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Get back to sport provides industry-leading education and training for fitness and healthcare professionals on injury management and neuromuscular rehabilitation. For the injured individual a quick and safe return to sport / activities can often seem like a lifetime away. Drawing on our years of industry and academic experience, we provide bespoke rehabilitation and conditioning programmes to faci

litate a safe and effective return to sport / activities. Visit my website: getbacktosport.com for up to date information and help on your training, rehab or education journey

20/08/2026

FOOT STRENGTH: HOW CAN WE TEST IT BETTER?

4th video in the series with Liz Bayley and I on foot and ankle testing.

If you’re lucky enough to have access to
a VALD Force Frame, this may be helpful. If not, it may help you think of other but similar testing configurations.

The goal here isn't necessarily to find the perfect piece of equipment. It's about asking:

👉🏼How can we make our testing as valid, reliable & clinically useful as possible, while keeping it simple enough to actually use during a busy clinic day?

Things we need to think about:

📖RESEARCH
There is some great emerging work around objective F&A strength testing. In particular, the work from Romain Tourillon & Roma et al (2024) provides useful insight into testing methodology (the final set up we show here with the knee strap almost directly replicates Romain's First Ray Toolkit Recommendation)

⚒️ EQUIPMENT
ForceFrame, HHDs, ForceDecks or custom dynamometers can all be useful, but you need to understand how your setup influences the measurement:

📐 PATIENT POSITION
Sitting vs long-sitting or even standing
Toes in neutral vs toes in extension
These seemingly small differences can have a big effect on the force produced

🧗 STABILITY
Give the patient as much stability as possible.
Support the back, leg and foot where appropriate, and use straps to help isolate the specific movement you're trying to test.
The aim is to minimise unwanted movement and make the test as reproducible as possible

📣 CUEING
Consistent cueing is essential:
If you're changing the instructions between testing sessions, you're potentially changing the test itself

🗄️ KNOW YOUR NORMATIVE DATA
Normative data for foot and ankle strength is becoming increasingly available — and this is hugely valuable clinically.

Rather than simply recording the number of Newtons produced, you can normalise force to body mass:
Force 👎 ÷ body mass (kg) = N/kg
This allows you to benchmark results and, importantly, track change over time.

A good result for this test set up would be around 3.3N/kg ( Tourillon)

The clinical value of strength testing..?Collecting data can be really useful to help guide rehabilitation - as long as ...
13/08/2026

The clinical value of strength testing..?

Collecting data can be really useful to help guide rehabilitation - as long as you know why and the limitations of your test.

One of the biggest changes I’ve seen in rehab over the past decade is the increasing use of objective strength testing, ...
06/08/2026

One of the biggest changes I’ve seen in rehab over the past decade is the increasing use of objective strength testing, which is a positive step. However, testing is often performed without detailed thought 🤔

Here’s ‘why’ to test, a flow chart to guide your decisions, and how to interpret your data within a clinical context

03/08/2026

Here’s video 3 the series produced by Liz Bayley and I on testing.

Our prior video showed how to use a HHD (Kinvent Push) for ankle inversion testing. We got loads of questions about eversion strength assessment in this format - so here’s the video!

Things to note, again I usually advise against holding HHDs during testing as it introduces an additional source of variability (you!), however here you can clearly see that Liz is merely supporting the HHD as her forearm is wedged between the device and wall. The resistance to my max effort is not dependent on her strength.

She does need to be strong though - a considerable amount of force (equal and opposite) is required to stabilise my ankle. As I evert strongly against the immovable HHD, without restraint, my ankle would migrate in the opposite direction and lead to massively under reported strength values.

Also note
- Untested limb should be extended on the bed, on top of the strapping.
- Dense foam roller provides even better stability
- Test in plantar flexed position to minimise peroneal involvement

✅ Pragmatic, HHD on plinth testing
✅ Lower leg strapped just above malleoli (minimise movement)
✅ Strong equal & opposite force for ankle stabilisation, just above lateral malleolus
✅ Solid HHD position using wall (ensure solid foot contact with HHD prior to testing)
✅ Forearm parallel to line of force application
✅ Quick to set up; pragmatic in-clinic test

As with all assessments, practice, practice, practice. With this will come a better understanding of the problems and ability to solve them.

Hope this was useful 👍🏻
Share, bookmark, pop us a question or comment 😊

For this and more see

https://getbacktosport.com/how-to-use-dynamometry-in-clinical-practice/

24/07/2026

Here’s another video in the series produced by Liz Bayley and I on foot and ankle testing.

Our prior video showed how to use the VALD Force Frame for ankle inversion testing. In this one we acknowledge that most people are using hand-held dynamometers (HHDs) and may be limited to clinic room testing.

SO we spent a loong time identifying all the potential testing errors and limitations and then trying to solve them. This is what we came up with - and we like it!

Usually I advise against holding the HHD as it introduces an additional source of variability (you!), however here you can clearly see that Liz holding the Kinvent Push HHD but has her left elbow tightly pressed into the wall. She is able to apply sufficient force with her right hand as I perform a max contraction and thus, along with the other elements, we achieve a solid stable position. Caveat - You do have to apply a significant amount of force (here with right upper limb).

✅ Pragmatic, HHD on plinth testing
✅ Knee supported - minimise movement
✅ Lower leg strapped just above malleoli (minimise movement)
✅ Strong equal & opposite force for ankle stabilisation, just above lateral malleolus
✅ Solid HHD position using wall (ensure solid foot contact with HHD prior to testing)
✅ Forearm parallel to line of force application
✅ Quick to set up; pragmatic in-clinic test

As with all assessments, practice, practice, practice. With this will come a better understanding of the problems and ability to solve them.

Hope this was useful 👍🏻
Share, bookmark, pop us a question or comment 😊

24/04/2026

Arrived in Croatia 🇭🇷. Looking forward to a weekend of S&C … and maybe a day off after in this beautiful country.

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