Test library › Foot, ankle & calf
Royal London Hospital test
For: Mid-portion Achilles tendinopathy
Painful overload of the Achilles tendon in its middle section, about 2 to 6 cm above the heel bone, often with a thickened, tender tendon.
A weak test on its ownWhat the numbers mean
- Positive result: a small shift: a positive result nudges the diagnosis up, but does not settle it.
- Negative result: barely informative: a negative result changes little.
Work out what a result means for your patient: probability calculator
Source
Reiman M, Burgi C, Strube E, et al. The utility of clinical measures for the diagnosis of Achilles tendon injuries: a systematic review with meta-analysis. J Athl Train. 2014;49(6):820–829. Full text (PubMed Central) · meta-analysis
Figures as they will appear in Rule It In, Rule It Out (Trokos, forthcoming). If a newer or better study changes them, this page changes with the book. Figures last updated from the book on 6 October 2026.
Get the book for spotting a high ankle sprain, and knowing when the Achilles is torn
This page gives the published figures. Rule It In, Rule It Out adds how to do this test, what counts as positive, how to read the result, and, where studied, whether combining it with other tests helps.
Coming in late 2026 as a PDF and a paperback. Join the list to hear when it's out
One study, one test, once a month
Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.
By subscribing you agree to receive Rule It In by email, about once a month. You will get a confirmation email first, and nothing is sent until you click it. Your address is stored by Kit (Kit.com, United States) and used only for this newsletter; Kit records which issues are opened and which links are clicked. Unsubscribe with one click in any issue. Privacy.