 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.

5. Knee Extension
Precaution
Prevent hip rotation and flexion.
Factors limiting motion
 Tension of knee flexor muscles.
Tension of cruciate ligament.
Tension collateral ligament

6. 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.

7. 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

8. 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

9. 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

10. 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

11. 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.

12. 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

13. 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.