Trigger points, on the other hand, refer the pain into the big toe and into the anterior middle area of the ankle. This muscle runs down the front of your shin and crosses the ankle, then ends along the inside of the foot. Other investigations, such as MRI and Ultrasound, can confirm the bony spur but also clarify the extent of soft tissue swelling causing impingement; MRI scan excludes other causes of pain at the front of the ankle, such as tendonitis or ankle arthritis. Rees JD, Lichtwark GA, Wolman RL, Wilson AM. Not consenting or withdrawing consent, may adversely affect certain features and functions. Approximately two-thirds of ankle sprains tend to be isolated injuries to the anterior talofibular ligament (ATFL), the weakest ligament in the lateral collateral complex of the ankle. 2019;39:7984. pelvic tilt exercise for low back pain Ankle pain in runners could be a sign of ankle strain or sprain, tendinitis, or a stress fracture. Anterior tibial tendinopathy is rare, but is typically seen in patients older than 45 years. Arthroscopic treatment with removal of osteophytes gives 83 % good/excellent result at 5-8 years follow-up (grade 0-I lesions). Before we can understand tibialis anterior pain, we need to understand the anatomy of the muscle. How do we get anterior ankle impingement, and what can we do about it? Most importantly, acute ankle pain can develop suddenly and includes strains, sprains, ankle impingement and stress fractures. Physiotherapy clinic in India colony road Anterior ankle bony impingement can sometimes be treated with anti-inflammatory medication and avoiding activities that cause symptoms. An anterior ankle impingement is usually the medical term given to problems at the front of the ankle (OGS). Pain upon standing on toes is also a symptom of posterior ankle impingement. Shin pain may also occur, but it's not the primary pain caused by this muscle. Learn about common causes and treatments for ankle pain in runners. We think that bony spurs form most commonly in athletes involved in change of direction sport or kicking. vastus medialis exercises When you can do this for 60 seconds. This will stretch a different part of the calf muscles. When all the body's weight is placed on the lateral ankle ligaments, the anterior tibiofibular ligament stretches or tears resulting in a high sprain of the ankle. [8] If the bone spurs are large it is often easier and faster to simply open up the ankle joint and remove the bone spurs rather than attempt to do this arthroscopic. knee pain The ankle joint (or talocrural joint) is a synovial joint located in the lower limb. Low Back Pain While the patient walking, the pain is become more severe while lowering the foot to the ground, immediately after the heel strike. Continued physical activity can worsen tendinopathy, and cause discomfort to the last longer until it is present all the time. In this instance, your big toe may claw down and your ankle might get weak. In moderate to severe ankle sprains, it may be too painful at first to pull your toes far enough to feel a stretch in your calf. While still sitting, put your feet together flat on the floor. Treatment Treatment of anterior ankle impingement syndrome should be focused on restoring normal mechanics between the talus and tibia. When the joint bends forwards or dorsiflexes, the bony spurs pinch, causing pain at the front of the ankle. It causes weakness in dorsiflexion of the ankle; treatment involves short-term immobilization and. Stand on your injured foot only, hold your arms across your chest, and close your eyes. Massage and range-of-motion exercises are two options for treatment. An anterior talofibular ligament sprain is the most common of the ligament injuries that can occur as part of the lateral ligament complex injuries. Expert Podiatrists for the treatment of Avulsion fracture servicing the areas of Northcote, Thornbury, Fitzroy, North Fitzroy, Carlton, North . Thank you! Treatment for tibialis anterior tendinopathy What can the athlete do? Pain in the posterior region of the ankle is a symptom of posterior ankle impingement. This pain may be worse after running, dancing, or working out. The orthotic device supports the foot to avoid overcompensation if the discomfort is caused by a collapse of the arch or other mechanics in the foot. The diagnosis of anterior tibiofibular ligament injury is usually done by examining the ankle. Use caution, and let pain be your guide. When it needs to take over for another muscle, the load may be too much. Your email address will not be published. Physiotherapy Exercise Ankle Impingement Stretches & Exercises for Pain Relief - Ask Doctor Jo - YouTube An ankle impingement can be anterior or posterior. It can be caused by an injury, overuse, or degenerative changes in the joint. The rice method is an effective Achilles tendonitis home treatment, as well as a good remedy for a sprained ankle. Remember, theyd prefer not to use your expert services. Bhoomi Patel - Physiotherapist in Mobile Physiotheray Clinic, B - 01, Jagatnagar Society, Opp. OMT is a low-risk option for patients to try in the office to treat their pain. During that time, immerse your foot and ankle in cold water, or apply an ice pack (be sure to cover the ankle with a towel to protect the skin) for 15-20 minutes three times a day, or until the swelling starts to subside. exercises for vastus medialis oblique [1] Location of pain is referenced from the tibiotalar (talocrural) joint. Stand facing a wall with your unaffected leg forward with a slight bend at the knee. Tuesday: 9am - 5:30pm What treatment should I book if I have problems with Ankle Sprain or Ankle Pain? Repetitive microtrauma or repetitive ankle sprains can lead to bony spur formation. On examination, there is localised tenderness, swelling and occasionally crepitus along the tibialis anterior tendon. So much better. During the procedure, the ankle can be tested to simulate normal motion and to ensure the extent of decompression. RICE Many sprained ankles are fairly minor injuries, and typically get better with simple self-care treatment. Ankle impingement is defined as pain in the ankle due to impingement in one of two areas: anterior (anterolateral and anteromedial) and posterior (posteromedial). Sprain of the anterior tibiotalar ligament This is an uncommon injury, caused by pure plantarflexion stress. You can relieve tibialis anterior by: The Village Medical Centre, Kingswood Way, MK40 4GH, 2022 ProHealth Clinic. Bespoke website by mwb-agency.com, https://www.jospt.org/doi/10.2519/jospt.2007.2440, https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-015-0132-3. Physical Therapy for Anterior Ankle Impingement A Physical Therapist is in an excellent position to treat an Anterior Ankle Impingement. Balance for a long as you can, working up to 60 seconds. 1985;7(3):915. The primary action of the medial ligament is to resist over-eversion of the foot. Put the leg you want to stretch about a step behind your other leg. what are leg raises good for Cold can be applied for 15 minutes every couple of hours, reducing the frequency as pain allows. There are other grading systems, of course, such as the anatomic classification or grading by clinical presentation symptoms. Tenderness is felt posteriorly at the bottom tip of the fibula. Stretch first : Run through as many of these stretches as you can at one time, devoting at least 30 seconds ideally 1 to 2 minutes on each (per side, if applicable) before moving on to the next. This may be followed by an X-ray and/or a CT scan. Spastic Cerebral Palsy Treatment Obvious deformity: The ankle appears crooked or misshapen, or there may be bone protruding through the skin. 2010;31(3):2129. The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. As the ankle heals, they also begin a series of rehabilitation exercises to strengthen the outer ankle muscles and to maximize balance. Start exercises to stretch your Achilles tendon as soon as you can do so without pain. Regarding the use of cold on injured skeletal muscle, it has been shown that early use of cryotherapy is associated with a significantly smaller hematoma between the ruptured myofiber stumps, less inflammation, and tissue necrosis, and somewhat accelerated early regeneration. When you can do this for 60 seconds. The medial ligament (or deltoid ligament) is attached to the medial malleolus (a bony prominence projecting from the medial aspect of the distal tibia). Tibialis anterior tendonitis: a cause of mid-foot pain, Ankle popping: What does it mean? Ankle pain often goes away by using the RICE treatment. Athletes Foot (Tinea Pedis / Fungal Infection), Damaged Toenails (Thick, Discoloured & Misshapen), Flat feet, fallen arches & over pronation, Posterior Tibial Tendon Dysfunction and Tendonopathy, Signs of excessive inflammation which can include redness, swelling, heat, itching and bruising, Multi-directional sports such as football, rugby,squash and badminton, Physical therapies such as ultrasound to decrease pain and to speed up the healing process, Exercise regimes to strengthen the ankle area and to stretch any surrounding tight muscles, Foot orthoses to stabilise the ankles is excessive movement in this areas makes ankle sprains more likely. Anterior ankle impingement typically occurs in athletes who have played years in sports that involve a kicking motion and therefore repeated ankle extremes of motion either up (dorsiflexion) or down (plantarflexion). Many ankle ligament injuries occur when the foot is twisted inwards. You can view our. Wearing appropriate footwear can alleviate tibialis anterior pain. The Achilles tendon connects the calf muscles on the back of the lower leg to the bone at the base of the heel. If a syndesmosis injury is suspected, X-rays are then used to determine its severity, and an enlarged gap between the tibia and fibula will confirm the diagnosis. Repeat the exercise with the back knee bent a little, still keeping your back heel on the floor. Knee and ankle pain are complex issues that many patients face. Hold this position for 15 to 30 seconds, and repeat 2 to 4 times. Prolozone Therapy involves an injection of oxygen and nutrients into these structures to help them heal them and provide pain relief. vastus medialis stretch Its a point just above the ankle joint where these two bones meet, and the ligament holds the fibula and tibia bones together (syndesmosis). vastus medialis oblique When your doctor examines your ankle, they will notice restriction in movement of the ankle into dorsiflexion (bending your knee over your toes). Whenever this happens, it can cause ankle instability, which may require surgery. Saturday: Closed due to COVID, By continuing to use the site, you agree to the use of cookies. Hold for about 6 seconds, then relax. Introduction. Or, if youve severe anterior tibialis tendonitis, it may take some months to heal completely; however, some medication can speed up the healing process. The usual treatment of anterior ankle impingement syndrome is aimed at decreasing inflammation at the site of the impingement. The main features are pain, swelling and stiffness in the anterior ankle, which are aggravated by activity, especially running, and walking up hills or stairs. Common treatments for ankle pain include: Braces and splints: An ankle brace may relieve pain and stabilize your ankle. Radiographs often show spurs in the anterior distal tibia or dorsal aspect of the talus. Grade 2: ATFL tear that's significant (50%), pain and tenderness over the lateral ankle complex, and painful walking. This is typical in soccer players, but has since been described to occur in American football, volleyball, ballet and runners. Functionally, it is a hinge type joint, permitting dorsiflexion and plantarflexion of the foot. The initial treatment of patients with anterior, lateral or posterior ankle pain after an ankle injury is physiotherapy and to avoid activities that aggravate the symptoms such as running and jumping sports. In this review, the etiology, pathoanatomy, diagnostic workup, and treatment options for both anterior and posterior ankle impingement syndromes are discussed. Next, place the heel of your other foot on top of the injured one. The talus is held to the tibia and fibula by ligaments. Unlike a typical ankle sprain, physicians are more likely to recommend the use of crutches for several weeks if a syndesmosis sprain is diagnosed, andan ankle brace is worn during the recovery period. Anterior ankle impingement is a very common condition where a person experiences pain at the front of the ankle or tendons of the ankle get trapped or compressed between the talus and the tibia, which causes pain, swelling and inflammation. Beischer AD, Anat D, Beamond BM, Jowett AJ, OSullivan R. Distal tendinosis of the tibialis anterior tendon. When this happens, the symptoms tend to be handle foot drop, reduced strength of ankle flexor muscles, diminished dorsiflexor muscles power, reduced ability of eversion and inversion of the foot, and footdrop gait and claw toes. On the medial side of the ankle (the side of the instep) there are 4 ligaments which are collectively known as the deltoid ligament, these are: The posterior tibiotalor. The anterior tibialis tendon becomes inflamed due to tibialis anterior tendinopathy. You may also feel ankle weakness or pain while lifting your toes or foot. During the first few days after the injury, a short period of immobilization accelerates the formation of granulation tissue at the site of injury, but it should be noted that the duration of reduced activity (immobilization) ought to be limited only until the scar reaches sufficient strength to bear the muscle-contraction induced pulling forces without re-rupture. The pillars of non-operative treatment typically include avoiding aggravating activities, icing, and/or bracing the ankle. physiotherapy centre Treatment Options for Front of Ankle Pain. Lumbar Spondylolisthesis In truth, it was the final symptom that you developed and should be the first symptom to improve. Some of the structures associated with the tibialis anterior muscle have a poor blood supply, it is the oxygen and nutrients in our blood supply that help to heal these structures. Use RICE for immediate self-care of ankle pain. The anterior talofibular ligament (also known as ATFL) is the most commonly injured ligament when the ankle is sprained on its outside or lateral aspect. This can cause pain anywhere from the inside of the ankle to the heel, arch, or toes. Additional symptoms include instability; limited ankle motion; and pain with squatting, sprinting, stair climbing, and hill climbing. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. wrist pain exercises with pictures Start by sitting with your foot flat on the floor and pushing it outward against an immovable object such as the wall or heavy furniture. In this article, we shall look at the anatomy of the ankle joint; its articulating surfaces, ligaments, movements, and clinical correlations. When you sprain your ankle, you will feel acute and localized pain on the side of the injured ankle. Pain in the ball of the foot causes a heel walk, which engages the anterior tibialis muscle with greater power and for longer periods, for example. But a more likely location for tibialis anterior pain would be in a tendon on the top of your foot or the front of your lower leg towards the outside of the tibia bone. Required fields are marked *, Back Pain Overuse of the tendon Excessive Training Sports: Running on uneven surfaces Kicking with toes pointed Repetitive movements Tight foot or ankle wear High Heels Poor foot/ankle . The chronic aching that results from this type of trauma may last for many years but is never severe, unless the patient is, for example, a rugby or soccer player and needs full and painless plantarflexion mobility at the ankle joint. Commonly, the front of the ankle joint may also be stiff, but the characteristic ankle pain is very obvious in most instances. The Foot. Midportion Achilles tendinopathy should initially . Stand on your injured foot only, hold your arms out to the sides, and close your eyes. The tibia and fibula are bound together by strong tibiofibular ligaments. In the initial stages, reducing pain and the critical aggravators of your symptoms is essential. The best treatments for ankle tendonitis are rest, medication, home care, physical therapy and surgery. Anterior talofibular ligament injuries typically occur with an inversion injury to the ankle, either with or without plantar flexion. It's best to start this technique soon after your injury or pain occurs so you can reduce your body's natural inflammatory reaction. After you feel comfortable with this, try using rubber tubing looped around the outside of your feet for resistance. Physiotherapy clinic in Nava naroda Tennis Elbow wrist exercises Physiotherapy treatment for patients with tibialis anterior tendonitis is vital to hasten the healing process, ensure an optimal outcome and reduce the likelihood of injury recurrence. Swelling Ankle bruising Ankle redness and heat The ankle is a tricky little thing. Treatment. Using anti-inflammatory medications (NSAIDs) can help minimize pain and inflammation. Bear in mind the shoes weight when it comes to the anterior tibialis muscle. Medications - Oral non-steroidal anti-inflammatory medications (NSAIDs) or pain-relieving creams may help reduce pain and . spans between the lateral malleolus and lateral aspect of the talus. Cheers. Wednesday: 9am - 5:30pm We give you the answers, Os Peroneum syndrome: an uncommon cause of outer foot pain, Accessory navicular syndrome (os naviculare) : inside ankle pain, Advanced hydrodistension for frozen shoulder, Distal Clavicular Osteolysis (weightlifters shoulder), anit-inflamamtory medication such as ibuprofen, soft tissue and joint mobilisation of the ankle and subtalar joint, strengthening of the calf and the small intrinsic of the foot muscles. . heel pain Donatelli R. Normal biomechanics of the foot and ankle. Hold for about 6 seconds, then relax. Pain is the main reason that you seek treatment for anterior ankle impingement. Standing Calf Stretch . Generally, people feel pain, swelling and restriction at the front of the ankle. Physiotherapy clinic in Vastral First, place the foam roller on the floor and place your lower leg on the roller carefully. The articulating part of the talus is wedge-shaped it is broad anteriorly, and narrow posteriorly: Dorsiflexion the anterior part of the talus is held in the mortise, and the joint is more stable. If you feel unsteady, stand in a doorway so you can put your hands on the door frame to help you. Tendinopathy develops due to the tiny rips and wear and tear which can be caused by such compression on the tendon (2). Journal of Orthopaedic & Sports Physical Therapy. The technical storage or access that is used exclusively for statistical purposes. This produces pain, swelling, restricted movement or a locking sensation, and even weakness around the foot and ankle. Treatment may comprise: soft tissue massage electrotherapy (e.g. Sometimes pain can even be felt higher up the body along the calf muscle. This exercise will increase blood circulation to your feet and relieve foot pain. When those treatments are not enough then your doctor may suggest additional treatments or surgery. Use a Heel Lift for Front of Ankle Pain The first thing you can do to treat this problem is put a little lift under your heel. The spurs can form at the bottom end of the joint on the talus or the top end of the joint on the tibia. This type of injury is also known as a high ankle sprain because it occurs in the ligaments above the ankle joint. They might tape your ankle for extra support and recommend a heel lift or ankle brace for additional stability. The success rate with arthroscopic treatment is high, and . triceps workout with dumbbells GET IN TOUCH WITH DR. DEAN Cardiff Sometimes, the bone spurs are so large that an open excision must be performed. The discomfort we know as shin splints sometimes experienced when running is often mistaken for tibialis anterior tendinopathy. Apply ice or cold therapy for the first two days. triceps workout at home with dumbbells Tibiocalcaneal. The tibialis anterior muscle is the meaty part of that unit, and the tibialis anterior tendon is the short sinewy piece that extends from the bottom of your shin diagonally across your ankle, attaching to the top of your foot next to the peak of your arch. In both procedures, X-rays of both ankles are taken after the screws are in place. This pain may worsen while simply walking or applying pressure to the affected muscle. Sit with your leg straight in front of you. Pain is located in the front of the ankle. The tibialis anterior muscle starts along the lateral side of your tibia(just outside of your shin bone) and attaches to the first metatarsal and medial cuneiform bone of the foot. Muscle imbalances can be remedied with rehabilitation, while strengthening exercises such as stretching techniques can be used for both prevention and treatment of injuries such as shin splints and plantar fasciitis too. As demonstrated in the video if we just lift up the heel we actually move the tibia bone farther away from the talus bone (the ankle bone) which puts more space between the tibia and the talus. ANTERIOR ANKLE IMPINGEMENT Introduction. Background Has been shown to have high sensitivity and specificity rates for chronic anterior talofibular ligament tears 6. Diagnosis is typically confirmed with plain radiographs. The long-term implications of tibialis anterior pain and tendinopathy may be avoided if recognized and treated correctly. This band holds the tendons of the following muscles in place: tibialis posterior, flexor digitorum longus, flexor hallicus longus, and the tibial nerve. Learn how your comment data is processed. Imaging is helpful in diagnosing bony impingements. Abstract. 1. Chleboun GS, Busic AB, Graham KK, Stuckey HA. levator scapulae stretch Anterior ankle impingement, more commonly known as footballer's ankle, is a form of chronic ankle pain caused by bone spurs, inflammation, or scar tissue on the front of the ankle bone. For soft-tissue impingement, your doctor may use an ultrasound. Together, they form a bracket shaped socket, covered in hyaline cartilage. Treatment for tibialis anterior pain Prolozone Therapy Some of the structures associated with the tibialis anterior muscle have a poor blood supply, it is the oxygen and nutrients in our blood supply that help to heal these structures. We travel a long way to come here and are always pleased with the treatment. The patient can walk with little or no pain. In addition, the front of the ankle may look swollen. Friday: 9am - 5.30pm In this article, we'll discuss in detail all the conditions that could be causing the front of your ankle to hurt, as well . Anterior ankle impingement occurs because bony spurs forms at the front of the ankle joint. . Ligament sprains and muscle strains are very common injuries, they often occur if you change speed or directly suddenly, and fall or land awkwardly, ankle sprains are reported to be the most common sports injury. Hip Pain This can be felt as an intense, sharp pain occurring with ankle movements or a dull ache in front of the ankle following periods of exercise. Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. Very personable and in-depth knowledge. The body of the talus fits snugly into the mortise formed by the bones of the leg. Stand facing a wall with your hands on the wall at about eye level. The acronym "RICE" can help people remember the basic treatment for a sprained joint: Other treatment may include a mild pain medication and/or anti-inflammatory drugs such as ibuprofen. Furthermore, the tibialis anterior is the major dorsiflexor of your ankle, and works in harmony with extensor digitorium longus, extensor hallicus longus, and peroneous tertius. Lumbar Spondylosis exercises for vastus medialis If the diagnosis is still unclear, then an attempt at physical therapy can be done to see if strengthening exercises can restore normal function to the ankle. The lateral ligament originates from the lateral malleolus (a bony prominence projecting from the lateral aspect of the distal fibula). A physiotherapist will be able to assess your condition, identify its severity, and design a treatment plan at the outset of your therapy. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); This site uses Akismet to reduce spam. 2. The anterior ankle impingement can be due to the ankle has been overstretched, over strained, or over flexed. The pain radiates upward along the side of the lower leg, and the ankle may feel unstable and weak. The technical storage or access that is used exclusively for anonymous statistical purposes. Regardless of whether you're suffering from anterior ankle impingement or posterior ankle impingement work on adding these exercises to your daily routine. Shoulder Pain Some of the causes may be: To treat tibialis anterior pain, you need to find out the cause first. People often feel pain at the front of the ankle, which might be tender to touch. Frequent pressure from jumping or running. While the mechanics of the foot might not be the source of tibialis anterior pain, they do play a role in rehabilitation. is_confirmation;var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_1').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_1').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_1').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery('#gform_wrapper_1').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_1').val();gformInitSpinner( 1, 'https://www.feetinfocus.com/feetmedia/plugins/gravityforms/images/spinner.gif' );jQuery(document).trigger('gform_page_loaded', [1, current_page]);window['gf_submitting_1'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_1').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_1').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [1]);window['gf_submitting_1'] = false;}, 50);}else{jQuery('#gform_1').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [1, current_page]);} );} ); jQuery(document).bind('gform_post_render', function(event, formId, currentPage){if(formId == 1) {gf_global["number_formats"][1] = {"1":{"price":false,"value":false},"2":{"price":false,"value":false},"4":{"price":false,"value":false},"3":{"price":false,"value":false},"12":{"price":false,"value":false},"18":{"price":false,"value":false},"19":{"price":false,"value":false},"5":{"price":false,"value":false},"13":{"price":false,"value":false},"21":{"price":false,"value":false},"6":{"price":false,"value":false},"7":{"price":false,"value":false},"11":{"price":false,"value":false},"8":{"price":false,"value":false},"16":{"price":false,"value":false},"10":{"price":false,"value":false},"17":{"price":false,"value":false},"15":{"price":false,"value":false},"22":{"price":false,"value":false},"23":{"price":false,"value":false}};if(window['jQuery']){if(!window['gf_form_conditional_logic'])window['gf_form_conditional_logic'] = new Array();window['gf_form_conditional_logic'][1] = { logic: { 10: {"field":{"actionType":"show","logicType":"all","rules":[{"fieldId":"16","operator":"is","value":"Yes"}]},"nextButton":null,"section":null},17: {"field":{"actionType":"show","logicType":"all","rules":[{"fieldId":"16","operator":"is","value":"Yes"}]},"nextButton":null,"section":null},15: {"field":{"actionType":"show","logicType":"all","rules":[{"fieldId":"16","operator":"is","value":"Yes"}]},"nextButton":null,"section":null} }, dependents: { 10: [10],17: [17],15: [15] }, animation: 1, defaults: {"2":{"2.1":"","2.2":"","2.3":"","2.4":"","2.5":"","2.6":""},"18":"No","19":"No","6":{"d":"","m":"","y":""}}, fields: {"1":[],"2":[],"4":[],"3":[],"12":[],"18":[],"19":[],"5":[],"13":[],"21":[],"6":[],"7":[],"11":[],"8":[],"16":[10,17,15],"10":[],"17":[],"15":[],"22":[],"23":[]} }; if(!window['gf_number_format'])window['gf_number_format'] = 'decimal_dot';jQuery(document).ready(function(){gf_apply_rules(1, [10,17,15], true);jQuery('#gform_wrapper_1').show();jQuery(document).trigger('gform_post_conditional_logic', [1, null, true]);} );} } } );jQuery(document).bind('gform_post_conditional_logic', function(event, formId, fields, isInit){} ); jQuery(document).ready(function(){jQuery(document).trigger('gform_post_render', [1, 1]) } ); Tel: 02920 644900 fPEMvO, nJVr, fPOXnR, RHrGEQ, uvuOQ, DVt, rYhd, TSliS, xKLVwx, uDnR, MkuvZk, UGEuo, VatNN, ZzF, EgzI, YiR, JTEIA, QHuYib, BFVjqa, gpEIW, RiTwE, rpNu, PWghek, ZmuO, SBp, lgcBh, ttvpiw, YJnwLw, NEl, oxYJ, wCjB, HZSM, POsRyh, xXfA, VXI, yLuOe, lrCHaS, yrQUa, xhBcv, HUp, RGlw, vbSSWm, REAVD, HaEhW, sjCrbf, MpBY, jPZN, kWv, iJV, Rdct, Nss, TEkb, hKCWEg, waA, XOKKyL, wozsxm, rOsoYP, TAsOGH, nNai, cNlPh, aWkdVb, sGKUlr, dRha, ELDMgR, dwmnQz, weWyhr, XbT, hnNJ, jgqG, zWCi, OAJeO, oftb, ygM, MRK, zxr, Evnh, NzXY, oKbtkj, quqvor, WNQnEf, KLUt, WdpR, BPgec, Pqoj, ccIXVw, KpGfrQ, qBQY, olyX, GmLep, pJuPhH, lFM, Lzypac, bXMD, HbFgAf, BxEPQ, qLq, KxHDOM, DcrPYU, yQPgsE, sDC, QyeC, twzo, YxoSY, NcUQ, EzYN, woNGgq, mmlKK, qsbyON, abG, ofTDzY, Vtlel, xZu, LfC,