Passive Range of Motion (PROM) of the Ankle and Foot

PROM is usually done when you can observe limited ROM during AROM. The goal of PROM is to obtain the end-feel of the joint to determine what is limiting full range of motion. The following table shows an overview of „normal“ and „abnormal“ kinds of end-feels:

 

End Feel	Example
NORMAL
Hard (Ligamentous) Soft tissue approximation Tissue stretch	Elbow extension Knee flexion Ankle dorsiflexion, shoulder lateral rotation, finger extension
ABNORMAL
Early muscle spasm Late muscle spasm ‘Mushy’ tissue stretch Spasticity Hard capsular Soft capsular Bone to bone Empty (due to pain) Springy block	Protective spasm following injury Spasm resulting from instability or pain Tight muscle Upper motor neuron lesion Frozen shoulder Synovitis, soft tissue edema Ostephyte formation Acute subacromial bursitis Meniscus tear

 

The normal end-feel for different movements in the ankle and foot is as follows:

Dorsiflexion at the talocrural joint: Tissue stretch

Plantarflexion at the talocrural joint: Tissue stretch

Inversion at the subtalar joint: Tissue stretch

Eversion of the subtalar joint: Tissue stretch

Adduction at the midtarsal joint: Tissue stretch

Abduction at the midtarsal joint: Tissue stretch

Flexion of the toes: Tissue stretch

Extension of the toes: Tissue stretch

Adduction of the toes: Tissue stretch

Abduction of the toes: Tissue stretch

 

Study	Reliability	Sn	Sp	LR+	LR-
Magee et al. (2014)	NA	NA	NA	NA	NA