Have you also torn your Achilles Tendon? Let's learn about the Thompson Test!

Sometimes, when you're playing or running, you might hear a 'click' sound from the heel of your foot, followed by a sudden, severe pain. It's like a tendon has burst. At times like these, there's a simple test that doctors use to determine if your tendon has ruptured, or if your Achilles tendon has ruptured. This is what we call the 'Thompson test.' Shall we talk about this in a little more detail today?

What is the Thompson test?

Simply put, the Thompson test is a test where your doctor holds you still, without any big machines, and examines your body. It basically checks to see if your Achilles tendon – your calf muscle – is torn, or as doctors call it, ruptured . Doctors sometimes call it the calf squeeze test , because it involves gently squeezing your calf muscle. Sounds simple, right?

When does a doctor perform the Thompson test?

If your doctor suspects that your Achilles tendon has ruptured, they will perform the Thompson test. Imagine that you are an athlete, and while running or jumping, you suddenly hear a popping sound in the back of your leg, followed by severe pain. Or maybe you feel swelling in that area. This is the first test your doctor will do.

The best part is that this is an in-office test. It doesn't require a separate visit and expensive equipment. It can be done as part of a basic exam, as soon as you report your symptoms. However, after this test, you will often need to have another imaging test, such as an ultrasound or an MRI (Magnetic Resonance Imaging) scan, to confirm the injury. We'll talk about that later.

How to do this test? It's very easy!

This is a quick, easy test to check the condition of your Achilles tendon. Here's how the doctor does it:

• You will be placed in a prone position on the examination table. Your ankles and feet should be over the edge of the table. Sometimes this is done with your knees bent to 90 degrees, which will relax the calf muscles.
• Then the doctor will gently but firmly squeeze your calf muscle, which is the muscle at the bottom of your leg.
• When squeezing, the doctor will carefully check to see if your heel and foot bend slightly downward (plantarflexion), that is, if they move slightly or lift upwards.
• Normally, if your Achilles tendon is healthy, your heel should bend downward when you squeeze the tendon. This is because this tendon connects your calf muscle to your heel bone (calcaneus). It's like a rubber band being pulled sideways.
• The doctor will probably do the same thing with your other leg. They will measure how far the heel of the uninjured leg moves and compare it to the injured leg. The difference will be obvious.

Do I need to prepare anything for this?

Oh no! You don't need to do anything special to prepare for this `Thompson test`. The most important thing is that if you think you have torn your `Achilles tendon`, meaning if you hear a `click` sound in your leg like I mentioned earlier, or if you have severe pain, see a doctor as soon as possible. Don't delay, because if you do, the condition could get worse.

How will I feel during the test? Will it hurt?

Try to relax as much as possible during this test. If you tense your muscles, it may be difficult for the doctor to see the exact position, and the results may be inaccurate.

Usually, the Thompson test will not increase your pain or other symptoms of an Achilles tendon tear. The doctor may feel a little stiff when he squeezes your tendon, but it is unlikely to cause any significant pain. However, if you feel any unusual discomfort or unbearable pain when the doctor squeezes your tendon, tell your doctor right away. They will listen to you.

What happens after the Thompson test?

Okay, now the doctor has done the Thompson test. If the doctor thinks you may have a torn Achilles tendon (that is, a positive test), that is not the end of the story. You will probably also need to do another imaging test. This is a test that takes pictures to see exactly what the injury looks like, how far it is torn, whether it is completely torn, or just a little torn.

Examples of this are:

• Ultrasound test: This uses sound waves to take pictures of the cervix.
• An MRI (Magnetic Resonance Imaging) scan: This uses magnetic fields and radio waves to take detailed pictures of the brain and surrounding tissues. This is more detailed than an ultrasound.

What are the results I get? What do they mean?

The results of the Thompson test are not like those you might have seen in other medical tests. That is, it does not give an exact number or a range. It is more like a 'yes' or 'no' question, or 'true' or 'false'. The doctor is only checking to see if your Achilles tendon is torn.

• A positive result means: If your heel does not bend downwards at all (no plantarflexion) when the doctor squeezes the tendon, it means that your Achilles tendon is most likely torn.
• The result is negative (`Negative`) meaning:If your heel bends downward normally when the doctor squeezes the tendon (plantarflexion present), it means that the Achilles tendon is not torn, or that it cannot be confirmed by this test alone, and it may even be partially torn.

The results of this test and other imaging tests will help your doctor decide what treatment you need. In most cases, a complete tear of the Achilles tendon will require surgery to repair. Sometimes, a cast or boot can be used instead of surgery. It's best to talk to your doctor about this.

At what point should I definitely see a doctor?

If you think you may have a torn Achilles tendon, or if you have any of these symptoms, see a doctor without delay.

• If you hear a 'click' or 'snap' sound behind your ankle, especially during vigorous physical activity (e.g., running, jumping, playing badminton).
• Suddenly, you feel a sharp, unbearable pain behind your ankle. It may feel like someone kicked you.
• If you have difficulty walking after the injury, if you feel like you can't put your foot down, especially if you can't stand on tiptoes.
• If there is swelling and bruising behind the ankle.

If you have these symptoms, don't stay home. Don't think, "It will get better on its own." The best thing you can do is seek medical advice immediately.

Are there any other tests to check if the Achilles tendon is torn?

Yes, the Thompson test is just one of several main physical tests that doctors use to diagnose an Achilles tendon rupture. The others are:

• Matles Test: This is similar to the Thompson test. You will be asked to lie on your stomach and either extend your legs out to the side of the bed or bend your knees to 90 degrees. Normally, if your Achilles tendon is healthy, your foot will be at a slight angle, meaning it will be slightly bent downward (slight plantarflexion). However, if the tendon is torn, your foot will be in a flat or neutral position, or dorsiflexed.
• Achilles tendon palpation: Palpation is when the doctor feels something with his fingers and squeezes it. The doctor often does this along with other tests. The Achilles tendon is a large, thick tendon that can be felt under the skin. So if it is completely or partially torn, the doctor may be able to feel a gap (or defect) in the torn area.

But remember, no matter what physical test the doctor performs, in the end, they will need to do at least one imaging test (often an ultrasound or MRI) to get a clear picture of the injury.

Is it okay to walk with a torn Achilles tendon?

Many people can walk and move their ankles to some extent even if their Achilles tendon ruptures. However, it can be painful and difficult. If you think you have a problem with your Achilles tendon, even if you can walk or bear weight on your leg, see a doctor right away.

Because when you use your ankle and put full weight on your leg, an existing injury (including an Achilles tendon rupture) can get worse. A slightly torn tendon can even tear completely.

Until a doctor can diagnose your injury, if you have crutches, a walker, or other mobility aid, it's best to use them. Resting your leg is very important.

So, what are the things we need to remember from all of this? (Take-Home Message)

Tearing the Achilles tendon is a common injury, especially for athletes or those who do sudden movements like running or jumping. It can be scary, but it can be treated and cured if you get the right treatment.

The Thompson test is a simple, safe, and highly effective test that a doctor can use to screen for this condition. It can help identify a problem quickly.

However, this test alone cannot tell everything. You will probably need to have another test, such as an ultrasound or MRI, to see exactly how much damage has been done to the tendon.

An Achilles tendon tear can take a while to heal, and it can be very challenging (especially with physiotherapy). You may not even remember the Thompson test when you start running and jumping again. However, this simple test is a quick first step on your recovery journey.

So, if you hear a 'click' sound coming from the back of your leg and feel pain, don't forget to see a doctor. Then, with tests like this, you can start the necessary treatment quickly. You'll be better soon and be able to go back to your work!

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