thompson test post surgery

I am 3.5 weeks post surgery and tried Thompson test today out of curiousity. It was "negative" which is a good thing. My surgery foot moved toward the ceiling as it should. ROM was not as good as my good leg but it was good to see.  I think surgically most people should have a negative test but I was wondering when you get a negative test with non surgery healing and whether this means anything for my recovery,PT process etc. other than telling me its attached.

14 Responses to “thompson test post surgery”

  1. No idea. I think I was around 4 or 5 weeks into “the boot” (non-surgery), and PWB heading toward FWB, before I even got permission to take it off to shower. So I didn’t play around with squeezing my calf much.

    The whole idea that the non-surgical approach can mend a torn AT and make it the right length is so incredibly magical, and so counter-intuitive, that I wasn’t in any mood for “testing” until it was quite clear that there really was a good connection there again!

    I suspect the Thompson test would find an intact AT very soon after a surgical repair. Check doug53’s early blog posts to see how soon he began “twitching” and “firing” his calf muscle, but I think it was less than a week. So in a way, your result is “no news”, steady as she goes with your protocol!

  2. 3.5 months out of surgery everything going well. I had an ultrasound 2 weeks ago(as part of as study I am in) on both tendons. Repaired tendon looks much thicker and muscle tissue looks different. Doc says everything looks good though and will take a lot of time for the final stage tissue to develop. Joined a soccer league for end of June, not sure if I am going to be able to play or not but Doc thinks it is a possibility. PT 3x a week diminishes to one time this week and home assignment next week. They have been holding me off but i expect to be able to start light jogging this week. Did a few light jogs up and down the driveway and it felt good. I think the thing that is helping the most is standing electrical stim on calf while doing raises which helps me “peak out on my calf raises” since those last couple Cm’s are hard to get on single raises.

  3. Mike: Can you clarify what you mean by “electrical stim”? Thx,

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  5. im four weeks out of surgery and i’m not getting any movement when i do the test. i just saw the doctor and he said it looks great, but he didn’t do the test.

  6. Hi john w, It’s pretty difficult to do an accurate Thompson Test on yourself. I’m 14 weeks post-surgery and my gait is almost normal and strength is progressing very well but if I do a Thompson Test on myself, I don’t see any movement. I can’t be sure but I’d say your probably OK.

    If you’re four weeks out and trying to test yourself, I’m assuming that you went into a boot pretty quickly. Start your own blog and keep us up to date. Dennis has made starting your own blog very easy.

  7. I’m 2 weeks post surgery and just went for my 1st check up to remove the cast, re-position my foot upwards, and re-apply a new cast. While the cast was off, my Dr tried the thompson calf sqeeze test. I could tell that while he was doing it, my foot was giving him no response. I asked the Dr if this concerned him, and he said No, I think it could be because your calf has atrophied. Really, it’s only been 2 weeks? He did another test where he asked me to raise and lower my foot. That worked, and I could feel the tightness of the tendon catching as I raised my foot up. I was supposed to be in this new cast for 4 weeks but before I left the Dr told me it would be 5. When I asked him why the additional week, he said he just wanted to play it safe and give my leg more time to heal. IDK, I’m just a little worried that calf test did not provide any response.

  8. Hi Mark

    A suggestion. Have you been to the main achillesblog, Your post here has joined a relatively old blog, and I would be concerned that you are reading ‘old stuff’ whereas in the past 2 or 3 years there has been lots about best practice.

    Also check out the UWO protocol on the main page and blogs like Suddsy’s (/suddsy) which cover UWO (Canada) and Exeter (UK) but others too.

    Hopefully you will receive plenty of replies to your post here.


  9. hey mark and john, don’t worry about the thompson test at all. i was the same as both of you and tried to thompson test myself which was unsuccessful. I had the same protocol as mark. After recast i was supposed to stay in a hard cast for 4 weeks, but changed my dr. appointment and got it off a week earlier. After that i went to a boot with no wedges and within a couple of days i was fwb walking around. My best advice to you is move it and stretch it inside the cast. each day it will get stronger. It takes force to re-rupture so don’t worry about it disconnecting either, its there and you’ll get a chance to feel it when you move to a boot. i’m at 6 1/2 weeks now and i walk in my boot full time and have walked in two shoes in my house. best advice is don’t let it just sit. move it, stretch it, and work it but not to the extent of discomfort or try to push it because it won’t benefit you at all. small movements, small stretches….hope this helped

  10. I read that in a normal tendon that is not surgically repaired, after the inflammatory tissue clean up stage, right around 3 weeks is the stage when the collagen matrix or scaffolding is finished setting between the disconnected strands and the first type of baby tendon fibers just start to fill it in. The reason for early mobilization and PT is to train those baby fibers to line up to hold tension properly. If they’re not trained early enough, they stay frayed in a disarrayed weakened state, similar to tendinosis when they mature to the adult type at about 1 year. Training the matrix that sets around week 3 seems to be key. This leads me to believe a negative Thompson test is possible in non surgical recoveries at 3 weeks because something should be connected by then.

    I have one of those higher up, close to a full tear with still a few fibers keeping it together and am able to start very slight dorsi/plantar flexion exercises according to the NWO protocol at week 2. My inversion/eversion was initially stiff from being in the boot but after a week, almost the same as my good side. Taking it out of the boot to shower at 3 weeks, it is noticeably less floppy than when I showered at 1 week. I doubt I could do all that without a negative Thompson test, something is set.

    The only difference in what I’m doing is starting in higher heel lifts and pulling the wedges out a little more gradually than the protocol because my Dr wanted to make sure the ends of my tendon were all touching initially and through the 3rd week for a better connection. In the mean time, I’m able to put enough weight on it to still do about half the workouts in p90x. Trying to get that blood flowing.

    Anyone got a suggestion for what type of 2-shoes is best coming off this injury? I can’t find anything about it online.

  11. Hi, John W and Mark; Its been two years scince your comments in this thread. I would like to know how everything turned out? I went in to remove stitches two weeks after operation and failed the Thompsons test which freaked me out and still is. I was put in a fast after and currently in it for 4 weeks. This will be my last week getting it off on Friday. Any advice will be greatly appreciated.

  12. Aricuzzi - By failing the Thompson test I assume your foot did not move. In a strange way that is actually called a pass but we get what you mean. It is quite normal for this to happen at 2 weeks so I would not worry. The next time your tendon is exposed to the world you should be able to feel the continuity.

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