Fibula Dorsal Manipulation with Sandbag

Position of the therapist:

• Standing at the short edge of the bench facing cranially

Position of the patient:

• Supine lying position
• Feet hanging off the bench
• Sandbag under the proximal tibia
• Leg in internal rotation
• Patient’s foot in plantar flexion and inversion (to create pre-tension at the proximal tibiofibular joint into dorsal direction)

Hand placement:

• Ipsilateral hand fixates the patient’s proximal tibia on the sandbag
• Contralateral hand grasps the fibular head (thenar eminence on ventral part and fingers against the dorsal side)

Direction of the manipulation:

• Dorsomedial via contralateral head