Tip Toe Standing Test

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Purpose[edit | edit source]

The purpose of a tip toe standing test is to differentiate between the two different categories of flatfoot (pes planus), namely flexible flatfoot and fixed flatfoot.[1]

This is an indirect, observational method of assessment.[1]

Technique[edit | edit source]

Figure A: Medial Arch collapse in weight bearing. During weight-bearing, the disappearance of the medial longitudinal arch of the foot is seen. On posterior view, angling of the Achilles tendon (hindfoot valgus) is observed.
  1. The patient stands on flat ground. This can be done at a wall or other place where external support can be used.

2. The patient is then asked to stand on tip toe. In a flexible flatfoot the heel will turn inwards (varus position) and the medial arch will become apparent. In a fixed flatfoot the medial longitudinal arch will remain unobservable.[2]

To further test for a flexible flatfoot, the Hubscher maneuver (or Jack's test) can also be done.

Figure B: Tiptoe test. While raising up on tiptoe, reconstruction of the medial longitudinal arch collapsed during weight-bearing is observed.

[3]


Resources[edit | edit source]

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References[edit | edit source]

  1. ↑ 1.0 1.1 Rodriguez N, Volpe RG. Clinical diagnosis and assessment of the pediatric pes planovalgus deformity. Clinics in Podiatric Medicine and Surgery. 2010 Jan 1;27(1):43-58.
  2. ↑ Alazzawi S, Sukeik M, King D, Vemulapalli K. Foot and ankle history and clinical examination: A guide to everyday practice. World Journal of Orthopedics. 2017 Jan 18;8(1):21.
  3. ↑ Dr. Estefania Birrer Gonzalez. Toe Standing Test For Flexible Flatfoot. Available from: https://www.youtube.com/watch?v=nolevVWzdio [last accessed 16/07/2022]
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