Career

Using Shoes to Diagnosis

 
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Rethink your shoewear …

If you’re looking for an easy orthopedic test that can learn AND remember in less than 10 seconds, then you’re in luck! This is a simple test that you can have someone perform on their own without you even touching them. Now, this evaluation tool has been out for years, but some clinicians may not have been taking advantage of it, so let’s briefly mention it … .it’s called “taking off the shoe” test (aka. TOST).

Here are the simple steps to performing it:

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  1. Stand with your involved posterior heel against the medial arch of the contralateral foot (left foot being tested here)

  2. The feet should now form a “T” or be at a 90 degree angle to each other

  3. Attempt to take off the involved side shoe using the other shoe for help

  4. Recreation of symptoms along the posterior thigh is indicative of a biceps femoris pathology

Now how simple was that?

During this initial study, they claimed that this test had a sensitivity AND specificity of 100%. You can’t beat that! That right there is a gold nugget you tuck away in your clinical toolbox ready to be whipped out at a moments notice.

Imagine, you can already have a diagnostic impression of what tissue is involved even before you have them lay on the table, and even before you start palpating the area! All you’d have to do now is confirm your findings and rule out other possible players like sacroiliac joint dysfunction or triple extension inefficiency.

Hope that little nugget helps you out!

Thanks for being curious and taking the time to read this! Hope it added value to your life and equips you to become better than you were yesterday!

 
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Dr. Joe Jaime, DC, DACBSP®, ATC, CSCS®, FRC®ms, CES