What is the normal capsular pattern for the talocrural joint?

• A. Plantar flexion > Dorsiflexion
• B. Dorsiflexion > Plantar flexion
• C. Plantar flexion = Dorsiflexion
• D. Pain at end range only

Answer: (A)

When the joint capsule is involved, the pattern of motion loss tends to follow the directions where the capsule becomes taut first. For the talocrural joint, the posterior structures tighten with plantarflexion, so plantarflexion is more limited than dorsiflexion. Dorsiflexion relies more on the anterior aspects, which are less restricted early on, so it remains relatively freer. Therefore the normal capsular pattern shows plantarflexion greater than dorsiflexion. If the loss were equal, or if pain limited motion only at the end range without a directional pattern, that would suggest a non-capsular issue.