Ankle and foot special tests are most useful when chosen to confirm or refute a hypothesis from the mechanism - an inversion sprain points to the lateral ligaments, an external-rotation injury to the syndesmosis, and a sudden calf 'pop' to the Achilles. This guide groups the tests that change management, with how to perform each one and how to interpret a positive or negative result.
Stability tests after an inversion injury - best performed once acute pain and swelling have settled, comparing side to side.
After a lateral inversion injury, use the anterior drawer test for the ATFL and the talar tilt test for the calcaneofibular ligament, comparing both to the uninjured side. They are most reliable once acute swelling has settled.
It screens for a high ankle (syndesmotic) sprain. Compressing the tibia and fibula at the mid-calf that reproduces pain over the syndesmosis suggests injury, particularly after an external-rotation mechanism.
The Thompson (calf squeeze) test is highly accurate. With the patient prone, squeezing the calf should normally plantarflex the foot; absence of that movement suggests a complete Achilles tendon rupture and warrants urgent referral.