Knee To Wall Test

What is a Knee to Wall Test?

The ankles are a crucial part of the body, providing mobility, stability, and shock absorption. They allow us to move efficiently, maintain balance, and perform everyday tasks such as walking, running, and climbing stairs. Additionally, the ankle joint is vital in absorbing impact, preventing excessive stress on the knees, hips, and lower back.

Healthcare professionals, particularly physical therapists, use the Knee to Wall Test, also known as the weight-bearing lunge test (WBLT) or dorsiflexion lunge test (DFT), to assess ankle joint mobility. This test evaluates the ankle dorsiflexion range, helping identify restricted ankle joint dorsiflexion that may contribute to poor ankle mobility and movement inefficiencies.

To perform this test, you need a wall for support, a tape measure to record the distance, and a vertical line drawn on the wall aligned with the tape measure on the floor. The patient begins by placing one foot on the tape measure, ensuring an imaginary line runs through the heel and big toe, aligned with the vertical marker. They then lunge forward, attempting to touch their knee to the wall while keeping the heel flat on the ground. If they succeed, the foot is moved slightly farther away, and the movement is repeated.

The goal is to determine the maximum distance at which the knee can still touch the wall while maintaining heel contact with the ground. The opposite leg remains on the floor for support, and the patient may use the wall for balance. Once the maximum distance is determined, it is recorded in centimeters (cm), with each centimeter corresponding to approximately 3.6° of ankle dorsiflexion.

Because it provides consistent results, this test is reliable for testing ankle range and detecting ankle joint dorsiflexion limitations (Bennell et al., 1998), which can impact functional movement and increase injury risk. Identifying poor ankle mobility early allows targeted interventions, such as mobility exercises and stretching techniques, to restore proper ankle range and prevent compensatory movement patterns.

How does our Knee to Wall Test template work

This free Knee to Wall Test provides a comprehensive, easy-to-follow guide so you can accurately and effectively assess the flexibility and tightness of your patient's ankle. Here's how to get started:

Step 1: Download the test

You can access the free Knee to Wall Test by clicking the "Use template" button, which allows you to customize it via the Carepatron app. You can also download it from the Carepatron app or our resources library, which offers heaps of assessment tools and templates for your practice.

Step 2: Prepare your patient

Provide your patient with a copy of the Knee to Wall Test and explain its purpose. Instruct them to stand facing a wall, with their feet hip-width apart and their heel and big toe aligned along an imaginary straight line.

Step 3: Start the assessment

Ask your patient to bend one knee forward, attempting to touch the wall while keeping their heel flat on the ground. If they succeed, move their foot slightly farther away and repeat the movement. The goal is to find the maximum distance the knee can reach the wall without lifting the heel. Measure this distance in centimeters (cm).

Step 4: Analyze your results

Measure the distance from the wall to the tip of the big toe, typically recorded in centimeters. A greater distance while keeping the heel flat on the ground and the knee touching the wall indicates better ankle mobility. Each centimeter corresponds to approximately 3.6° of ankle dorsiflexion.

The inability to touch the knee to the wall may indicate a restriction in ankle mobility, which may be due to bony, ligamentous, or muscular limitations. A difference of 1.5 cm or more in the measured distance between the left and right legs may suggest a clinically significant asymmetry in the ankle dorsiflexion range of motion (Cirrone, 2022).

Step 5: Write down observations and recommendations

Record your observations and note any recommendations or exercises you might have for the patient. If necessary, refer them to a specialist for further evaluation.

When to use a knee to wall assessment?

This test helps identify stiff ankles, calf muscle tightness, and limited ankle dorsiflexion, which can affect movement and overall lower limb function. You can use this assessment in the following scenarios:

Your patient has experienced an ankle injury

If your patient has suffered an ankle injury, the Knee to Wall Test can help determine the extent of the injury and assess their dorsiflexion mobility. Measuring maximal dorsiflexion can help guide treatment plans and outline appropriate exercises to restore function and prevent further complications.

Your patient is experiencing difficulty with movement

Restricted ankle joint mobility can contribute to difficulty walking, running, or performing functional movements. If your patient has poor flexibility or stiffness in their ankles, this test will help evaluate their dorsiflexion mobility and guide appropriate interventions to improve movement.

Your patient is suffering from chronic ankle pain

Chronic ankle pain can often stem from tightness or stiffness in the muscles surrounding the ankle, including the calf muscles. Using the Knee to Wall Test, you can identify mobility restrictions, pinpoint the root cause of the discomfort, and recommend targeted treatments to improve flexibility and reduce pain.

Your patient is having difficulty bending their ankles

Limited ability to bend the ankle may indicate stiff ankles, joint restrictions, or calf muscle tightness. The Knee to Wall Test provides a clear measure of ankle dorsiflexion and helps determine how to improve range of motion, reduce joint stiffness, and enhance ankle function.

Benefits of free Knee to Wall Test PDF

The Knee to Wall Test offers a range of benefits for healthcare professionals and patients. Here are some of them:

It's completely digital

Our free Knee to Wall Test PDF is entirely digital, so you can access it anytime, anywhere. You can also store it easily on any device and print as many copies as you need.

It's clinically approved

The Knee to Wall Test is backed by credible research and is clinically approved. This ensures accurate assessments for your patients and better outcomes for their treatments.

It's comprehensive

This free assessment tool offers a step-by-step guide for performing the Knee to Wall Test. It also includes a field for writing down recommendations so you can easily refer to them.

It's easy to understand

We've made the Knee to Wall Test as simple and straightforward as possible to ensure easy understanding. All the instructions are in plain language, so you can quickly administer the test and assess your patients' ankle conditions.

References

Bennell, K., Talbot, R., Wajswelner, H., Techovanich, W., Kelly, D., & Hall, A. (1998). Intra-rater and inter-rater reliability of a weight-bearing lunge measure of ankle dorsiflexion. Australian Journal of Physiotherapy, 44(3), 175–180. https://doi.org/10.1016/s0004-9514(14)60377-9

Cirrone, A. (2022). Assessing a clinical test of ankle joint range of motion: Influence of variations in foot and tibia length. DigitalCommons@SHU. https://digitalcommons.sacredheart.edu/acadfest/2022/all/139/