TipToe and Heel Walking Test

What is Tiptoe and Heel Walking Test?

The tiptoe and heel walking test identifies or pinpoints a nerve root disorder in the lumbar spine.

The Procedure of Performing Tiptoe And Heel Walking Test?

To perform this test you’ll have to go through 2 procedures first is for tiptoe walking and the second is for heel walking. Let me first explain to you the tip-toe walking procedure 

Tip-toe walking procedure

Heel walking procedure

  • Now the patient is asked to stand on his or her heels.
  • Then after that, the examiner asks the patient to walk three-four steps.


Here is the video Tutorial of the Tiptoe and Heel Walking Test


Test Results of Tiptoe and Heel Walking Test

As there are 2 procedures, so there will be 2 separate results

Result of Tiptoe walking procedure

Inability or difficulty to walk or stand on the tiptoe indicates a lesion of the S1 nerve root.

Result of Heel Waking Procedure

Inability or difficulty to walk or stand on the heels indicates a lesion of the L4-L5 nerve root.

Special Note

A differential diagnosis must be excluded, that is the ruptured Achilles tendon, as this injury makes it impossible to stand on tiptoe, especially when the patient is standing only on the affected leg.

You May Also Read 

Nerve Root Disorder Test

Duchenne Sign – Used to assess a nerve root disorder.

Thomsen Sign – Indicates or signals sciatic nerve root irritation.

Sacroiliac Joint Tests

Mennell’s Sign / Mennell’s Test – Used to assess degenerative processes in the sacroiliac joint.

Springing Test – To detect functional impairment in the Thoracic & Lumbar spine & Sacroiliac Joint.

Gaenslen’s Test – To detect any pathology or dysfunction around the sacroiliac joint.

Standing Flexion Test/ Standing Forward Flexion Test – To assess sacroiliac joint dysfunction.

Faber Test / Patrick’s Test – Used to assess the pathology or dysfunction at the hip joint, muscles around the hip joint, and at the sacroiliac joint.

Thoracic Spine Test 

Ott Sign – For Measuring the ROM of the Thoracic Spine

Cervical Tests 

Cervical Flexion Compression Test –  To identify if there is a Herniated disk in the Cervical spine.

Jackson Compression Test –  To Detect Cervical Radiculopathy (Cervical Nerve Root Compression).

Spurling Test – For Diagnosing Cervical Radiculopathy.

Cervical Distraction Test – To detect the presence of cervical radiculopathy.

O’Donoghue Test – Helps in differentiating between muscular pain (strain) and ligamentous pain (articular problem) in the cervical spine.

Soto Hall Test – For Detecting Problem in Patient’s Neck (Cervical Spine).

Maximum Compression of the Intervertebral Foramina Test of Cervical Spine – For Detecting Facet Joint Dysfunction in the Cervical Spine.

Some other Tests

Transverse Humeral Ligament Test 

Lippman Test – To detect pathology in the long head of the biceps tendon.

Pelvic Ligament Tests – used for the assessment of the pelvic ligaments.

Supported Forward Bend Test (Belt Test) – helps in differentiating lumbar pain and sacroiliac pain.

Adam’s Forward Bend Test – For detecting the presence of scoliosis (either functional or structural).

Noble Compression Test/Noble Test –  To assess pain coming from iliotibial band syndrome.

Neer Test –  For detecting the presence of shoulder impingement syndrome.


Clinical Tests for the Musculoskeletal System: Examinations-Signs-Phenomena by K. Buckup

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