Sports Med - Special Tests: Leg and Foot

Anterior drawer test - Examiner’s position

• In front of patient

• One hand stabilizing the ankle

• One hand cups the calcaneus, the foot on the forearm

Anterior drawer test - Action

Calcaneus and talus are drawn forward (up) while stabilizing the leg

Anterior drawer test - Positive

• Increased translation of talus

• Lack of end feel

• Pain

Anterior drawer test - Pathology

Anterior talofibular ligament sprain

Talar tilt (inversion & eversion) - Examiner’s position

• In front of patient

• One hand cups calcaneus, maintains the foot in neutral

• One hand stabilizes the leg

Talar tilt (inversion & eversion) - Action

Rolls the calcaneus medially and laterally (invert, then evert)

*Can add plantarflexion or glide during test

Talar tilt (inversion & eversion) - Positive

• Increased tilt of talus

• Lack of end feel

• Pain

Talar tilt (inversion & eversion) - Pathology

Inversion:

• Calcaneofibular ligament sprain (neutral)

• Possible Anterior talofibular ligament sprain (plantarflexed)

Eversion:

• Deltoid ligament sprain (dorsiflexion)

• Posterior talofibular ligament sprain (dorsiflexion)

Kleiger’s (external rotation) test - Examiner’s position

• In front of patient

• One hand stabilizes tibia and fibula

• One hand grasps the medial aspect of the foot, supporting the ankle in neutral or plantarflexed position

Kleiger’s (external rotation) test - Action

Dorsiflex foot and external rotation of foot outwards

*Could perform in plantarflexion in attempt to isolate anterior deltoid fibers

Kleiger’s (external rotation) test - Positive

• Laxity

• Pain

Kleiger’s (external rotation) test - Pathology

• Deltoid ligament sprain

• High ankle sprain

• Rule out fracture

• Rule out involvement of Spring ligament

Squeeze (fracture) test - Examiner’s position

• Adjacent to injured leg

• Hands cupped behind tibia and fibula (away from the site of pain)

Squeeze test - Action

Squeezing of tibia and fibula

*Can progress toward injured site

Squeeze test - Positive

• Pain

• Crepitus (grating or crunching sensation)

Squeeze test - Pathology

• Syndesmosis sprain

• Fracture

Bump test - Examiner’s position

Anterior to patient

Bump test - Action

• Dorsiflex ankle

• Bump calcaneus with the heel of the examiner’s palm

Bump test - Positive

Pain

Bump test - Pathology

Stress fracture of talus or leg

Thompson’s test - Examiner’s position

• Side of the patient

• One hand to squeeze the gastrocnemius

Thompson’s test - Action

Squeeze the gastrocnemius and observe the plantarflexion of the foot

Thompson’s test - Positive

No plantarflexion

Thompson’s test - Pathology

Achilles tendon rupture