Ankle and Spine Special Tests

Question 1

Anterior drawer test

Answer 1

For ATFL sprain

Hold foot in 20 degrees PF

Question 2

Lateral rotation stress test

Answer 2

AKA Kleiger test
Pt seated, knee in 90 deg flex.
Apply lateral rotation force to foot
Positive High Ankle Sprain: Pain over tibiofibular ligaments and interosseous membrane

Positive deltoid sprain: pain medially and therapist can feel talus shift away from medial malleolus.

Question 3

Talar tilt test

Answer 3

For calcaneofibular ligament sprain
Pt sidelying, knee 90 deg flex
Stabilize distal tibia, tilt talus into abd and add.
Positive: Excessive adduction

Question 4

Thompson Test

Answer 4

For Achilles tendon rupture

Pt prone with feet extended over edge of table

Question 5

Tibial torsion test

Answer 5

Pt seated with knees over edge of table
Place thumb and index finger over medial and lateral malleolus
Measure acute angle formed by axes of the knee and ankle

Normal: 12-18 degrees lateral rotation

Question 6

True leg length discrepancy test

Answer 6

Supine, legs 15-20 cm apart
Measure from ASIS to distal medial malleolus
Positive: Discrepancy greater than 1 cm

Question 7

Cervical flexion rotation test

Answer 7

Pt should have 45 degrees rotation each direction
Indicates dysfunction at AO joint
Can also be used as provocative test for cervicogenic headache

Question 8

Distraction test

Answer 8

For patients currently experiencing radicular symptoms
Apply distraction force
Positive for cervical nerve root compression if pain decreases with distraction

Question 9

Foraminal compression test

Answer 9

Spurlings
Seated, head sidebent
Positive for nerve root compression if compression > pain in arm

Question 10

Vertebral artery test

Answer 10

Supine
Bring head passively into ext, ER, rotation to ipsilateral side
Positive: dizziness, nystagmus, slurred speech, loss of consciousness

Question 11

Gapping Test/ SI joint stress test

Answer 11

For sprain of anterior SI ligaments/ SI dysfunction
Supine, therapist applies downward/lateral force on ASIS
Positive: Pain in SI joint, glutes, or posterior leg

Question 12

Sitting flexion test

Answer 12

For SI restriction
Pt seated, feet on floor, hips and knees 90/90
Therapist monitors PSIS as patient flexes forward
Positive: One PSIS moves more than the other

Question 13

Slump test

Answer 13

For neural tension
In slumped position, therapist dorsiflexes foot, then extends knee
If can’t extend knee, pt extends neck.
If symptoms decrease with neck extension, positive

Question 14

Standing flexion test

Answer 14

Same as sitting flexion test, but in standing

Feet 12 inches apart

Question 15

Straight Leg Raise Test

Answer 15

For neural tension or lesion in spinal cord (e.g. disc herniation)
- Passive SLR to point of pt reported tightness
- Decrease SLR until no tightness felt
- DF foot or flex neck
Positive: Symptoms return