Single-heel rise test

Name of test

Single-heel rise test

What it tests

Integrity of posterior tibial tendon

How to do it

The patient stands facing away from the examiner. The patient is asked to stand on her affected leg only (first figure) and then plantar flex the ankle such that she will rise up onto her toes (second figure).

The normal response

Normally, when the patient plantar flexes the foot at the ankle there is inversion of the foot.

As you see (depicted by the black line) in the first figure, the skin crease is roughly parallel to the ground when standing flat; when up in a single leg rise stance, the skin crease line is now reflects ankle inversion

What it means if not normal

Absence of foot inversion during plantar flexion denotes posterior tibial tendon rupture or chronic posterior tibial tendonitis. Other signs of posterior tibial tendon rupture or tendonitis are pain to palpation and swelling posterior to the medial malleolus and weakness of foot inversion.

Comments

It is critical that the patient start this movement while standing on one foot. Some patients will be able to HOLD themselves on a single leg but cannot INITIATE a single leg rise

Citations

7479410, 6861387

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