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  1. LCG Active Member


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    Does anyone know of a specific clinical test to evalate the integrity (or lack of) the spring ligament??
     
  2. Atlas Well-Known Member


    Extremely difficult to isolate some passive structures in the foot with clinical testing.

    It may be wise to first exclude via resistance testing, adjacent active musculo-tendinous structures. Even palpation would be difficult in that it would be almost impossible to rule out tenderness in an underlying or adjacent structure.

    But what we should remember is that for the spring ligament to be strained/stretched/inflamed etc. that the forces and micro-motion involved would also affect similar tissues (in terms of role, function, and shared stress etc.)

    If you are considering this, low dye taping should ease symptoms. Of course LDT will also unload the adjacent plantar fascia, tib-post tendon, and other adjacent plantar ligaments.


    FWIW, I have never diagnosed a spring ligament injury. Maybe my assessment is not thorough enough; maybe it is impossible to isolate; maybe somewhere in between.


    Ron
     
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    Articles:
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    Medial Heel Lateral Push Test: The First Clinical Examination of Spring Ligament Integrity
    Chandra Pasapula, Adam Devany, Ahmed Magan, A. Memarzadeh, V. Pasters, S. Sherrif
    The Foot; Article in Press
     
  4. stevewells Active Member

    Can anyone describe this test please?
     
  5. Steve:

    Here is a paper from the same authors for a "neutral heel push test". I don't know if the "medial heel push test" is the same test. I believe a test like this would have a lot of false positives.
     

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  6. Dieter Fellner Well-Known Member

    Got some pictures attached. The diagnosis is often suspected with damage to the posterior tibial tendon. Palpation of the ligament can assist too. The MRI will shed more light on this. Ultimately the structure is evaluated intra-operatively.

    Kevin, I believe this is the correct paper which was incorrectly titled.
     

    Attached Files:

  7. Like I said before, I think an examiner will have very many false positives using this test. What if the patient simply has a more compliant spring ligament, and not a torn one. Will this test be able to discriminate between the two? I doubt it.
     
  8. stevewells Active Member

    Thanks Kevin
     
  9. Dieter Fellner Well-Known Member

    Kevin,

    Perhaps the test is performed also under the presumption a ligament tear will provoke a pain response on testing and / or the test is compared to the contralateral side. But I agree in principle. Of limited value.
     
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