Silfverskiold Test

Original Editor - Rucha Gadgil
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Purpose[edit | edit source]

The Silfverskiöld test commonly used to identify isolated gastrocnemius contracture associated with several foot and ankle pathologies was first described by Nils Silfverskiöld [1]. The Silfverskiöld test differentiates gastrocnemius tightness from an achilles tendon contracture by evaluating ankle dorsiflexion with the knee extended and then flexed[2].

Technique[edit | edit source]

It measures the dorsiflexion (DF) of the foot at the ankle joint (AJ) with knee extended & flexed to 90 degrees. The test is considered positive when DF at the AJ is greater with knee flexed than extended.

The test is performed with the patient seated or in supine. Two hands are utilized to perform the technique, with one hand neutralizing and locking the subtalar (ST) joint and the other stabilizing the talonavicular (TN) joint and forefoot in order to isolate the ankle joint motion[3]. With the subtalar joint (STJ) in neutral, forefoot is supinated and foot is dorsiflexed with knee in full extension. Measurement is taken of the DF range. Then the test is repeated with knee flexed at 90 degrees.

Less dorsiflexion with a soft and spongy feel when the knee is extended, indicates a gastroc contracture and equally limited DF with the knee flexed and extended, points to either a soleal equinus or an osseous block.

Evidence[edit | edit source]

Inter- and intrarater reliability testing of the clinical Silfverskiöld test : ICC values of 0.230 to 0.791. poor inter- and intrarater reliability[4].

References[edit | edit source]

  1. SilfverskiöldN.:  Reduction of the uncrossed two-joints muscles of the leg to one-joint muscles in spastic conditions. Acta Chir Scand;1924;56:315-30.
  2. DiGiovanni CW, Kuo R, Tejwani N, et al: Isolated gastrocnemius tightness. J Bone Joint Surg Am   2002;84(6):962-970.
  3. Hansen ST. Functional reconstruction of the foot and ankle. Lippincott Williams & Wilkins; 2000.
  4. Molund M, Husebye EE, Nilsen F, Hellesnes J, Berdal G, Hvaal KH. Validation of a New Device for Measuring Isolated Gastrocnemius Contracture and Evaluation of the Reliability of the Silfverskiöld Test. Foot & Ankle International. 2018;39(8):960-965.