Ankle & Foot
Ligamentous Instability (Sprains)
Evidence: suggestive
Talar Tilt Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Assessing the Calcaneofibular Ligament (CFL).
- Checking for lateral ankle instability.
How to Perform
- Position: Patient lies on their side or back. Foot is relaxed (90° angle).
- Action: Grasp the heel and tilt it sideways (inversion and eversion).
- Comparison: Compare the amount of tilt to the uninjured side.
Interpretation of Results
- Positive Test: Excessive inward tilting (inversion) or pain indicates a ligament tear.
Clinical Context & Limitations
The Talar Tilt Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Ankle & Foot region, combining the Talar Tilt Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.
