Strunsky’s Sign is an ankle examination procedure and assessment for metatarsalgia or forefoot inflammation. It is a clinical sign wherein vigorous abduction followed by a sudden release of the little toe causes extensor plantar reflex.


Patient should be awake and cooperative to when checking for Strunskys Sign.

  1. Patient may be supine or seated during the procedure.
  2. The examiner grasps the toes and rapidly flexes them.
  3. The examiner observes for signs of discomfort or pain.

Examiner grasps the patient’s toes and flexes them.


Positive Strunsky’s Sign

There is positive Strunsky’s Sign when there is forefoot pain with toe flexion. This could indicate the presence of forefoot inflammation or metatarsalgia.

Clinical Note

Differential diagnosis of forefoot pain: metatarsal stress fracture, interdigital (Morton’s) neuroma, bunion/bunionette, hammer toe/claw toe/mallet toe, gout, or another arthrophy.