Heel Thump Test

Orthopedic Exam / Special Tests for Physical Therapy: Ankle and Foot

Heel Thump Test


  • To determine if there is a tibial stress fracture.
  • The heel-thump special test is a useful screening tool for evaluating ankle injuries and for differentiating syndesmotic sprains from lateral ankle sprains.

Video Instructions, Procedure, Positive Test:

Heel Thump Special Test: Video Instructions (Procedure below)

Heel Thump Test: PROCEDURE: 

  • the patient is in seated or supine
  • the examiner uses one hand to stabilize the leg
  • with the other hand, the examiner applies a firm thump on the heel with the fist so that the force is applied to the center of the heel and in line with the long axis of the tibia.

Heel Thump Test: POSITIVE TEST:

  •  A positive test (i.e., pain) in the area of the ankle indicates a syndesmosis injury. Pain along the shaft of the tibia may indicate a stress fracture.