Click to Play The heel percussion test (AKA bump or tap test) is used to differentiate a tibial stress fracture from medial tibial stress syndrome. The examiner stabilizes the patient's lower leg on the table and brings the foot into a relaxed neutral position. The examiner then applies a percussive force to the plantar surface of the heel toward the lower leg. A positive result of this exam will be the illicitation of localized pain at the point of the suspected fracture.