Posterior Tibial Tendon Dysfunction: What does the single heel raise test mean in assessment?

Abstract

This paper aims to review the literature pertaining to single heel raise test, which is used for the assessment of PTTD. Whilst there is little published information relating to the origins of this test, there is also a clear paucity of information pertaining to the interpretation of the test findings. Understanding why clinicians utilize this test in the assessment of this debilitating pathology and how the result is interpreted is important in helping to bridge the remaining knowledge gap surrounding this condition. This review will contribute to the body of knowledge that is helping to explain why PTTD is an under recognized and underdiagnosed condition. Databases that were searched include PubMed, MEDLINE 1990-present, SportDiscus, AMED 1990-present, CINAHL 1990-present, BMJ Clinical Evidence, Cochrane Library, ISI Web of Knowledge (science) 1990 to present, Ingentaconnect, Science Citation Index, Science Direct and Wiley Interscience. Until recently there has been very little work isolating the tibialis posterior muscle activity in dysfunction. There has been even less work surrounding the individual elements of the assessment this condition such as the single heel rise test. Areas covered within the review are the history of the test, validity and reliability of the test, kinematic changes associated with the test in the presence of PTTD and the biomechanical changes in the presence of PTTD and how this may impact of the execution and interpretation of the test findings. The results from this review are inclusive in relating the single heel raise test to the assessment and diagnosis of PTTD. There is variable use of this test in clinical practice in addition to the clinical setting and patient groups where it is utilized. Further work is indicated surrounding validity and interpretation of the test findings.