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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