Transcript Special Tests For the Lower Leg and Ankle

Mike Boisselle
Geared 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
Anatomy
Isolate
Stabilize
Bilateral comparison
Patient position
Positive signs
Medical Emergencies
Homan’s Sign
•Patient is in supine position,
in knee extension
•Dorsiflex patient and squeeze
gastroc
•Positive sign-pain
•Pain indicating
thrombophlebitis
Anterior Drawer Test
 Patient seated legs over
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

table
Stabilize distal tibia and
fibula
Apply anterior force to
calcaneus
Positive test: pain and/or
laxity
Indicating 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
table
 Stabilize distal tibia, and grasp
calcaneus
 Tilt the calcaneus into
abduction
 Pain and/or laxity indicates
deltoid ligament damage
Thompson Test
 Patient prone on table with
heels off edge
 Examiner squeezes muscle belly
of gastrocnemius-soleus
complex
 Normal response is slight
plantar flexion
 Absence of plantar flexion
indicates Achilles tendon
rupture
Tap or Percussion Test
 Patient sitting with feet over
tables edge
 Passively dorsiflex patient
 Apply a firm tap to patients heel
 Pain is indicative of possible
fracture
Feiss Line
 Patient 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 drop
 Indicates congenital pes
planus
 Weight bearing navicular
drop
 Indicates functional pes
planus
Interdigital Neuroma Test
 Patient seated with legs over
table
 Squeeze the metatarsal heads
together 3 minutes
 Pain, tingling, numbness in
the foot, toe or ankle
 Positive test indicating
interdigital neuroma
Compression Test
 Patient 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 Test
 Patient sitting at edge of table
 Stabilize distal tibia and fibula
 Grasp calcaneus
 Dorsiflex and externally rotate
 Pain or laxity indicates
syndesmosis sprain
Tinel’s Sign
 Patient sits with feet at edge of
table
 Tap posterior tibial nerve on
medial side
 Positive test- radiating pain and
tingling
 Indicative of tarsal tunnel
syndrome