Deltoid Ligamentous Stress Test (Passive Relaxed)

Purpose:
To assess the deltoid ligament using 3 separate passive movements:

Procedure:

• Patient is seated with their leg flexed at the knee and hanging over a table
• Therapist stabilizes the anterior surface of the tibia and fibula proximal to the ankle (with one hand) and …
• 1. Test Anterior Fibers of the Deltoid Ligament:
  • Therapist uses their other hand to graps the dorsal surface of the foot, combining eversion and plantarflexion of the foot and applying overpressure
• 2. Test Middle Fibers of the Deltoid Ligament:
  • Therapist repositions their hand so the calcaneus is grasped (still stabilizing the anterior surface of the tibia and fibula proximal to the ankle with their other hand). Hindfoot is taken into eversion with overpressure
• 3. Test Posterior Fibers of the Deltoid Ligament:
  • Therapist repositions their hand so the calcaneus is grasped (still stabilizing the anterior surface of the tibia and fibula proximal to the ankle with their other hand). Therapist combines eversion and dorsiflexion of the foot with overpressure

Note: to perform a general assessment of the deltoid ligament, evert the hindfoot only

Positive Sign:

Pain and Hypermobility local to the ligament
Muscle spasm end feel may be present with a subacute injury