Special Tests For the Lower Leg and Ankle

Mike BoisselleGeared Towards Athletic Training Students

Special Tests

Specific procedures applied to determine the presence of pathomechanics

Unique to each structure, joint, or body part

Bilateral Comparison

Keep In Mind While Performing Special Tests

AnatomyIsolateStabilizeBilateral comparisonPatient positionPositive signsMedical Emergencies

Homan’s Sign

•Patient is in supine position, in knee extension

•Dorsiflex patient and squeeze gastroc

•Positive sign-pain

•Pain indicating thrombophlebitis MEDICAL

EMERGENCY

Anterior Drawer TestPatient seated legs over

tableStabilize distal tibia and

fibulaApply anterior force to

calcaneusPositive test: pain

and/or laxityIndicating anterior

talofibular ligament sprain

Talar Tilt (Inversion)Patient sitting with legs over

table

Stabilize distal tibia, and grasp

talus

Tilt the talus into adduction

Pain and/or laxity indicates

calcaneofibular ligament

damage

Talar Tilt (Eversion)Patient sitting with legs

over tableStabilize distal tibia, and

grasp calcaneusTilt the calcaneus into

abductionPain and/or laxity

indicates deltoid ligament damage

Thompson TestPatient prone on table with

heels off edgeExaminer squeezes muscle

belly of gastrocnemius-soleus complex

Normal response is slight plantar flexion

Absence of plantar flexion indicates Achilles tendon rupture

Tap or Percussion TestPatient sitting with feet

over tables edgePassively dorsiflex patientApply a firm tap to

patients heelPain is indicative of

possible fracture

Feiss LinePatient seated legs over

table

Draw a dot on medial malleolus, and first MTP joint

Draw a line connecting dots

Observe the navicular tubercle

Weight bearing and non weight bearing

Feiss Line (continued)Non weight bearing

navicular dropIndicates congenital

pes planus

Weight bearing navicular drop

Indicates functional pes planus

Interdigital Neuroma TestPatient seated with legs

over tableSqueeze the metatarsal

heads together 3 minutes

Pain, tingling, numbness in the foot, toe or ankle

Positive test indicating interdigital neuroma

Compression TestPatient sitting feet just

over edge

Compress the tibia and fibula

Start away from pain, work towards

Pain may indicate fracture

That cannot be right…

Kleiger’s TestPatient sitting at edge of

table

Stabilize distal tibia and fibula

Grasp calcaneus

Dorsiflex and externally rotate

Pain or laxity indicates syndesmosis sprain

Tinel’s SignPatient sits with feet at edge

of tableTap posterior tibial nerve on

medial sidePositive test- radiating pain

and tinglingIndicative of tarsal tunnel

syndrome