Fibular head dysfunction

Proximal Fibular Head Dysfunction—Fibula on Tibia... 

FIG. 94-11 Motion testing for proximal fibular head dysfunctions. 

Increased anterior slide with decreased posterior slide signifies anterior fibular head dysfunction increased posterior slide with decreased anterior slide signifies posterior fibular head dysfunction. 

The body of the talus is wedge-shaped and wider in its anterior portion. Dorsiflexion creates a close-packed position of the talus in the crural arch. Further dorsiflexion induces separation of the tibiofibular articulation, with lateral and caudal displacement of the distal fibula and medial rotation around the tibia. This motion of the fibula can be a major source of fibular head dysfunction. 

FIG. 100-1 High-velocity, low-amplitude thrusting technique for an anterior fibular head dysfunction. 

The fibular head, lateral to the knee joint, should be articulated in an anterior/posterior glide. Because of the combined mechanics with the ankle mortise, a posterior glide somatic dysfunction is the most common knee somatic dysfunction with anterior glide the next. 

A posterior fibular head somatic dysfunction is accompanied by foot inversion, forefoot adduction, and lower leg internal rotation. 

Fibular head somatic dysfunctions are the commonly seen somatic dysfunctions of the knee. They are often the cause of lateral knee pain. 

FIG. 100-2 High-velocity, low-amplitude thrusting technique for a posterior fibular head somatic dysfunction. (Physician is on opposite side to allow viewing of hand positions.)... 

There are two additional, interesting dysfunctions often seen in the knee region, which really are not part of the knee joint function. These are the pes anserine bursitis and the fibular head somatic dysfunction. 

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