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Inspection Normal
Inspection Right
• • •
Inspection Left
• • •
Swelling Normal
Swelling Right
Swelling Rt Location
• • •
Swelling Left
Swelling Lt Location
• • •
Ecchymosis Normal
Ecchymosis Right
• • •
Ecchymosis Rt Location
• • •
Ecchymosis Left
• • •
Ecchymosis Lt Location
• • •
Tenderness Normal
Tenderness Right
Tenderness Rt Location
• • •
Tenderness Left
• • •
Tenderness Lt Location
• • •
ROM Dorsiflexion Normal N=20
ROM Dorsiflexion Right N=20
ROM Dorsiflexion Left N=20
Dorsiflexion Strength Normal
Dorsiflexion Strength Right
Dorsiflexion Strength Left
ROM Plantar Flexion N=40
ROM Plantar Flexion Right N=40
ROM Plantar Flexion Left N=40
Plantar Flexion Strength Normal
Plantar Flexion Strength Right
Plantar Flexion Strength Left
Heel Cord Tightness Normal
Heel Cord Tightness Right
Heel Cord Tightness Left
Ankle Alignment Normal
Ankle Alignment Right
Ankle Alignment Left
Ankle Inversion Normal N=30
Ankle Inversion Right N=30
Ankle Inversion Left N=30
Ankle Eversion Normal N=20
Ankle Eversion Right N=20
Ankle Eversion Left N=20
Homans Test Normal
Homans Test Right
Homans Test Left
Anterior Draw Test Normal
Anterior Draw Test Right
Anterior Draw Test Left
Posterior Drawer Test Normal
Posterior Drawer Test Right
Posterior Drawer Test Left
Tinel's Normal
Tinel's Right
Tinel's Left
Previous surgical wound
Surgical wound signs
• • •
ankle diagram

Optimize Ankle Examination Medical Form

Sports Medicine Specialist

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Published: Nov. 19, 2022, 8:54 a.m.
Doctor: Dr. History Physical
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Sunnyvale, CA 94089

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