FEC Newsletter

Jeff Staheli
September 18, 2025

🟢 This edition highlights the knee joint 🟢

The joint we will be focusing on is the tibiofemoral joint.

The tibiofemoral joint is the largest joint in the body.

It is primarily a hinge joint with a ROM of approx 150 degrees. This joint also provides a small amount of rotation, where the tibia externally rotates approximately 10 degrees.

⭐️ Important to remember the important role this joint plays in shock absorption. When this joint is dysfunctional, it puts stress to the joints above & below ⭐️

Assessing the tibiofemoral joint

Remember the popliteus is the muscle that disengages terminal extension in the knee – so if it is not working properly, it throws off the entire rhythm of the knee through the gait cycle.

Setup for this assessment:

✅ Patient is prone
✅ Knee is bent to approx 90 degrees
✅ Place ankle into dorsiflexion
✅ Internally rotate tibia
✅ Dr uses hand to stabilize leg on lateral aspect of knee
✅ Dr places other hand on distal aspect of tibia, this will be used to internally rotate tibia
✅ Instruct patient to resist internal rotation

🔴 A positive test is an inability to resist internal rotation and a corresponding adjustment is needed 🔴

Adjusting the tibiofemoral joint

In the FEC we review multiple adjustments for this joint including a long-axis distraction and some speeder board adjustments.

For today we will walk through the bucket handle adjustment

⭐️ A common mistake is a lack of pretension. Be sure to remove any slack by bringing the patient’s knee into flexion.

⭐️ For doc position, make sure the elbow is above the thrust hand. Another common mistake is to have the elbow tucked along the torso. This will change the vector of the thrust.

⭐️ Click the button below to watch a quick video that guides you through the adjustment 👇

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