A 38-year-old recreational badminton player feels a sudden 'snap' in the back of his ankle during a lunge. He can walk but cannot rise onto his toes. There is a palpable gap 4 cm above the calcaneum. With the patient prone and the knee flexed to 90 degrees, squeezing the calf produces no plantarflexion of the foot. This sign is called:

• A Phalen test
• B Ober test
• C Lachman test
• D Thompson (Simmonds) test ✓

Explanation

The Thompson or Simmonds calf squeeze test is the standard clinical test for complete Achilles rupture: squeezing the calf in the prone position should produce plantarflexion if the gastrocnemius-soleus complex is continuous with the calcaneum, and its absence confirms rupture. It is more reliable than assessing active plantarflexion, which persists through long toe flexors and peronei even after complete rupture. Ober tests iliotibial band tightness, Lachman tests the ACL and Phalen tests median nerve compression at the wrist.

Reference: DeLee and Drez's Orthopaedic Sports Medicine, 5th ed.

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Written and medically reviewed by the StethoPrep medical team.