Related Experiment Video
Updated: May 12, 2026
A Passive Ankle Dorsiflexion Testing System for an In Vivo Model of Overuse-induced Tendinopathy
Published on: March 1, 2024
What is the best clinical test for Achilles tendinopathy?
Anne-Marie Hutchison1, Rhodri Evans, Owen Bodger
1Department of Physiotherapy, Trauma and Orthopaedics, Morriston Hospital, Abertawe Bro Morgannwg University Health Board and College of Medicine, Swansea University, Wales, United Kingdom. Anne-Marie.Hutchison@wales.nhs.uk
Background:
Differential diagnosis of Achilles pathology is demanding. This study evaluates the diagnostic accuracy of clinical tests identified for a chronic mid body Achilles tendinopathy. Ultrasound scanning provides the reference standard.
Methods:
Twenty-one participants with, and without, an Achilles tendinopathy, had an ultrasound scan followed immediately by the application of ten clinical tests. The accuracy and reproducibility of each test was determined.
Results:
The most valid tests are; pain on palpation of the tendon (sensitivity 84%, specificity 73%, kappa 0.74-0.96) and the subjective reporting of pain 2-6 cm above the insertion into the calcaneum (sensitivity 78%, specificity 77%, kappa 0.75-0.81).
Conclusion:
Only location of pain and pain on palpation were found to be sufficiently reliable and accurate, to be recommended for use.
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