The Tarsal Twist Manipulation: A Case Report
DOI:
https://doi.org/10.37506/ijpot.v16i3.18388Keywords:
Extremity manipulation; Tarsal twist; Ankle sprain; Physical therapy; Case report.Abstract
Background and Purpose: Ankle joint injuries account for up to 34% of all athletic related injuries, with lateral
ankle sprains comprising up to 85% of these ankle injuries. Clinical practice guidelines for ankle sprains are wellestablished
and should be utilized in the management of lateral ankle sprains; however, it is unknown how lower
extremity joint manipulation may add to the management of lateral ankle sprains. The purpose of this case report
is to describe the outcomes of a 14-year-old male basketball player with a lateral ankle sprain who responded
favorably to a Tarsal Twist manipulation.
Case Description: A 14-year-old male basketball player was seen in physical therapy for the management of a
lateral ankle sprain. The patient experienced localized pain and swelling at the lateral ankle, pain with activity,
decreased range of motion, weakness, and decreased balance. Treatment included standard of care, with the
inclusion of a Tarsal Twist manipulation.
Outcomes: A test-retest method was utilized to determine the outcomes of the Tarsal Twist manipulation.
Immediate improvements in the Star Excursion Balance Test and a decrease in pain with activity occurred after the
Tarsal Twist manipulation. Following seven visits of physical therapy utilizing standard of care with the addition
of the Tarsal Twist manipulation, the patient was able to return to basketball.
Discussion: A meaningful change in the Star Excursion Balance Test and pain during activity occurred immediately
after the Tarsal Twist manipulation, suggesting that this manipulation was helpful for this patient.
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Copyright (c) 2022 Christopher Temples, Cade Mullins, Maegan Powell, Nicholas B. Washmuth
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.