1. Special Tests For the Lower Leg and Ankle
Mike Boisselle
Geared Towards Athletic Training Students

2. Special Tests
Specific procedures applied to determine the presence of pathomechanics
Unique to each structure, joint, or body part
Bilateral Comparison

3. Keep In Mind While Performing Special Tests
Anatomy
Isolate
Stabilize
Bilateral comparison
Patient position
Positive signs
Medical Emergencies

4. Homan’s Sign Patient is in supine position, in knee extension
Dorsiflex patient and squeeze gastroc
Positive sign-pain
Pain indicating thrombophlebitis
MEDICAL EMERGENCY

6. Anterior Drawer Test Patient seated legs over table
Stabilize distal tibia and fibula
Apply anterior force to calcaneus
Positive test: pain and/or laxity
Indicating anterior talofibular ligament sprain

8. 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

9. 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

11. 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

12. 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

13. 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

14. Feiss Line (continued)
Non weight bearing navicular drop
Indicates congenital pes planus
Weight bearing navicular drop
Indicates functional pes planus

16. 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

17. Compression Test Patient sitting feet just over edge
Compress the tibia and fibula
Start away from pain, work towards
Pain may indicate fracture

18. That cannot be right…

19. 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

20. 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