Royal London Hospital Test | Achilles tendinopathy/tendinitis
Achilles Tendinopathy is a common injury seen in sporting populations. Traditionally, the diagnosis of Achilles tendinopathy is based on clinical presentation and history taking revealing Achilles tendon pain that’s usually worse in the morning and that warms up during activity. Often, patients report a sudden spike in activity that overloaded the tendon. Reiman et al (2014) reviewed the literature on tests for Achilles tendon pathology and found a pooled sensitivity of 54% and a specificity of 86% for the Royal London Hospital Test. As the included studies were of mixed risk of bias and on the basis of the found values the clinical value is at most moderate.
To conduct the test, the patient can be in sitting position with the foot over the edge of the bench. The ankle is in neutral or slight plantarflexed position while you palpate the achilles tendon for tenderness. In midportion tendinopathy, this is commonly the case 2-5cm from the calcaneal insertion or right at the calcaneus in insertional tendinopathy.
The patient is then asked to move the ankle into maximum dorsiflexion. The tendon is then again palpated at the previously found tender spot.
Then the patient moves the foot into maximum plantarflexion and the tender spot is again palpated.
The test is considered positive for achilles tendinopathy if the pain on the tender spot initially found is absent in the maximally dorsiflexed position.
The authors have no explanation as to why the pain disappears on maximal tension on the tendon.
21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE
Another orthopedic test for Achilles tendinopathy is the Arc Test that can help to distinguish between Achilles tendinopathy and an inflammation of the tendon sheath, called tenosynovitis.
What customers have to say about the Assessment E-Book
The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!
The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
Great work, guys
The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!
The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.
The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
Congrats guys you’ve done an incredible job.
I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
In one word: amazing. Keep going guys ! Best wishes from france.
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.