Execution
- 1Position the patient prone or supine with the foot accessible.
- 2Stabilize the distal leg.
- 3Grasp the heel and foot.
- 4Passively force the ankle into plantarflexion or applies an axial thrust through the heel toward plantarflexion.
- 5Ask whether posterior ankle pain is reproduced.
Positive outcome
Reproduction of posterior ankle pain is positive for posterior ankle impingement. The test may implicate os trigonum, a prominent posterior talar process, posterior soft-tissue impingement, or flexor hallucis longus involvement. Pain location and sport history help interpretation.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Hamilton (1982) | NA | NA | NA | NA | NA |
CommentMagee discusses posterior ankle impingement in athletes who repeatedly plantarflex, including ballet dancers, divers, soccer players, and track athletes. Heel thrust or forced plantarflexion has limited diagnostic-accuracy evidence as a singleton. It is best used to reproduce symptoms and guide imaging or differential testing for FHL pathology.
Low Clinical Value