1. Special Test Quick Reference
John Little, SPT
Wheeling Jesuit University
Cervical Spine
● Ligamentous
○ Sharp Purser
○ Aspinall Transverse Ligament Test
○ Alar Ligament Test
● Nerve
○ Spurling’s Test
○ Bakody’s Sign
○ Tinel Sign
● Artery Insufficiency
○ Vertebral Artery Test
Shoulder
● Rotator Cuff
○ Drop Arm Test
○ Empty Can
○ Lift Off Test
● Labral
○ Jerk Test
○ Anterior Drawer
○ O'brien's Test
○ Biceps Load Test
○ Clunk Test
● Bicep
○ Speed’s Test
○ Yergason’s Test
● Instability
○ Load and Shift Test
○ Sulcus Sign
○ Jerk Test
○ Apprehension Test
○ Labral Crank Test
● AC Joint
○ AC Shear

2. ● Impingement
○ Hawkins-Kennedy
○ Coracoid Test
○ Neer Impingement Test
Elbow
● Medial Epicondylitis
○ Golfer’s Elbow Test
● Lateral Epicondylitis
○ Mills Test
○ Cozen Test
○ Maudsley’s Test
Hip
● Muscular Tightness
○ Thomas Test
○ Ely Test
○ Ober Test
○ Nobel Compression Test
● Pathology/Labral Tear
○ Scour
○ FABER
Knee
● ACL
○ Anterior Drawer
○ Lachman Test
● PCL
○ Posterior Sag/Godfrey Sign
○ Posterior Drawer
○
● MCL
○ Valgus Stress Test
● LCL
○ Varus Stress Test
● Meniscus
○ McMurray Test
○ Thessaly Test
○ Apley’s Compression
○ Bounce Home

3. ● Patella
○ Patellar Apprehension
○ Clark’s Sign
○ McConell Test
Ankle
● Ligamentous
○ Anterior Drawer
○ Talar Tilt
○ Kleiger’s Test
● Achilles Tendon
○ Thompson Test
● Syndesmosis
○ Squeeze Test
○ Kleiger’s Test
○ Heel Thump

4. Special Test Explanation
John Little, SPT
Wheeling Jesuit University
Cervical Spine
● Ligamentous
○ Sharp Purser
■ Identify subluxation of C1 on C2, which may be result from a reduction in
integrity of the transverse ligament.
■ Patient sits with head and neck at neutral. Therapist stands to side of
patient placing one hand on pt’s forehead. The second hand in “golf tee”
hand position of thumb and index finger located at spinous process of C2
vertebra.
■ Therapist flexes the pt’s head on the neck and applies a posteriorly
directed force through the forehead as the C2 vertebra is stabilized.
■ Positive if reduction of C1 on C2 is noticed, there is a soft end feel, or
patient reports symptoms including esophageal pressure and other
neurological related cord compression symptoms.
○ Aspinall Transverse Ligament Test
■ To test the integrity of the transverse ligament when the Sharp-Purser test
is negative.
■ Patient supine with head and neck at neutral. The therapist stands at the
head of the patient with one hand at the patient’s chin to maintain head
and neck flexion. The other hand is at C2.
■ The therapist flexes the head and neck. Then, an anterior force directed by
the hand at C2.
■ Positive if end feel is soft or patient reports symptoms including
esophageal pressure and other neurologically related cord compression
symptoms.
○ Alar Ligament Test
■ To test the integrity of the alar ligament.
■ Patient supine with head and neck neutral. The therapist supports the
occiput with both hands while the index fingers palpate the spinous
process of the axis.
■ The occiput is side bent slightly to each side.
■ Positive if there is a delay in movement of the spinous process of the axis,
which rotates ipsilateral to the direction of side bending.

5. ● Nerve
○ Spurling’s Test
■ To test for the presence of a cervical radiculopathy
■ Patient sitting with neck passively positioned into extension, ipsilateral
side bending, and ipsilateral rotation.
○ This is performed in neutral for the lower quadrant sign.
○ For upper quadrant sign, the patient first performs cervical
protraction using a “chin poke” maneuver designed to isolate
forces to the upper cervical segments.
■ The therapist applies a gentle compression force consisting of triplanar
overpressure.
■ Positive if there is a reproduction in patient’s presenting symptoms.
○ Bakody’s Sign
■ Specifically C4/C5 nerve roots
■ Patient is sitting or lying down
■ Examiner passively or the patient actively elevates the arm through
abduction so that the hand or forearm rests on top of the head
○ Abduction of the arm decreases the length of the neurological
pathway and decreases the pressure on the lower nerve roots
■ Decrease of relief of symptoms indicated a cervical extradural
compression problem
■ If pain increases with positioning of the arm, it implies that pressure
increasing in the interscalene triangle
○ Tinel Sign
■ Patient sits with the neck slightly side flexed
■ Examiner taps the area of the brachial plexus with a finger along the nerve
trunks in such a way that the different nerve roots are tested
■ Pure local pain implies that there is an underlying cervical plexus lesion
■ Tingling sensation in the distribution of a neve, means the lesion is
anatomically intact and some recovery is occurring
■ If pain is elicited in the distribution of the peripheral nerve, this is positive
for a neuroma
● Artery Insufficiency
○ Vertebral Artery Test
■ To assess for vertebrobasilar ischemia/insufficiency.
■ Patient supine with head and neck in neutral. Therapist standing at the
patient’s head supporting the occiput with one hand as the other hand
provides a fulcrum at the upper cervical region.
■ The therapist first extends, then side bends and rotates the pt’s head
ipsilaterally until there is max motion in each plane. The position is held
for 15 to 30 seconds with eyes open as the therapist looks for presence of

6. any signs or symptoms. Repeat on opposite side following 30 sec to 1 min
rest.
■ Positive if the following signs occur: nystagmus, pupil dilation, slurred
speech, diminished responsiveness, apparent distress. Positive if following
symptoms occur: dizziness, tinnitus, nausea, blurred vision, any additional
unpleasant sensations.
Shoulder
● Rotator Cuff
○ Drop Arm Test
■ Examiner abducts the patient’s shoulder to 90 degrees and then asks the
patient to slowly lower the arm to the side in the same arc of movement
■ Positive test= patient is unable to return the arm to the side slowly or has
severe pain when attempting to do so
■ indicates tear in rotator cuff complex
○ Empty Can
■ Patient’s arm is abducted to 90 degrees with neutral rotation, and examiner
provides resistance to abduction
■ Shoulder is then medially rotated and angled forward 30 degrees (empty
can position) so that patient’s thumb points towards floor in the plane of
the scapula
■ positive test= weakness or pain
■ indicates a tear of the supraspinatus tendon or muscle, or neuropathy of
suprascapular nerve
○ Lift Off Test
■ Patient stands and places dorsum of hand on back pocket or against
midlumbar spine. Patient then lifts hand away from back.
■ Inability to do so indicates a lesion of subscapularis muscle
■ Abnormal motion in scapula may indicate scapular instability
● Labral
○ Jerk Test
■ Pt sits with arm medially rotated and forward flexed to 90 degrees
■ Examiner grasps patient’s elbow and axially loads humerus in proximal
direction
■ While maintaining axial loading, examiner moves arm horizontally
(horizontal adduction) across the body
■ + test for recurrent posterior instability is production of sudden jerk or
clunk as humeral head slides off (subluxes) the back of the glenoid

7. ■ When arm is returned to original 90 degrees abduction position, 2nd jerk
may be felt as head reduces
■ Positive signs also indicate positive test for posteroinferior labral tear
○ Anterior Drawer
■ Pt supine.
■ Place pt’s hand of affected shoulder in your axilla, holding the patient’s
hand with the arm so that the patient remains relaxed.
■ Shoulder to be tested is abducted b/w 80-120 degrees, forward flexed up
to 20 degrees, and laterally rotated up to 30 degrees
■ Examiner then stabilizes the patient’s scapula with opposite hand, pushing
spine of scapula forward with index and middle fingers
■ Examiner’s thumb exerts counter pressure on patient’s coracoid process
■ Using arm that is holding patient’s hand, examiner places their hand
around the patient’s relaxed upper arm and draws humerus forward
■ Movement may be accompanied by a click, by patient apprehension, or
both
■ Positive test indicates anterior instability depending on amount of anterior
translation
■ Click may indicate labral tear or slippage of humeral head over glenoid
rim
○ O'brien's Test
■ Assesses for SLAP lesion
■ The patient sits with the test shoulder in 90 degrees of forward flexion, 40
degrees of horizontal adduction, and maximal internal rotation.
■ The examiner stands with one hand grasping the subject’s wrist.
■ The patient horizontally adducts and flexes the test shoulder against the
examiner’s manual resistance.
■ The test is then repeated with the subject’s arm in an externally rotated
position.
■ Positive Sign: Pain or popping in the internally rotated position (but not in
the externally rotated position) is a positive test.
○ Biceps Load Test
■ Assesses integrity of superior labrum
■ Patient is supine with shoulder abducted to 90 degrees and externally
rotated, and forearm is supinated.
■ Therapist passively externally rotates the shoulder until the patient
becomes apprehensive.

8. ■ Rotation is stopped and the therapist resists elbow flexion while in this
position.
■ Positive Test: If apprehension decreases or the patient feels more
comfortable, the test is negative for a SLAP lesion. If pain stays the same
or worsens and apprehension remains, the test is considered positive
○ Clunk Test
■ Tests labrum
■ Pt lies supine
■ Examiner places one hand on the posterior aspect of the shoulder over the
humeral head.
■ Examiner’s other hand holds the humerus above the elbow
■ Examiner fully abducts the arm over the patient’s head. Then the examiner
pushes anteriorly with the hand over the humeral head (a fist may be used
to apply more anterior pressure) while the other hand rotates the humerus
into lateral rotation
■ Positive Sign: A clunk or grinding sound indicates both a positive test and
a tear of the labrum. The test may also cause apprehension if anterior
instability is present
● Bicep
○ Speed’s Test
■ Examiner resists shoulder forward flexion by the patient while the
patient’s forearm is first supinated, then pronated, and the elbow is
completely extended
■ Positive test= elicits increased tenderness in the bicipital groove especially
with the arm supinated and is indicative of bicipital paratenonitis or
tendinosis
○ Yergason’s Test
■ designed to check ability of transverse humeral ligament to hold biceps
tendon in bicipital groove
■ With patient’s elbow flexed 90 degrees and stabilized against the thorax
and with the forearm pronated, examiner resists supination while the
patient also laterally rotates the arm against resistance
■ If examiner palpates the biceps tendon in the bicipital groove during
supination and lateral rotation movement, the tendon will be felt to pop
out of the groove if the transverse humeral ligament is torn
● Instability
○ Load and Shift Test
■ Checks atraumatic instability problems of glenohumeral jt
■ Pt sits with no back support and with hand of test arm resting on thigh

9. ■ Sit with good posture!
■ Stand behind pt and stabilize shoulder with 1 hand over clavicle and
scapula
■ With other hand, grasp head of humerus with thumb over posterior
humeral head and fingers over anterior humeral head
■ Run fingers along anterior humerus and thumb along posterior humerus to
feel where humerus is seated relative to glenoid
■ If fingers “dip in” anteriorly as they move medially but thumb doesn’t, it
indicates humeral head is sitting anteriorly
■ Normally humeral head feels more anterior when it is properly “seated” in
glenoid
■ The humerus is then gently pushed anteriorly or posteriorly (most
common) in glenoid if necessary to seat it properly in glenoid fossa
■ This is “load” portion
■ Then push the humeral head anteriorly (anterior instability) or posteriorly
(posterior instability) noting amount of translation and end feel. “Shift”
portion of test
■ ***With anterior translation, if head is not centered, posterior translation
will be greater than anterior, giving false negative test
○ Sulcus Sign
■ Pt stands with arm by side and shoulder muscles relaxed
■ Examiner grasps patient’s forearm below elbow and pulls arm distally
■ Presence of sulcus sign may indicate inferior instability or glenohumeral
laxity but should only be considered positive for instability if patient is
symptomatic (ex: pain/ache on activity, shoulder doesn’t feel “right” with
activity)
■ Bilateral sulcus sign is not as clinically significant as unilateral laxity on
affected side
■ Grade it by measuring from inferior margin of acromion to humeral head
● 1+ = distance of less than 1 cm
● 2+ = 1-2 cm
● 3+ = more than 2 cm
○ Jerk Test
■ Pt sits with arm medially rotated and forward flexed to 90 degrees
■ Examiner grasps patient’s elbow and axially loads humerus in proximal
direction
■ While maintaining axial loading, examiner moves arm horizontally
(horizontal adduction) across the body
■ + test for recurrent posterior instability is production of sudden jerk or
clunk as humeral head slides off (subluxes) the back of the glenoid

10. ■ When arm is returned to original 90 degrees abduction position, 2nd jerk
may be felt as head reduces
■ Positive signs also indicate positive test for posteroinferior labral tear
○ Apprehension Test
■ Also called crank test for anterior shoulder dislocation
■ Checks for traumatic instability problems causing gross or anatomical
instability of shoulder, although relocation portion of test is sometimes
used to differentiate instability and impingement
■ Abduct arm to 90 degrees and laterally rotate patient’s shoulder slowly
■ Apprehension = +
○ Labral Crank Test
■ This test is used to evaluate the different glenohumeral ligaments or for
anterior shoulder instability. This test may also be used to assess a labral
tear
■ With the subject standing, the examiner places the distal hand on the
subject’s elbow and the proximal hand on the subject’s proximal humerus
and then passively elevates the subjects shoulder to 160 degrees in the
scapular plane.
■ With the distal hand, the examiner applies a load along the long axis of the
humerus while the proximal hand externally and internally rotates the
humerus.
● AC Joint
○ AC Shear
■ While the pt is sitting, the examiner cups his hands over the deltoid with
one hand with one hand over the clavicle and one hand over the spine of
the scapula.
■ Squeeze the heels of the hands together
■ Abnormal movement indicates a positive test for AC joint pathology.
● Impingement
○ Hawkins-Kennedy
■ Pt stands while examiner forward flexes arm to 90 and then forcibly
medially rotates the shoulder
■ May also be performed in different degrees of forward flexion or
horizontal adduction
■ Positive: Pain
■ Indicative of: supraspinatus paratenonitis/tendinosis or secondary
impingement

11. ○ Coracoid Test
■ Same as Hawkins-Kennedy, but involves horizontally adducting arm
across body 10 to 20 degrees before doing medial rotation
■ More likely to approximate lesser tuberosity of humerus and coracoid
process
■ Positive: pain
○ Neer Impingement Test
■ Pt’s arm is passively and forcibly fully elevated in scapular plane with the
arm medially rotated by the examiner
■ Positive: If patient’s face show’s pain
■ Indicative of: overuse injury to supraspinatus muscle and sometimes to
biceps tendon
■ If positive with arm laterally rotated, examiner should check AC joint
Elbow
● Medial Epicondylitis
○ Golfer’s Elbow Test
■ The patient should be seated or standing and should have his/her fingers
flexed in a fist position.
■ The examiner palpates the medial epicondyle with one hand and grasps
the patient’s wrist with his/her other hand.
■ The examiner then passively supinates the forearm and extends the elbow
and wrist.
■ A positive test would be a complaint of pain or discomfort along the
medial aspect of the elbow in the region of the medial epicondyle
● Lateral Epicondylitis
○ Mills Test
■ The pt is seated.
■ While palpating the lateral epicondyle, the examiner passively pronates
the patient’s forearm, flexes the wrist fully, and extends the elbow
■ A positive sign would be pain over the lateral epicondyle of the humerus.
○ Cozen Test
■ Pt is seated.
■ The patient’s elbow is stabilized by the examiner’s thumb, which rests on
the patient’s lateral epicondyle
■ The patient is then asked to actively make a fist, pronate the forearm, and
radially deviate and extend the wrist while the examiner resists the motion.
■ A positive sign would be a sudden severe pain in the area of the lateral
epicondyle of the humerus

12. ○ Maudsley’s Test
■ Pt is seated.
■ The examiner resists extension of the third digit of the hand distal to the
proximal interphalangeal joint, stressing the extensor digitorum muscle
and tendon
■ A positive test is indicated by pain over the lateral epicondyle of the
humerus.
Hip
● Muscular Tightness
○ Thomas Test
■ Patient supine with the hips near the end of table.
■ Both hips and knees flexed and the thigh on the side opposite the thigh
held against the chest
■ Patient will slowly lower on lower limb down toward the table
■ Tight rectus femoris: knee will not be flexed to neutral
■ Tight Iliopsoas: lower limb does not lower to the table
○ Ely Test
■ Patient prone, examiner passively flexes the knee.
■ Tight rectus femoris: When the knee is flexed, the hip on the same side
flexes, indicating that the rectus femoris is tight on the same side.
○ Ober Test
■ Patient side-lying, lower leg flexed at hip and knee.
■ Stabilize pelvis and passively abduct and extend the patient’s upper leg
with the knee straight or flexed 90°
■ Slowly lower upper LE.
■ Tight TFL: The leg remains abducted and does not fall to the table.
○ Nobel Compression Test
■ Patient supine accompanied by hip flexion
■ Apply pressure to lateral femoral epicondyle or 1-2 cm proximal WHILE
patient slowly extends the knee while pressure is maintained
■ IT Band Friction Syndrome: 30° of flexion, patient has severe pain over
lateral femoral condyle
● Pathology/Labral Tear
○ Scour
■ Patient lies supine, examiner flexes and adducts patients hip so that hip
faces the patient’s contralateral shoulder resistance to movement is felt
■ Slight resistance is maintained while patient hip is taken into abduction in
a flexion arc movement
■ A positive sign would be any irregularities or patient apprehension
○ FABER
■ Patient lies supine.
■ Examiner places lower limb so that the contralateral foot is on top of the
knee.

13. ■ allow knee to fall parallel with contralateral leg (looks like a figure 4)
■ A positive test would be if the knee remains above the contralateral lower
limb, does not go parallel.
Knee
● ACL
○ Anterior Drawer
■ The purpose of this is to test the integrity of the ACL.
■ The patient is supine with the hip and knees flexed to 90.
■ The clinician is sitting on the pts involved foot with hand contact at the
proximal tibia with thumb over the anterior joint line to assess mobility
■ An anteriorly directed force is exerted thru the hand contacts.
■ A positive test would be excessive anterior translation of the tibia or less
that firm, abrupt end feel.
○ Lachman Test
■ The purpose is to test integrity of the ACL.
■ The patient is supine with hip and knee flexed to 30 degrees.
■ The clinician is sitting at the foot of the table, one of the clinician's hands
stabilizes the distal femur as the other hand grasps the posterior tibia
■ Procedure: anteriorly directed force is applied to the proximal tibia
■ Interpretation: positive test if there is excessive anterior translation of the
tibia or less than a firm, abrupt end feel
● PCL
○ Posterior Sag/Godfrey Sign
■ Patient is supine
■ Examiner holds both legs while flexing the patient's hips and knees to 90
■ observe tibial tuberosity
■ A test is positive if there is posterior instability a posterior sag of the tibia
is seen
○ Posterior Drawer
■ Tests integrity of PCL
■ Patient is supine hip and knees flexed to 90
■ The clinician is sitting on the pts involved foot with hand contact at the
proximal tibia with thumbs over the anterior joint line to assess mobility
■ The force is posteriorly directed force exerted thru the hand contacts
■ A test is positive if there is excessive posterior translation of the tibia, or
less than a firm, abrupt end feel
● MCL
○ Valgus Stress Test
■ The pt is supine with the knee flexed to 0 or 30 degrees
■ The clinician is standing to the side of the pt
■ The force is medially directed, valgus force applied to the knee
■ A test is positive if there is medial joint line pain and/or laxity when
compared bilaterally

14. ● LCL
○ Varus Stress Test
■ The pt supine with the knee flexed to 0 or 30 degrees
■ The clinician is standing to the side of the pt
■ The force is laterally directed, varus force applied to the knee
■ A test is positive if there is lateral joint line pain and/or laxity when
compared bilaterally
● Meniscus
○ McMurray Test
■ Purpose: test integrity of the medial and lateral meniscus
■ Patient: supine
■ Clinician: standing to the side of the pt grasping just proximal to the ankle
with one hand as the other hand is positioned to apply force and palpate
the medial and lateral tibiofemoral joint line
■ Procedure: tibia is externally rotated, and a valgus force is applied as the
knee is passively brought into flexion and extension as the clinician
palpates the medial joint line for the medial meniscus. Internal tibial
rotation with a varus stress as the knee is flexed and extended with
palpation at the lateral joint line is performed to test the lateral meniscus
■ Interpretation: positive test if there is a palpable click, joint audible, or
pain over the joint line
○ Thessaly Test
■ Purpose: test integrity of the medial and lateral meniscus
■ Patient: unilateral standing on the involved leg with the knee in 20 degrees
flexion
■ Clinician: standing in front of the patient and holding the patient's arms
■ Procedure: the patient turns to the R and then L on the weight bearing leg
as you guide the motion
■ Interpretation: positive test if there is locking, catching, or pain at either
the medial or lateral joint line
○ Apley’s Compression
■ Purpose: meniscus lesion
■ patient in prone position with knee flexed 90 degrees
■ patients thigh is anchored to examining table with PT's knee
■ PT medially and laterally rotates the tibia, combined first with distraction,
while noting restriction, excessive movement or discomfort
■ distraction: stabilize femur. Correct hand placement to distract the TIBIA,
not just ankle. Cup the heel.
■ test repeated using compression instead of distraction
■ *compression tests meniscus; distractions test ligaments

15. ○ Bounce Home
■ Purpose: meniscus lesion
■ patient lies supine and heel of the patients foot is cupped in the PT's hand
■ patients knee is completely flexed and the knee is passively allowed to
extend
■ if extension is not complete, or has a rubbery end feel "springy block"
there is something blocking full extension. Most likely torn meniscus
■ Interpretation: if their knee is allowed to quickly extend in one movement
or jerk and the patient experiences a sharp pain on the joint line, which
may radiate up and down the leg, positive for meniscus lesion
● Patella
○ Patellar Apprehension
■ Patient lies supine with the thigh on examining table and examiner holding
leg in full extension off table. Examiner translates patella laterally using
examiner thumb, and examiner flexes knee to 90 degrees and then
extends leg.
■ A positive test is pain with translation or flexion.
○ Clark’s Sign
■ Purpose: assess the presence of a problem with the articulation between
the articular surface of the patella and the articular surface of the femoral
condyles
■ Examiner presses down slightly proximal to the upper pole or base of the
patella with the web of the hand as the patient lies relaxed with the knee
extended
■ Patient: asked to contract the quadriceps muscles while the examiner
pushes down
■ Interpretation: if the patient can complete and maintain contraction
without pain, the test is considered negative. If the test causes retropatellar
pain and the patient cannot hold a contraction, the test is considered
positive
■ Amount of pressure must be carefully controlled…. Increasing pressure
each time. Knee should be tested in 30, 60, and 90 degrees of flexion as
well as full extension
○ McConell Test
■ Purpose: test for chondromalacia patellae
■ Patient: sitting with femur laterally rotated
■ Procedure: patient performs isometric quadriceps contractions at 120, 90,
60, 30 and 0 degrees with each contraction held for 10 seconds
● If pain is produced, patient’s leg is passively returned to full
extension by examiner
● The patient’s leg is then fully supported on the examiner’s knee,
and the examiner pushes the patella medially

16. ● The medial glide is maintained while the knee is returned to the
painful angle and the patient performs an isometric contraction,
again with the patella held medially
■ Interpretation: if the pain is decreased, the pain is patellofemoral in origin.
Ankle
● Ligamentous
○ Anterior Drawer
■ Purpose: identify the capsuloligamentous integrity of the ankle joint, in
particular the integrity of the ATFL
■ Patient: supine with the ankle in 10-15 degrees of PF
■ Clinician: standing at the foot of the pt
■ Procedure: the lower leg is stabilized while the calcaneus is grasped and
translated anteriorly
■ Interpretation: test is positive if the talus translates anteriorly the extent to
which is graded on a scale where 0 indicates no laxity and 3 indicates
gross laxity
○ Talar Tilt
■ Purpose: identify the lateral ligament integrity of the talocrural and
subtalar joints
■ Patient: supine or side lying with the ankle in 10 to 15 degrees of PF
■ Clinician: sitting at the foot of the pt grasping the patient’s ankle at the
malleoli
■ Procedure: a medially directed thrust is applied to the calcaneus
■ Interpretation: the test is positive if there is increased laxity when
compared to the noninvolved side with a less firm end feel
■ Calcaneofibular ligament
○ Kleiger’s Test
■ Purpose: to identify the presence of the tibiofibular syndesmotic sprain
(high ankle sprain)
■ Patient: supine or sitting with the knee flexed to 90
■ Clinician: standing to the side of the pt with one hand supporting the lower
leg at the calf and the other supporting the foot
■ Procedure: hold the talocrural joint in neutral and apply an ER force to the
ankle
■ Interpretation: test is positive if there is a reproduction of pain proximal to
the talocrural joint
● Achilles Tendon
○ Thompson Test
■ Purpose: to identify the presence of an Achilles tendon rupture
■ Patient: prone with the foot off the edge of the table
■ Clinician: standing to the side of the pt
■ Procedure: while grasping the mid belly of the calf, a squeeze is applied
■ Interpretation: test is positive if the foot fails to PF when the squeeze is
applied

17. ● Syndesmosis
○ Squeeze Test
■ Purpose: to identify the presence of a tibiofibular syndesmotic sprain, aka
high ankle sprain
■ Patient: supine, side lying, or sitting
■ Clinician: standing at the foot of the patient with both hands grasping the
lower leg
■ Procedure: a manual squeeze is applied by both hands to the lower leg
■ Interpretation: test is positive if there is an onset of pain proximal to the
talocrural joint
○ Kleiger’s Test
■ Purpose: to identify the presence of the tibiofibular syndesmotic sprain
(high ankle sprain)
■ Patient: supine or sitting with the knee flexed to 90
■ Clinician: standing to the side of the pt with one hand supporting the lower
leg at the calf and the other supporting the foot
■ Procedure: hold the talocrural joint in neutral and apply an ER force to the
ankle
■ Interpretation: test is positive if there is a reproduction of pain proximal to
the talocrural joint
○ Heel Thump
■ Purpose: to assess the presence of a stress fracture , syndesmosis
■ Patient: in non-weight bearing with the ankle in neutral
■ Clinician: sitting or standing at the pts foot
■ Procedure: apply a firm force with the thenar eminence to the pts
calcaneus
■ Interpretation: test is positive if there's pain