Understanding the External Rotation Stress Test (Syndesmosis Ligament Test) Assessment
To assess the integrity of the **Distal Tibiofibular Syndesmosis** (high ankle sprain ligaments) by applying a rotational stress.
Watch How It's Done
How do I start?
Patient is sitting with the knee flexed to 90° and the foot hanging freely.
What happens?
The examiner stabilizes the distal tibia and applies a forceful, passive **external rotation force** to the foot.
In Plain English
What Does a Positive Result Mean?
Reproduction of **pain localized to the distal anterior and/or posterior tibiofibular joint** (the high ankle region).
Helpful Tip:
This test is highly specific for syndesmosis sprains. It is the rotational component of Kleiger's Test.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other Foot Tests
Coleman Block Test
To assess the **flexibility of a hindfoot varus deformity** and determine if it is fixed (bony) or flexible (soft tissue) in a patient with a **Cavus Foot (High Arch)**.
Feiss Line Test (or Feiss Line Grading)
To clinically assess and grade the degree of **longitudinal arch collapse (Pes Planus or Flat Foot)**.
Navicular Drop Test (or Staheli's Arch Index)
To quantify the change in height of the **medial longitudinal arch** from non-weight bearing to full weight bearing (assessing flexible flatfoot).
Toe Spread Test
To assess the **strength and endurance of the intrinsic foot muscles** (IFMs), which are essential for arch stabilization and dynamic balance.