A positive Toe Walk Test indicates a lesion at which nerve root level?

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Multiple Choice

A positive Toe Walk Test indicates a lesion at which nerve root level?

Explanation:
Toe walking mainly tests plantarflexion of the foot, which is driven by the tibial branch of the sciatic nerve and is strongest in the S1 myotome. A positive Toe Walk Test means the patient has weakness in plantarflexion, pointing to irritation or compression of the S1 nerve root. In lumbar pathology, a disc herniation at L5–S1 often compresses the traversing S1 nerve root, producing this specific deficit. By contrast, problems at higher levels (L4–L5 affecting the L5 root and involved in dorsiflexion, or L3–L4/L2–L3 with more proximal findings) wouldn’t present with isolated trouble toe-walking. So the test localizes to the S1 nerve root, commonly from an L5–S1 disc herniation.

Toe walking mainly tests plantarflexion of the foot, which is driven by the tibial branch of the sciatic nerve and is strongest in the S1 myotome. A positive Toe Walk Test means the patient has weakness in plantarflexion, pointing to irritation or compression of the S1 nerve root. In lumbar pathology, a disc herniation at L5–S1 often compresses the traversing S1 nerve root, producing this specific deficit. By contrast, problems at higher levels (L4–L5 affecting the L5 root and involved in dorsiflexion, or L3–L4/L2–L3 with more proximal findings) wouldn’t present with isolated trouble toe-walking. So the test localizes to the S1 nerve root, commonly from an L5–S1 disc herniation.

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