Triple Compression Stress Test Special Test

What is it used for?

• Diagnosing Tarsal Tunnel Syndrome (Posterior Tibial Nerve entrapment).
• Considered more sensitive than Tinel's Sign for this condition.

How to Perform

• Position: Patient lies supine or sits with the leg relaxed.
• Action: The examiner places the ankle in full Plantar Flexion and Inversion (Supination).
• Compression: Simultaneously, the examiner applies constant digital pressure over the posterior tibial nerve (behind the medial malleolus). Maintain for 30 seconds.

Interpretation of Results

• Positive Test: Reproduction of numbness, tingling, or paresthesia in the foot or toes (plantar distribution).

Diagnostic Accuracy

• Sensitivity: 85-92%
• Specificity: 86-100% (Magee)

References

• Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.