Dorsiflexion Compression Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Syndesmosis Injury (High Ankle Sprain).
- Differentiating syndesmosis pain from other ankle pain.
How to Perform
- Step 1: Patient stands and lunges forward into maximum ankle dorsiflexion. Note if this causes pain.
- Step 2: Examiner uses both hands to firmly compress the medial and lateral malleoli (ankle bones) together.
- Step 3: While maintaining this compression, the patient lunges into dorsiflexion again.
Interpretation of Results
- Positive Test: The pain felt in Step 1 is significantly decreased or eliminated during Step 2 (compression stabilizes the separation, reducing pain).
Clinical Context & Limitations
The Dorsiflexion Compression 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 Dorsiflexion Compression Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.
