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Minnesota State University, Mankato

Minnesota State University, Mankato
Athletic Training

Special Tests

Page address: http://ahn.mnsu.edu/athletictraining/spata/footanklemodule/specialtests.html

Anterior Drawer Test

Steps
Athlete is sitting over the edge of the table with the knee bent
Examiner stabilizes the lower leg with one hand & cups the calcaneus with the forearm supporting the foot in slight plantar flextion (~ 20° ) and slight inversion (few degrees)
Examiner draws the calcaneus & talus anteriorly and slighlty medially
Positive Test
Pain, anterior translation, dimple/sulcus, and/or "clunk"
Positive Test Implications
ATF ligament sprain/capsular sprain
See Test

Heel Tap ("Bump") Test

Steps
Athlete is sitting or lying supine, with the involved foot off the end of the table & the knee straight
Examiner stabilizes the lower leg with one hand & bumps the calcaneus with the other hand
Examiner bumps the calcaneus 2–3 times with progressively more force
Positive Test
Pain (at area of complaint)
Positive Test Implications
Possible fracture
See Test

Squeeze Test

Steps
Athlete is sitting or lying with his/her knee extended
Examiner cups his/her hands behind the tibia & fibula, away from the site of pain
Examiner compresses the tibia & fibula, gradually adding more pressure
Positive Test
None
Positive Test Implications
Possible fracture
See Test

Varus/Valgus Stress Testing of the MTP

Steps
Athlete is supine or sitting with his/her knees extended
Examiner stands lateral to the involved foot
Examiner stabilizes the proximal bone close to the joint to be tested
Examiner grasps the bone distal to the joint to be tested near the middle of its shaft
Examiner moves the distal bone medially/laterally, attempting to open up the joint
Positive Test
Increased laxity or pain
Positive Test Implications
Collateral ligament sprain
See Test

Tinel's Sign Test

Steps
Athlete is supine with the hip of the affected side externally rotated and the foot slightly everted
Examiner taps over the tarsal tunnel
Positive Test
Radiating pain in the foot and toes
Positive Test Implications
Tarsal tunnel syndrome
See Test

Thompson's Test

Steps
Athlete is prone with his/her knee extended
Examiner squeezes the calf musculature while observing for ankle plantar flexion
Positive Test
Foot does not plantar flex when calf is squeezed
Positive Test Implications
Achilles tendon rupture
See Test

Supple Ples Planus Test

Steps
Athlete is sitting on the edge of the table
Examiner is positioned on a stool facing the athlete
Examiner notes the presence of a medial longitudinal arch
Examiner has the athlete stand with his/her body weight evenly distributed
Positive Test
Medial longitudinal arch disappears when weight bearing
Positive Test Implications
Supple Pes Planus
See Test

Side–to–Side Test

Steps
Athlete is sitting (or supine with the knee slightly flexed)
Examiner stabilizes the lower leg with one hand
Examiner grasps the rearfoot and slides the talus/calcaneus laterally and medially
Positive Test
Pain; noticeable "clunk"
Positive Test Implications
Syndesmosis sprain
None
See Test (Medial Subtalar Glide)
See Test (Lateral Subtalar Glide or Cotton)

Percussion Test

Steps
Athlete is sitting with the involved leg off the end of the table
Examiner taps distally from the involved structure
Positive Test
Pain (at the area of complaint only)
Positive Test Implications
Possible fracture
See Test

Navicular Drop Test

Steps
Athlete is sitting with both feet on the floor
Examiner places a dot over the navicular tuberosity with the athlete in a non–weight bearing position
Examiner kneels in front of the athlete & places the subtalar joint in the neutral position with the athlete's foot flat against the ground, but non–weight bearing
Examiner positions a 3x5 index card next to the medial longitudinal arch & makes a mark on the card corresponding to the level of the navicular
Examiner has the athlete stand with his/her body weight evenly distributed & marks the new level of the navicular on the card
Examiner measures the distance between the two marks
Positive Test
Navicular drops more than 10 mm
Positive Test Implications
Hyperpronation of the foot
See Test

Kleiger's (External Rotation) Test

Steps
Athlete is sitting with his/her legs over the edge of the table
Examiner stabilizes the lower leg with one hand
Examiner grasps the medial aspect of the foot while supporting the ankle in neutral
Examiner rotates the foot laterally
Positive Test
Medial/lateral joint pain; syndesmosis (anterior Tib–fib) pain
Positive Test Implications
Deltoid ligament sprain (medial/lateral joint pain); syndesmosis involvment (syndesmosis/tib–fib pain)
See Test

Inversion Talar Tilt Test

Steps
Athlete is sitting with his/her legs over the edge of the table
Examiner grasps the calcaneus with one hand & stabilizes the lower leg with the other hand
Examiner provides inversion stress rolling the calcaneus inward while the ankle is in neutral
Examiner provides an inversion stress by rolling the calcaneus inward while the ankle is in the plantar flexed position
Positive Test
Talus tilts or gaps excessively; pain
Positive Test Implications
Involvement of ATF (PF position)/CF (neutral position)
See Test

Eversion Talar Tilt Test

Steps
Athlete is sitting with his/her legs over the edge of the table
Examiner grasps the calcaneus with one hand & stabilizes the lower leg with the other hand
Examiner provides an eversion stress rolling the calcaneus outward while the ankle is neutral
Positive Test
Talus tilts or gaps excessively; pain
Positive Test Implications
Deltoid ligament sprain
See Test

Intermetatarsal Glide Test

Steps
Athlete is supine or sitting with his/her knees extended
Examiner is standing in front of the athlete's feet
Examiner grasps the heads of the two metatarsals
Examiner moves the two metatarsal heads in opposite directions
Examiner repeats the procedure until all four intermetatarsal joints have been evaluated
Positive Test
Pain or increased glide
Positive Test Implications
Trauma to deep transverse metatarsal ligament and/or interosseus
See Test

Interdigital Neuroma Test

Steps
Athlete is positioned in the supine position on the table
Examiner uses the eraser end of a pencil to apply pressure to the intermetatarsal space
Positive Test
Replication of symptoms/increase of symptoms
Positive Test Implications
Interdigital neuroma
See Test

Homan's Sign Test

Steps
Athlete is sitting or supine with the knee extended
Examiner passively dorsiflexes foot while knee is extended
Examiner palpates the calf
Positive Test
Calf pain
Positive Test Implications
Deep vein thrombophlebitis (DVT)
See Test

Fracture Test

Steps
Athlete is supine or seated with his/her feet off teh end of the table
Examiner grasps the foot around the mid–shaft of the metatarsals & squeezes metatarsals or compresses the bone from one end to the other and rotates the bone
Positive Test
Pain and/or crepitus
Positive Test Implications
Possible MT fracture
See Test (Grind)
See Test (Compression)

Feiss' Line Test

Steps
Athlete is sitting with his/her feet off the end of the table
Examiner places a mark on the apex of the medial malleolus, the navicular tubercle & the plantar aspect of the 1st MTP joint & draws a line connecting the marks
Examiner has the athlete stand with his/her feet approximately 1' apart & the weight evenly distributed
Examiner marks the new position of the navicular tubercle
Positive Test
Navicular drops more than 10 mm
Positive Test Implications
Hyperpronation of the foot
See Test