[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [Musculoskeletal system](https://durgical.com/en/clinical-exam/#a-musculoskeletal) › Thompson test [Clinical exam](https://durgical.com/en/clinical-exam/) · [Musculoskeletal system](https://durgical.com/en/clinical-exam/#a-musculoskeletal) # Thompson test - Maneuver Squeezing the calf of a person lying face down should point the foot downward; if the foot does not move, the Achilles tendon is torn. Updated 2026-11-01 **See it in 3D:** [Achilles tendon](https://durgical.com/en/anatomy/calcaneal-tendon/) · [Gastrocnemius (inner head)](https://durgical.com/en/anatomy/medial-head-of-gastrocnemius/) · [Gastrocnemius (outer head)](https://durgical.com/en/anatomy/lateral-head-of-gastrocnemius/) · [Soleus](https://durgical.com/en/anatomy/soleus-muscle/) · [Calcaneus](https://durgical.com/en/anatomy/calcaneus/) ## Key points - Patient prone with the feet off the end of the table; squeeze the calf. - Normal: the foot plantarflexes. Positive (abnormal) test: the foot does not move, complete Achilles tendon rupture. - It is highly sensitive and highly specific for complete rupture. - Ruptures usually occur about 2 to 6 centimetres above the calcaneus, in a poorly supplied zone. - The patient may keep some active plantar flexion through the long flexors: this does not exclude a rupture. ## What it is The Thompson (or Simmonds-Thompson) test checks the continuity of the Achilles tendon. Squeezing the triceps surae mass makes an intact tendon pull on the calcaneus and the foot plantarflexes; if the tendon is completely torn, the foot does not move. It is very useful because many patients with a rupture can still move the foot using other muscles. ## The anatomy it tests - The Achilles tendon joins the two heads of gastrocnemius and the soleus (triceps surae) to the calcaneal tuberosity. - Squeezing the muscle mass shortens the unit and, if the tendon is intact, pulls the calcaneus up so the foot points down. - If the tendon is torn, the force does not reach the calcaneus and the foot does not move. - The long toe flexors and tibialis posterior can produce some active plantar flexion, which confuses the exam. ## How to do it - Patient prone with both feet hanging over the edge of the table and the muscles relaxed (or kneeling on a chair). - Inspect how both feet hang: the torn side usually hangs closer to neutral. - Feel along the tendon for a gap above the calcaneus. - The examiner squeezes the widest part of the calf with one hand, healthy side first. - Normal: the foot plantarflexes on squeezing. - Positive Thompson: no plantar flexion, or much less than on the healthy side. ## What a positive result means - Positive: complete Achilles tendon rupture. - Typical story: sudden heel pain when pushing off or jumping, like a kick or a blow from behind, sometimes with a pop. - Associated factors: occasional sport in middle-aged adults, prior tendinopathy, corticosteroid or fluoroquinolone use. - A partial tear can give a normal test. - Pain and thickening with no gap and a normal Thompson point to Achilles tendinopathy. ## Usefulness and limits - Sensitivity and specificity for complete rupture are high, although the data are limited. - Ultrasound confirms the rupture and measures the gap between the ends. ## Test yourself Think of the answer, then tap the question to see it. ## What is the normal result of the Thompson test? When the calf is squeezed, the foot plantarflexes. ## What does it mean when the foot does not move as the calf is squeezed? A complete rupture of the Achilles tendon. ## Why can a patient with an Achilles rupture still point the foot down? Because the long toe flexors, flexor hallucis longus and tibialis posterior can produce some plantar flexion. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/clinical-exam/thompson-test/) ## See it in 3D The structures of Durgical's 3D anatomy where it is found. - [Achilles tendon](https://durgical.com/en/anatomy/calcaneal-tendon/) - [Gastrocnemius (inner head)](https://durgical.com/en/anatomy/medial-head-of-gastrocnemius/) - [Gastrocnemius (outer head)](https://durgical.com/en/anatomy/lateral-head-of-gastrocnemius/) - [Soleus](https://durgical.com/en/anatomy/soleus-muscle/) - [Calcaneus](https://durgical.com/en/anatomy/calcaneus/) ## Related - [Ottawa ankle and knee rules](https://durgical.com/en/clinical-exam/ottawa-ankle-and-knee-rules/) - [Deep tendon reflexes and their grading](https://durgical.com/en/clinical-exam/deep-tendon-reflexes-and-their-grading/) - [Joint examination: inspection, palpation and range of motion](https://durgical.com/en/clinical-exam/joint-examination-inspection-palpation-and-range-of-motion/) ## Related conditions - [Achilles tendon rupture](https://durgical.com/en/conditions/achilles-tendon-rupture/) - [Achilles Tendinopathy](https://durgical.com/en/conditions/achilles-tendinopathy/) [← All of the clinical exam](https://durgical.com/en/clinical-exam/) Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis. Sources: [Thompson Test in Achilles Tendon Rupture](https://jetem.org/thompson-test-achilles-tendon-rupture) (Journal of Education and Teaching in Emergency Medicine (JETem), 2016); [Musculo-Skeletal Exam – Practical Guide to Clinical Medicine](https://sites.ucsd.edu/clinicalmedguide/musculo-skeletal-exam/) (UC San Diego School of Medicine, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/clinical-exam/thompson-test/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/thompson-test/