Squeeze Test

Purpose[edit | edit source]

The purpose of the squeeze test is to aid in the diagnosis of syndesmotic ankle sprains. The squeeze test is also known as the fibular compression test and available literature suggests that it is used alongside with the ankle external rotation test.[1]

Technique[edit | edit source]

The squeeze test compresses the proximal fibula against the tibia to assess the integrity of the bones, interosseus membrane, and syndesmotic ligaments. Pain occurs with fracture or diastasis and is considered positive.[2][3]

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Evidence[edit | edit source]

The squeeze test has been found to have moderate reliability (kappa = 0.50) according to a study performed by Alonso et al.[5] and according to the study done by de César PC et al, the test has a sensitivity of 30% and a specificity of 93.5% for a high ankle sprain.[1] In the study done by Sman AD et al, it is recommended that though the squeeze test has highest specificity, it would be ideal to use a combination of sensitivity and specific signs and tests to confirm ankle syndesmosis involvement. They suggests to use the dorsiflexion-external rotation stress test along with the squeeze test to get a better diagnose along with other symptoms.[6]

Resources[edit | edit source]

'A biochemical analysis of the squeeze test for sprains of the syndesmotic ligaments of the ankle.'[7]

References[edit | edit source]

  1. 1.0 1.1 de César PC, Ávila EM, de Abreu MR. Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain. Foot & ankle international. 2011 Dec;32(12):1110-4.
  2. Birrer RB, Fani-Salek MH, Totten VY et al. Managing ankle injuries in the emergency department. The Journal of Emergency medicine. 1999;17:651-660.
  3. Brosky T, Nyland J, Nitz A et al: The ankle ligaments: consideration of syndesmotic injury and implications for rehabilitation, J Orthop Sports Phys Ther 21:197-205, 1995.
  4. Syndesmosis Squeeze Test. Available from:https://www.youtube.com/watch?v=rM9Rk1oucHM&feature=emb_logo&ab_channel=PhysicalTherapyNation
  5. Alonso A,Khoury L, Adams R. Clinical tests for ankle syndesmosis injury: reliability and prediction of return to function. J Orthop Sports Phys Ther. 1998 Apr;27(4):276-84.
  6. Sman AD, Hiller CE, Rae K, Linklater J, Black DA, Nicholson LL, Burns J, Refshauge KM. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. British journal of sports medicine. 2015 Mar 1;49(5):323-9.
  7. Teitz CC, Harrington RM. A biomechanical analysis of the squeeze test for sprains of the syndesmotic ligaments of the ankle. Foot & ankle international. 1998 Jul;19(7):489-92.