Ankle & Foot
Bone, Fracture & Joint Pathology
Evidence: confirmed
Calcaneal Squeeze Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Calcaneal Stress Fractures.
- Differentiating heel pain sources (e.g., Plantar Fasciitis vs. Stress Fracture).
How to Perform
- Position: Patient sits or lies prone with feet hanging off the table.
- Action: The examiner cups the heel (calcaneus) with both hands.
- Compression: Apply firm, steady pressure from both sides (medial and lateral) to compress the calcaneus.
Interpretation of Results
- Positive Test: Significant pain is produced by the compression.
- Note: Plantar fasciitis is typically tender on the plantar aspect, whereas stress fractures are tender with medial-lateral compression.
Clinical Context & Limitations
The Calcaneal Squeeze Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Ankle & Foot region, combining the Calcaneal Squeeze Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.
- Miller, M. D. (2020). Miller's Review of Orthopaedics (8th ed.). Elsevier.
