National Physical Therapy Examination (NPTE) Practice Exam

A patient with medial foot and ankle pain is most likely weak in which combination of movements?

1. Dorsiflexion and eversion

2. Dorsiflexion and inversion

3. Plantar flexion and eversion

4. Plantar flexion and inversion

The correct answer is: Plantar flexion and inversion

The rationale for identifying weakness in plantar flexion and inversion in a patient with medial foot and ankle pain lies in the anatomical and functional relationships of the muscles involved and the mechanics of the foot and ankle. The primary muscles responsible for plantar flexion include the gastrocnemius and soleus, while inversion is primarily facilitated by the tibialis posterior and, to a lesser extent, the tibialis anterior. Weakness in these movements can lead to an inability to generate the necessary stability and support during gait, particularly on the medial side of the foot. This weakness may cause the foot to roll inward excessively, which can aggravate pain on the medial aspect of the ankle and foot. In patients experiencing medial foot and ankle pain, it is common to find overactivity or compensation in the muscles responsible for eversion and dorsiflexion as they attempt to stabilize the foot due to the weakness. This compensatory pattern can contribute to further strain and pain in the medial structures, leading to an emphasis on the need for strengthening plantar flexion and inversion to restore normal function and alleviate discomfort. Therefore, recognizing the association between weakness in plantar flexion and inversion and medial pain in the foot and ankle highlights the importance of targeted rehabilitation efforts to address these specific deficiencies