The Best Options On How To Perform An Achilles Tendon Rupture Test

For many runners, experiencing pain above your heel when you stretch your ankle may not seem that serious. You may assume it is an ankle sprain and nothing more.

The bad news is that a condition called an Achilles tendon rupture is often misdiagnosed as an ankle sprain. This misdiagnosis happens up to 25% of the time.

The good news is you can perform an Achilles tendon rupture test to help you get the proper diagnosis.

Before we go into how to perform this test, let us first learn a little more about the condition. (1)

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What Is An Achilles Tendon Rupture?

Simply put, it is the rupturing or tearing of the Achilles tendon which is the largest tendon in your body. This tendon runs from your heel to your calf and is what allows you to point your toes. (2)

The tendon can be ruptured (either partially or fully) when it is overstretched 

Symptoms Of An Achilles Tendon Rupture

Symptoms Of An Achilles Tendon Rupture

Although these may not be experienced by everyone, some additional symptoms include: (3)

  • Burning pain or stiffness in the heel area
  • ​Difficulty standing on your toes on the injured leg
  • ​Swelling near the heel area
  • ​Difficulty or inability to bend the foot downward

A condition called insertional Achilles tendinitis may also cause similar symptoms. This condition can be treated by Achilles tendon massage which helps break down scar tissue. Wearing the best shoes for Achilles tendinitis is another good solution.

How To Perform An Achilles Tendon Rupture Test

Merely examining the area based on appearance, feel and movement is not a reliable way to diagnose a rupture because it is not conclusive can be easily mistaken for an ankle sprain.

Some who have a ruptured tendon can still walk, others can still move their ankles up and down and many may not have a very high tenderness level, performing an Achilles tendon test is the best option.

Test #1: The Simmonds Triad Of Tests

This test was developed by Franklin Simmonds and later by Thomson and is considered the principal clinical test for the rupture of the Achilles tendon.

A positive result indicates a complete rupture of the tendon which means that a part of the tendon has completely lost integrity. (4)

This test is composed of three tests namely, the calf squeeze test, the ankle declination test and the Gap test. 

Test #2: Calf Squeeze Test

This is also known as Thomson’s test and is performed to determine whether the Achilles tendon is completely ruptured based on the reaction of the foot when the calf muscle is squeezed.

To perform this test at home, you will need a friend to see the result of the test. (5) 

You will need:

  • A flat surface to lie on like a bed or couch or table
  • ​A friend

What to do:

  • Lie face down on the couch or bed with your feet hanging on the edge of the surface
  • Have a friend squeeze the calf of the uninjured foot with both hands. Normally, the squeezing of the calf muscles will result in a flexing of the foot.
  • Next, have them squeeze the calf muscles of the injured foot with both hands.
  • If no flexion occurs and the foot hangs directly down, the test is positive

Test #3: The Angle Of Declination Test 

This test can determine whether the Achilles tendon is ruptured based on the altered angle of dangling or altered angle of declination.

When dangling, if the injured foot is more dorsiflexed than the uninjured foot, this is a positive result. (6)

You will need:

  • ​A flat surface to kneel on like a bed or chair
  • ​A friend

What to do:

  • ​Lie face down on a couch or knee on a chair. Make sure that your feet and ankles are dangling over the edge unsupported
  • ​Have your friend compare the angle of each foot
  • If the injured foot is more dorsiflexed, the test is positive

Test #4: Gap Test

When the Achilles tendon is ruptured, during an examination, a gap located at the back the foot above the ankle can be felt.

Although this test is the least sensitive, it is still a good way to diagnose an Achilles tendon rupture.

You will need:

  • ​A flat surface to lie on like a bed or couch or table
  • ​A friend

What to do:

  • ​Lie face down on the couch or bed with your feet hanging on the edge of the surface
  • ​Have your friend gently palpitate the entire Achilles tendon by squeezing it between the thumb and index finger
  • The test is positive if you can feel a palpable gap along the tendon

Conclusion

You don’t have to be among the many who misdiagnose their condition. Perform these three tests and you will never go wrong. Of course, prevention is always better than cure and strengthening your Achilles tendon is one way to do that.

Make sure you include stretches such as the heel cord stretch