Patient supine with hip flexed and adducted to the limit of movement; add compressive load
Tests for general hip pathology and degenerative joint disease
Positive: reproduction of pain symptoms or apprehension to perform
Image #140
Patrick (FABIR) test
Patient supine, passively flex, abduct, and externally rotate test leg so the foot is resting above knee on opposite leg; then slowly leg down toward the table
Identifiers dysfunction of hip, specifically mobility dysfunction
Positive: involved knee is unable to assume relaxed position and/or reproduction of painful symptoms
Image #141
Thomas test
Patient supine; one hip and knee maximally flexed to chest with hold; opposite limb is kept straight on table
Tests for tightness of hip flexors
Positive: straight limb flexes and patient is unable to keep this leg straight on leg
Thomas test
Ober’s test
Patient side-lying; lower limb flexed at the hip and the knee; passively extend and abduct tested with knee in 90 degrees while slowly lower the limb toward the table
Tests for tightness of tensor fascia late or iliotibial band
Positive: uppermost leg remains above horizontal
Image #143
Ely’s test
Patient is prone; flex knee of tested limb
Tests for tightness of rectus femoris
Positive: hip of tested limb flexes
Image #140
90-90 hamstring test
Patient position in supine; hip and knee supported in 90 degrees flexion; passively extend knee until end feel encountered
Test for tightness of the hamstrings
Positive: knee lacks 10 degrees or greater of knee extension
90-90 hamstring test
Piriformis test
Patient sidelying with foot tested limb passively placed lateral to opposite limb’s knee with tested adducted
Tests for piriformis tightness and syndrome
Positive: tested knee is unable to pass over resting knee or reproduction of pain- pain in buttocks or sciatic nerve pain
Piriformis test
Trendelenburg test
Patient standing and asked to stand on one leg; observe for stance leg pelvis
Tests for gluteus medius weakness
Positive: stance pelvis drops when in single leg stance
Trendelenburg test
Knee special test
Lachman test
Patient supine with knee flexed to 20-30 degrees; stabilize the femur and passively translate tibia anteriorly
Tests the integrity of the anterior cruciate ligament
Positive: excessive anterior translation on tibia compared to uninvolved limb
Test has higher sensitivity and specificity compared to anterior drawer test (preferred test)
Lachman test
Anterior drawer test
Patient supine with knee flexed to 45-90 degrees; therapist passively translates knee anteriorly
Tests the integrity of the anterior cruciate ligament
Positive: excessive anterior translation on tibia compared to uninvolved limb
Anterior drawer test
Posterior drawer test
Patient in supine with knee flexed to 45 degrees; therapist passively translates tibia posteriorly
Tests integrity of posterior cruciate ligament
Positive: excessive posterior translation on tibia compared to uninvolved limb
Posterior drawer test
Valgus stress test
Patient supine with knee resting at edge of mat; therapist applies valgus stress to the knee with knee flexed at 0 and 30 degrees
Tests the integrity of medial collateral ligament
Positive: laxity and pain compared to uninvolved side
Varus stress test
Patient supine with knee resting at edge of mat; therapist applies varus stress to knee with knee flexed at 0 and 30 degrees
Tests integrity of lateral collateral ligament
Positive: laxity and pain compared to uninvolved side
Pivot shift test
Patient supine with knee extended, hip flexed and abducted to 30 degrees and slight internal rotation; therapist holding knee with hand and the foot with another applies valgus force through a flexed knee
Tests the integrity of the anterior cruciate ligament
Positive: tibia reduction during the test by iliotibial band
Valgus test
McMurray test
Patient supine with knee maximally flexed; therapist passively internally rotates and extending knee- then moving to externally rotating and extending knee
Test lateral meniscus (internal rotation) and medial meniscus (external rotation)
Positive: reproduction of click, popping, or pain in knee
Image #152
Apley’s Compression Test
Patient positioned prone with the knee flexed to 90 degrees. The therapist applies a downward compressive force through the heel while medially and laterally rotating the tibia.
Tests the integrity of menisci of the knee
Positive: reproduction of pain
Image #155
Thessaly test
Patient standing on involved leg while holding therapist’s hands; patient rotates body and leg internally and externally with knee flexed to 5 degrees and then at 20 degrees
Test lateral meniscus (internal rotation) and medial meniscus (external rotation)
Positive: reproduction of click, popping, or pain in knee
Patellofemoral instability
Patient supine with knee flexed to 30 degrees and quadriceps are relaxed; therapist passively translates the patella laterally
Test for patellar instability
Positive: patient expresses apprehension or contracts the quadriceps muscle to prevent patellar dislocation.
Noble compression test
Patient supine with knee flexed to 90 degrees and hip flexion; therapist applies pressure 1-2cm proximal to lateral femoral epicondyle; with pressure maintaining, patient’s knee is passively extended
Tests the iliotibial band
Positive: patient experiences pain over the lateral femoral condyle
Ottwaa knee rules
Apply the Ottwa knee rules to:
Rule out fracture after acute knee injury
Refer for imaging with one or more positive answers
A negative test result states there is an absence of fracture
If therapist answers yes to any of these questions, then imaging should be done to rule out fracture
Age 55 years or older
Isolated patellar tenderness without bone tenderness
Tenderness of the fibula head
Inability to flex knee to 90 degrees
Inability to bear weight immediately after injury
Ankle special test
Anterior drawer test
Patient supine with foot off edge of mat; ankle in 20 degrees of plantarflexion; therapist translates talus anteriorly while stabilizing lower leg
Patient side-lying with knee slightly flexed and ankle in neutral position; therapist moves foot into maximal adduction (calceniofibular ligament) and abduction (deltoid ligament)
Tests the integrity of calcaneofibular ligament
Positive: laxity and/or pain
Image #160
Thompson’s test
Patient prone with foot off edge of mat; therapists squeezes calf muscle (ankle should plantarflex)
Tests integrity of Achilles tendon
Positive: no movement of foot
Immediate red flag if positive tests occurs- send to emergency room
Image #161
Windlass test
Weight bearing
Patient standing on step with toes positioned over the edge with equal weight bearing; this causes a passive extension of the first MTP joint
Non-weight bearing
Patient seated with knee flexed to 90 degrees; therapist stabilizes the ankle and passively extends the patient’s first MTP joint
Both tests for the presence of plantar fasciitis
Positive in both positions: reproduction of plantar surface pain
