What is a positive Thompson test for Achilles tendon injury?
In a patient with a ruptured Achilles tendon, the foot will not move. That is called a positive Thompson test. 2 The Thompson test is important because some people who tear their Achilles are still able to point their toes downwards, although the Thompson test would still be positive.
What are the references for the diagnosis of ruptured Achilles tendon?
References 1. Simmonds FA. The diagnosis of the ruptured Achilles tendon. Practitioner. 1957;179:56–8. [PubMed] [Google Scholar] 2. Thompson TC. A test for rupture of the tendo achillis. Acta Orthop Scand. 1962;32:461–5. [PubMed] [Google Scholar] 3. Thompson TC, Doherty JH. Spontaneous rupture of tendon of Achilles: a new clinical diagnostic test.
What is a collagen fibril test for Achilles tendon tear?
The collagen fibers are packed closely together, parallel to the direction of force. Each collagen fibril is arranged into fascicles, which contain blood vessels and nerve fibers. The goal of this test is to find out if there is a complete tear present in the Achilles tendon. The patient lies prone with his foot over the end of the table.
Is the Thompson test sufficient for the diagnosis of plantar fasciitis?
They could both actively plantar flex their ankles, but had a positive Simmonds-Thompson test result. This study indicates that the Thompson test is insufficient as a diagnostic of a complete rupture. ↑ 1.0 1.1 Thompson TC, Doherty JH.
How reliable is the Thompson test?
The sensitivity of the Thompson's test for the diagnosis of a complete Achilles tendon rupture is 96-100% and the specificity is 93-100%, but data is limited.
Can the Thompson test be wrong?
A study published in Clinics of Orthopedic Surgery has shown that false-negative Thompson tests account for 25% of neglected Achilles tendon ruptures. According to this study, a false-negative test result may happen when other muscles and tendons still allow plantar flexion in spite of the ruptured Achilles tendon.
What indicates a positive Thompson test?
A positive test has been reported to indicate a complete rupture of the tendon,4 and the cited mechanical reason for the positive test (complete rupture) is the loss of integrity of the soleal part of the tendon.
How does the Thompson's test determine a rupture in the Achilles tendon?
0:301:32Thompson Test Achilles Tendon Rupture/Tear - YouTubeYouTubeStart of suggested clipEnd of suggested clipThis makes the Thompson test an excellent tool to detect an Achilles tendon rupture. Without theMoreThis makes the Thompson test an excellent tool to detect an Achilles tendon rupture. Without the need for imaging such as MRI to conduct the Thompson test have your patient in prone lying position.
Can you walk on a partially torn Achilles tendon?
Can You Walk on a Partially Torn Achilles Tendon? A patient suffering from a partially torn Achilles tendon will have difficulty walking since that tendon is necessary for the foot to efficiently push off the ground. Depending on the severity of the injury, they may be able to walk, awkwardly.
Can you tell if your Achilles tendon is going to tear?
Although it's possible to have no signs or symptoms with an Achilles tendon rupture, most people have: The feeling of having been kicked in the calf. Pain, possibly severe, and swelling near the heel. An inability to bend the foot downward or "push off" the injured leg when walking.
Can an xray show a torn Achilles tendon?
Can an X-ray Show a Torn Achilles Tendon? An X-ray may show swelling of the soft tissues or another bone injury, but an ultrasound is most commonly used to diagnose a tear and document its size. An MRI may also be needed.
How do you test for Achilles tendinopathy?
Ultrasound. This device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images of the Achilles tendon in motion, and color-Doppler ultrasound can evaluate blood flow around the tendon. Magnetic resonance imaging (MRI).
Can you plantar flex with a torn Achilles?
With these tendons intact, a patient with a ruptured Achilles may still be able to actively flex the ankle, especially without resistance.
When should I start physio after Achilles rupture?
Light active dorsiflexion of the ankle until gentle stretch of Achilles after 4 weeks. Slowly increase the intensity and ranges of isometrics of Achilles within the range of the boot. Slowly increase passive range of motion and stretch on the Achilles after 6 weeks.
Can a partially torn Achilles tendon heal on its own?
The term “heal on its own” is a bit problematic in an Achilles tendon tear. While partial tears often “heal on their own,” a physician should be consulted for diagnosis and guidance through rehabilitation. Similarly, complete tears or ruptures should be evaluated and managed by a physician.
What is a positive Simmonds test?
Simmonds-Thompson test is a diagnostic tool for Achilles tendon rupture. The absence of foot plantarflexion on calf compression is interpreted as a positive test result and indicative of Achilles tendon rupture.
What is the tear in the Achilles tendon?
Achilles Tendon Tears. An Achilles tendon tear occurs when the tendon that connects the calf muscle to the heel bone is severed. This injury often occurs during sports activities such as basketball or tennis and is felt by the athlete as a sudden sharp pain directly behind the ankle. Most often, Achilles tendon tears are non-contact injuries.
How to tell if Achilles tendon is torn?
Typical symptoms of an Achilles tendon tear include pain behind the ankle joint, swelling of the tendon, and difficulty walking. 1 Some patients know right away what has happened, in others the condition is a little less clear. That is where a good physical examination by an experienced clinician can be helpful.
What is the Thompson test?
Updated on August 26, 2020. The Thompson Test is performed when making the diagnosis of a torn Achilles tendon . This should not be confused with the Thomas test, used to assess hip joint problems. Jan-Otto / Getty Images.
How to perform a Thompson test?
To perform the Thompson test, the patient should lie face-down on the examination table. The feet extend farther than the end of the bed. The examiner then squeezes the calf muscle. This motion, in a normal patient, should cause the toes to point downward as the Achilles pulls the foot.
Why do my toes point downwards?
This motion, in a normal patient, should cause the toes to point downward as the Achilles pulls the foot. In a patient with a ruptured Achilles tendon, the foot will not move. That is called a positive Thompson test. 2 . The Thompson test is important because some people who tear their Achilles are still able to point their toes downwards, ...
How long does it take to recover from a surgical procedure?
Most athletic patients are choosing a surgical repair as the recovery does seem to be faster, although even with surgical treatment a full recovery can take 6 months or longer. In addition, as with any surgical procedure, there are risks of surgery that should be considered prior to treatment.
Who is Jonathan Cluett?
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.
What happens when you squeeze your calf?
Squeezing the calf should cause contraction of the Achilles tendon, resulting in plantar flexion. If the Achilles tendon is completely ruptured, there will not be any apparent plantar flexion. YouTube.
What is the Thompson test?
The Thompson test examines the integrity of the Achilles tendon by squeezing the calf. It is performed as a clinical test to identify the presence of a complete Achilles rupture.
What is the Simmonds-Thompson test?
The Simmonds-Thompson test is an indication for a possible complete rupture, but its mechanism is not completely clear.
Which tendon bows away from the tibia?
By squeezing a healthy calf, the m. soleus deformed, which made the overlying m. gastrocnemius tendon bow away from the tibia resulting in plantar flexion. The m. soleus did not move in a longitudinal manner, while the m. gastrocnemius muscle moved about 1 cm proximally. These findings confirm the ultrasound findings.
Which test gave a positive result when the m. soleus alone was divided?
Thompson and Doherty found that the squeezing test gave a positive result when the m. soleus alone was divided. To elucidate these findings, Scott and colleagues separated the m. gastrocnemius tendon from the m. soleus down to 10 cm above the Achilles tendon, the place where the fibers form the tendon.
Where is the plantaris tendon located?
The plantaris tendon, when present, lies alongside the heel cord or is somewhat removed from it in its insertion into the medial aspect of the calcaneus. Tendons are strong, tough bands of inelastic fibrous connective tissue that connect muscle to bone.
Does a m. gastrocnemius tendon prevent plantar flexion?
Dividing the m. gastrocnemius tendon did not prevent full plantar flexion. We can conclude then that the plantar flexion is caused by bowing the calf tendons and less so by the proximal displacement of the bellies of the m. gastrocnemius. A study conducted by Douglas and colleagues came up with other findings.
What is Thompson's test?
Thompsons test is used to help diagnose a complete rupture of the Achilles tendon.
Can you move your foot if you rupture your Achilles tendon?
In a healthy ankle, your foot should move each time you squeeze the muscle. However, if you have a complete rupture of the Achilles tendon then your foot will not move as expected.
Who is Mike from Sports Injury Clinic?
Mike is a qualified Sports Injury Therapist, creator & CEO of Sportsinjuryclinic.net. Mike has a degree in Physical Education, Sports Science and Physics, a Diploma in Fitness Training & Sports Therapy and a Postgraduate Certificate in Education with Qualified Teacher Status.
Significant Findings
The left Achilles tendon had a defect on palpation, while the right Achilles tendon was intact. When squeezing the right (unaffected) calf, the ankle spontaneously plantar flexed, indicating a negative (normal) Thompson test. Upon squeeze of the left (affected) calf, the ankle did not plantar flex, signifying a positive (abnormal) Thompson test.
Discussion
The Achilles tendon (also: calcaneal tendon or heel cord) is derived from the medial and lateral heads of the gastrocnemius muscle, as well as the soleus muscle.
Topics
Thompson test, Simmonds-Thompson test, orthopedics, Achilles tendon rupture, calcanea tendon rupture, ankle pain, calf pain.
References
Lagergren C, Lindholm A. Vascular distribution in the Achilles tendon: an angiographic and microangiographic study. Acta Chir Scand. 1959;116 (5-6):491–495.