Manual Muscle Testing, Department of Human Performance, Minnesota State University

Manual Muscle Testing

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Abductor Hallucis

Origin

Medial process of tuberosity of calcaneus, flexor retinaculum, plantar aponeurosis and adjacent intermuscular septum

Insertion

Medial side of base of proximal phalanx of great toe. Some fibers are attached to the medial sesmoid bone

Action

Abducts and assists in flexion of the metatarsophalangeal joint of the great toe

Nerve

Tibial, L4–5 & S1

Patient

Sitting or supine

Fixation

Grasps heel firmly

Test

Abduction of great toe from axial line of foot

Pressure

Against medial side of the first metatarsal and proximal phalanx

See Test

 
Flexor Digitorum Brevis

Origin

Medial process of the calcaneal tuberosity, central part of plantar aponeurosis and adjacent intermuscular septa

Insertion

Middle phalanx of digits two through five

Action

Flexes the proximal interphalangeal joints and assists in flexion of the metatarsophalangeal joints of second through fifth digits

Nerve

Tibial, L4–5 & S1

Patient

Sitting or supine

Fixation

Stabilization of proximal phalanges with foot and ankle in neutral position

Test

Flexion of the proximal interphalangeal joints of the second through fifth digits

Pressure

Against the plantar surface of the middle phalanx of digits two through five in direction of extension

See Test

 
Flexor Hallucis Longus

Origin

Posterior surface of distal two thirds of fibula, interosseus membrane and adjacent intermuscular septa and fascia

Insertion

Base of distal phalanx of great toe on plantar surface

Action

Flexes the interphalangeal joint of the great toe and assists in flexion of the metatarsophalangeal joint, plantar flexion of the ankle and inversion of the foot

Nerve

Tibial, L5 & S1–2

Patient

Sitting or supine

Fixation

Stabilization of metatarsophalangeal joint with foot and ankle in neutral position

Test

Flexion of the interphalangeal joint of the great toe

Pressure

Against the plantar surface of the distal phalanx in direction of extension

See Test

 
Flexor Digitorum Longus

Origin

Middle three fifths of the posterior surface of the tibia from the fascia covering the tibialis posterior

Insertion

Bases of the distal phalanges of digits two through five

Action

Flexes the proximal and distal interphalangeal joints and metatarsophalangeal joints of second through fifth digits and assists in plantar flexion of the ankle and inversion of the foot

Nerve

Tibial, L5 & S1–2

Patient

Sitting or supine, knee flexed if gastrocnemius is tight

Fixation

Stabilization of metatarsals with foot and ankle in neutral position

Test

Flexion of the distal interphalangeal joints of the second through fifth digits the flexor digitorum is assisted by the quadratus plantae

Pressure

Against the plantar surface of the distal phalanx of digits two through five in direction of extension

See Test

 
Extensor Digitorum Longus

Origin

Lateral condyle of the fibula, proximal three fourths of the anterior surface of the body of the fibula, proximal part of the interosseous membrane, adjacent intermuscular septa and deep fascia

Insertion

Bbases of the middle and distal phalanges of digits two through five

Action

Extends the metatarsophalangeal joints and assists in extension of the interphalangeal joints of second through fifth digits and assists in dorsiflexion of the ankle and eversion of the foot

Nerve

Peroneal, L4–5 & S1

Patient

Sitting or supine

Fixation

Stabilization of foot in slight plantarflexion

Test

Extension of all joints of the second through fifth digits

Pressure

Sgainst the dorsal surface of the toes in direction of flexion

See Test

 
Extensor Digitorum Brevis

Origin

Distal portion of superiolateral portion of the calcaneus, lateral talocalcaneal ligament and apex of the inferior extensor retinaculum

Insertion

On the proximal phalanx of the great toe and the distal phalanges of toes two through four

Action

Extends the metatarsophalangeal joints and assists in extension of the interphalangeal joints of first through fourth digits and assists in extending the interphalangeal joints of toes two through four

Nerve

Deep Peroneal, L4–5 & S1

Patient

Sitting or supine

Fixation

Stabilization of foot in slight plantarflexion

Test

Extension of all joints of the second through fifth digits

Pressure

Sgainst the dorsal surface of the toes in direction of flexion

See Test

 
Extensor Hallucis Longus & Brevis

Origin of Longus

Middle half of anterior surface of the fibula and adjacent interosseous membrane

Origin of Brevis

Distal part of superior and lateral surfaces of the calcaneus, lateral talocalcaneal ligament and apex of the inferior extensor retinaculum

Insertion

Dorsal surface of base of proximal phalanx of great toe

Action

Extends the metatarsophalangeal joint of the great toe

Nerve

Deep Peroneal, L4–5 & S1

Patient

Sitting or supine

Fixation

Stabilization of foot in slight plantar flexion

Test

Extension of the metatarsophalangeal and interphalangeal joints of the great toe

Pressure

Against the dorsal surface of the distal and proximal phalanges in direction of flexion

See Test

 
Tibialis Anterior

Origin

Lateral condyle and proximal half of the lateral surface of the tibia, interosseous membrane, deep fascia & lateral intermuscular septum

Insertion

Medial and plantar surface of medial cuneiform bone, base of the first metatarsal bone

Action

Dorsiflexes the ankle joint & assists in inversion of the foot

Nerve

Deep peroneal, L4–5 & S1

Patient

Sitting or supine

Fixation

Examiner supports leg just above ankle

Test

Dorsiflexion of the ankle with inversion of the foot

Pressure

Against the medial side, dorsal surface of the foot, in direction of plantarflexion of the ankle & eversion of the foot

See Test

 
Tibialis Posterior

Origin

Most of the interosseous membrane, lateral portion of the posterior surface of the tibia, proximal 2/3 of the medial surface of the fibula, adjacent intermuscular septa & deep fascia

Insertion

Tuberosity of the navicular & by fiberous expansions to the sustentaculum tali, three cuneiforms, cuboid & bases of the second through fourth metatarsals

Action

Inversion of the foot & assists with plantarflexion of the ankle

Nerve

Tibial, L4–5 & S1

Patient

Sitting or supine with extremity in lateral rotation

Fixation

Examiner supports leg just above ankle

Test

Inversion of the foot with plantarflexion of the ankle

Pressure

Against the medial side & plantar surface of the foot, in direction of dorsiflexion of the ankle & eversion of the foot

See Test

 
Peroneus Longus

Origin

Lateral condyle of the tibia, head & proximal 2/3 of the lateral surface of the fibula, intermuscular septa & adjacent deep fascia

Insertion

Lateral side of the base of the first metatarsal

Action

Eversion of the foot, depresses the first metatarsal & assists with plantarflexion of the ankle

Nerve

Superficial peroneal, L4–5 & S1

Patient

Sitting or supine with extremity in medial rotation

Fixation

Examiner supports leg just above ankle

Test

Eversion of the foot with plantarflexion of the ankle

Pressure

Against the lateral border & plantar surface of the foot, in direction of inversion of the foot & dorsiflexion of the ankle

See Test

 
Peroneus Brevis

Origin

Distal 2/3 of the lateral surface of the fibula & adjacent intermuscular septa

Insertion

Lateral side of the base of the fifth metatarsal

Action

Eversion of the foot & assists with plantarflexion of the ankle

Nerve

Superficial peroneal, L4–5 & S1

Patient

Sitting or supine with extremity in medial rotation

Fixation

Examiner supports leg just above ankle

Test

Eversion of the foot with plantarflexion of the ankle

Pressure

Against the lateral border & plantar surface of the foot, in direction of inversion of the foot & dorsiflexion of the ankle

See Test

 
Soleus

Origin

posterior surfaces of the head of the fibula and proximal 1/3 of its body, soleal line and middle 1/3 of the medial border of the tibia & tendinous arch between the tiia and fibula

Insertion

With the tendon of the gastrocnemius (achilles tendon), into the posteior surface of the calcaneus

Action

Plantarflexion of the ankle

Nerve

Tibial, L5 & S1–2

 
Soleus 1

Patient

Prone with knee flexed to 90°

Fixation

Examiner supports leg just proximal to ankle

Test

Plantarflexion of the ankle

Pressure

Against the plantar surface of the foot, in direction of dorsiflexion of the ankle

See Test

 
Soleus 2

Patient

Prone with knee flexed to 90°

Fixation

None

Test

Plantarflexion of the ankle

Pressure

Against the plantar surface of the foot, in direction of dorsiflexion of the ankle & cupping the calcanues, providing resistance in the direction of dorsiflexion

See Test

 
Gastrocnemius

Origin of Medial Head

Proximal & posterior part of the medial epicondye and adjacent part of the femur, capsule of knee joint

Origin of Lateral Head

Lateral condyle and posterior surface of femur, capsule of knee joint

Insertion

Into the middle part of the posteior surface of the calcaneus

Action

Plantarflexion of the ankle

Nerve

Tibial, & S1–2

 
Gastrocnemius

Patient

Standing on two feet

Fixation

None

Test

Plantarflexion of the ankle bilaterally

Pressure

Body weight and gravity

See Test

 
Gastrocnemius 2

Patient

Standing on two feet

Fixation

None

Test

Plantarflexion of the ankle bilaterally

Pressure

Against shoulders bilaterally in the direction of dorsiflexion, body weight and gravity

See Test

 
Gastrocnemius 3

Patient

Single leg stance

Fixation

None

Test

Plantarflexion of the ankle

Pressure

Body weight and gravity

See Test