Foot & Ankle Special Tests

Question 1

What special tests can be used to test for Achilles rupture?

Answer 1

Calf squeeze test / Thompson

Question 2

What special tests can be used to test for lateral ligament (ATFL/CFL) damage?

Answer 2

• Anterior Draw Test
• Talar Tilt Test

Question 3

What special tests can be used to test for high ankle sprain?

Answer 3

• External rotation stress test (Kleiger Test)
• Cotton test

Question 4

Describe how to conduct the Thompson test / calf squeeze.

Answer 4

With the patient lying prone squeeze the calf muscle belly.

Question 5

What is the normal response expected in a Thompson test / calf squeeze?

Answer 5

As you squeeze the calf the foot plantar flexes.

Question 6

What does a positive response for a Thompson test / calf squeeze present as?

Answer 6

No or minimal plantar flexion on squeezing the calf
(TA Rupture)

Question 7

Describe how to conduct an Anterior draw test (ankle).

Answer 7

• Patient supine, foot relaxed, 10-20 degrees plantar flexion
• Stabilise the tibia /fibula and pull the talus anteriorly in the ankle mortise.
  OR
• Stabilise the foot and push the tibia/fibula posteriorly.
  (Tests integrity of ATFL).

Question 8

What does a positive result for an Anterior draw test (ankle) present as?

Answer 8

+ve test = hypermobility/gapping

Question 9

Describe how to conduct a Talar tilt test (ankle).

Answer 9

• Patient in supine, talus is tilted into inversion with the foot in neutral (CFL).
• If tested in plantarflexion this test will put more stress on the ATFL.

Question 10

What does a positive result for an Talar tilt test (ankle) present as?

Answer 10

+ve = hypermobility/gapping

Question 11

Describe how to conduct an External rotation stress test (Kleiger test).

Answer 11

• Patient in sitting
• Stabilise the tibia and fibula proximally, externally rotate the foot with the ankle in plantargrade.

Question 12

What does a positive result for an External rotation stress test (Kleiger test) present as?

Answer 12

Pain in over the anterior or posterior tibiofibular ligaments.

Question 13

Describe how to conduct an Cotton test (lateral stress test).

Answer 13

• Patient in supine
• Stabilise the tibia and fibula distally, lateral translation force to the calcaneus.

Question 14

What does a positive result for a Cotton test (lateral stress test) present as?

Answer 14

Increased translation or a click/clunk.

Question 15

What are some examples of function & capacity tests of the ankle?

Answer 15

• Single leg stand (eyes open/closed)
• Balance error scoring system (BESS)
• Star excursion test
• Y balance test
• Jump & Hop tests
• Calf endurance tests
• Single leg squat
• Lunges