Most stomach aches in children are not serious. But when the pain could be appendicitis, one simple clue stands out: the belly hurts more when the child lands from a small jump. In this short video, family physician Dr. Richard Honaker explains that sign and the order of symptoms that often comes with it.
If you think your child has appendicitis, call your pediatrician or get emergency care right away. Don’t wait to see if it passes. If your child can’t walk, has severe or worsening pain, or has a hard, swollen belly, go to the emergency room. If you think it’s an emergency, call 911.
What Dr. Honaker explains
- The typical order. Pain starts first, right around the belly button. An hour or two later come nausea and vomiting, in that order. An hour or two after that, the pain moves down to the lower right side of the belly, where the appendix is. He calls that progression very suggestive of appendicitis, though appendicitis can show up in many different forms.
- The jump. Have your child jump off a step that’s just 6 or 8 inches high. If their stomach hurts worse when they land, that’s what doctors call rebound, a sign of inflammation inside the abdomen.
- His advice: it could be appendicitis, so get it checked out.
Why landing hurts
The inside of the belly is lined by a thin layer of tissue called the peritoneum. When that lining is irritated or inflamed, as it can be in appendicitis, movement makes the pain worse. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says appendicitis pain may get worse when you move around, take deep breaths, cough or sneeze. The American Academy of Pediatrics (AAP) adds that walking or riding in the car can make a child’s pain worse.
Landing from a small jump jolts the whole belly at once, which is why Dr. Honaker uses it as a quick check.
You may notice the same thing without asking for a jump. Watch whether:
- walking hurts, or your child doesn’t want to walk
- riding in the car makes the pain worse
- coughing, sneezing or a deep breath hurts
- moving around makes the pain worse
Doctors use a version of this test
In the emergency room, a doctor may ask a child to stand on their toes and drop down onto their heels. This is called the heel-drop or “jarring” test, and surgeons have written about it since at least the 1980s. Doctors may also check whether coughing, hopping or gentle tapping on the belly causes pain in the lower right side. That check is part of the Pediatric Appendicitis Score, which doctors use to help judge how likely appendicitis is.
Research supports the idea, with limits:
- In a 2025 study of 142 children checked for appendicitis in a pediatric emergency department, a positive heel-drop test was more common in the children who turned out to have appendicitis. It worked about as well as checking for pain with coughing, hopping or tapping.
- In a 2016 study of 292 adults with suspected appendicitis in two emergency departments, the heel-drop test predicted appendicitis better than rebound tenderness, which doctors check by pressing on the belly and letting go.
In both studies, the test was one part of a full emergency exam, together with blood tests and other findings. Neither study tested it as a check parents do at home.
What the jump test can’t tell you
- No pain on landing doesn’t rule out appendicitis. A review in American Family Physician found that signs like this are more helpful for ruling appendicitis in than for ruling it out. The NIDDK notes that some people with appendicitis, especially children, don’t have the typical symptoms at all.
- Pain on landing doesn’t prove it’s appendicitis. Pain in one spot of the belly can also come from other organs, such as the gallbladder, an ovary or a testicle. Those need a doctor too.
- Don’t push a child who’s already hurting. If your child is in a lot of pain or can’t walk, skip the jump and get care.
Doctors put several pieces together to diagnose appendicitis: the history, a physical exam, blood and urine tests, and usually an ultrasound or other imaging. For the full picture of symptoms, tests and treatment, see our main guide: Appendicitis Symptoms Explained: How to Recognize the Warning Signs Before It’s Too Late.
What to tell the doctor
The order of symptoms is one of the first things a doctor will ask about. Jot down:
- when the pain started, and where it was at first
- where it hurts now
- whether nausea or vomiting came before or after the pain
- whether your child has a fever or has stopped wanting to eat
- what makes the pain worse, such as walking, a bumpy car ride or jumping
When to get help
Go to the emergency room or call 911 if your child:
- can’t walk
- has sudden, sharp belly pain, or pain that keeps getting worse
- has a rigid, hard or swollen belly
- is vomiting and can’t pass stool
- has green vomit, is vomiting blood, or has blood in their stool
- has trouble breathing
Call your child’s doctor right away for pain in one spot, especially low on the right side, or belly pain with a fever. Also call for belly pain that doesn’t go away within 24 hours.
While you wait for care, don’t give aspirin, ibuprofen, acetaminophen (Tylenol) or similar medicines without asking your child’s doctor first. If doctors think it may be appendicitis, they usually won’t give your child anything to eat or drink.
About the video
This clip comes from Dr. Honaker’s 2016 Medical Minute, Stomach Pain in Kids: When to Worry. You can watch the full version under the clip at the top of this page. In it, he also covers the harmless causes of stomach aches in children, such as constipation, food and stress.
More videos on this topic: Children’s Health and Digestion.
Frequently asked questions
What is the jump test for appendicitis?
The child jumps off a low step, about 6 to 8 inches high. If the belly hurts more on landing, that suggests inflammation inside the abdomen, which could be appendicitis. Doctors use a similar check in the exam room: standing on tiptoe and dropping onto the heels.
My child can jump without pain. Can it still be appendicitis?
Yes. Not every child with appendicitis has this sign, and some have no typical symptoms at all. If the pain keeps getting worse, moves to the lower right side, or comes with vomiting or fever, call your doctor or get emergency care.
Is pain on landing the same as rebound tenderness?
They’re closely related. Rebound tenderness means there’s more pain when a doctor presses on a tender spot of the belly and then lets go. Both point to an irritated or inflamed lining inside the belly. Dr. Honaker uses “rebound” for the pain a child feels on landing.
Does the jump test work for adults?
Emergency doctors use the heel-drop version for adults too. In a 2016 study of 292 adults, it predicted appendicitis better than pressing on the belly. But no single test can confirm or rule out appendicitis, so adults with worsening belly pain should get checked as well.
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, NIH): Symptoms & Causes of Appendicitis
- NIDDK: Diagnosis of Appendicitis
- MedlinePlus (National Library of Medicine, NIH): Abdominal pain - children under age 12
- MedlinePlus: Point tenderness - abdomen
- HealthyChildren.org (American Academy of Pediatrics): Appendicitis in Children and Teens
- American Family Physician (American Academy of Family Physicians): Acute Appendicitis: Efficient Diagnosis and Management (2018)
- Chun MK, et al. The CHANSE score: a novel clinical tool incorporating the heel drop test for the diagnosis of pediatric appendicitis. Frontiers in Pediatrics, 2025.
- Ahn S, et al. Clinical Importance of the Heel Drop Test and a New Clinical Score for Adult Appendicitis. PLoS One, 2016.
- Markle GB. Heel-drop jarring test for appendicitis. Archives of Surgery, 1985.
- Montreal Children’s Hospital: Abdominal Pain in Children
- Cincinnati Children’s: Stomach Pain in Kids: When to Worry (2021)
This page is for general information only and is not medical advice. Talk with a qualified health professional about your own situation. If you think you may have a medical emergency, call 911.
