Ankle & Foot
Muscle & Tendon
Evidence: confirmed
Silfverskiöld Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Differentiating between tightness in the Gastrocnemius muscle versus the Soleus muscle.
How to Perform
- Step 1: With the patient's knee extended (straight), passively dorsiflex the foot and assess the range.
- Step 2: Flex the patient's knee to 90 degrees and passively dorsiflex the foot again.
Interpretation of Results
- Tight Gastrocnemius: Dorsiflexion is limited when the knee is straight but improves significantly when the knee is bent.
- Tight Soleus/Achilles: Dorsiflexion is limited in both positions (knee straight and knee bent).
Clinical Context & Limitations
The Silfverskiöld 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 Silfverskiöld Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Miller, M. D. (2020). Miller's Review of Orthopaedics (8th ed.). Elsevier.
