Thompson Test | Achilles Tendon Rupture/Tear Assessment

Interestingly, 66% of all Achilles tendon ruptures are asymptomatic or patients have no pain, stiffness, or dysfunction in the tendon prior to rupture. Despite this, it is the case that 98% of all ruptured Achilles tendons show signs of degeneration. In 2014, Reiman et al published a systematic review including meta-analysis on the diagnostic accuracy of various clinical assessments for diagnosing Achilles tendon ruptures. Probably the most widely used test is the Thompson test. With a sensitivity of 96% and specificity of 93%, it has a high clinical value in the diagnosis as well as in the exclusion of Achilles tendon ruptures.

To perform the test, the patient lies on the bench with the lower legs extended in the prone position. The patient’s ankles extend beyond the edge of the bench. Now compress the calf with one hand and pay attention to the movement of the foot. If compression of the calf results in plantar flexion of the foot, it can be assumed that the tendon is intact.
However, if there is a lack of some degree of preload on the plantar flexion in the prone position and no further plantar flexion occurs due to compression of the calf, a rupture is likely.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Other common tests for Achilles tendon ruptures:

• Matles Test
• Gap Palpation Test
• Copeland Test

References

Maffulli N. The clinical diagnosis of subcutaneous tear of the Achilles tendon. The American journal of sports medicine. 1998 Mar;26(2):266-70.

Reiman M, Burgi C, Strube E, Prue K, Ray K, Elliott A, Goode A. The utility of clinical measures for the diagnosis of achilles tendon injuries: a systematic review with meta-analysis. Journal of athletic training. 2014;49(6):820-9.