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
Hip scour test
Patrick (FABER) test
Patient supine, passively flex, abduct, and externally rotate the test leg so the foot is resting above the knee on the opposite leg; then slowly leg toward the table
Identifiers : dysfunction of the hip, specifically mobility dysfunction
Positive: involved knee is unable to assume a relaxed position and/or reproduce painful symptoms
Patrick (FABER) test
Thomas test
Patient supine; one hip and knee maximally flexed to the chest with hold; opposite limb is kept straight on the table
Tests for the tightness of hip flexors
Positive: straight limb flexes, and the patient is unable to keep this leg straight on the leg
Thomas test
Ober’s test
Patient side-lying; lower limb flexed at the hip and the knee; passively extend and abduct tested with the knee at 90 degrees while slowly lowering the limb toward the table
Tests for the tightness of the tensor fascia lata or the iliotibial band
Positive: uppermost leg remains above horizontal
Ober's test
Ely’s test
Patient is prone; flex the knee of the tested limb
Tests for the tightness of the rectus femoris
Positive: hip of the tested limb flexes
Ely's test
90-90 hamstring test
Patient position in supine; hip and knee supported in 90 degrees flexion; passively extend the knee until end feel is encountered
Test for the tightness of the hamstrings
Positive: knee lacks 10 degrees or greater of knee extension
90-90 hamstring test
Piriformis test
Patient lying with the foot tested limb passively placed lateral to the opposite limb’s knee, with the tested limb 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 the pelvis of the stance leg.
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 the tibia anteriorly
Tests the integrity of the anterior cruciate ligament
Positive: excessive anterior translation onthe tibia compared to the uninvolved limb
Test has higher sensitivity and specificity compared to the anterior drawer test (preferred test)
Lachman test
Anterior drawer test
Patient supine with knee flexed to 45-90 degrees; therapist passively translates the knee anteriorly
Tests the integrity of the anterior cruciate ligament
Positive: excessive anterior translation on the tibia compared to the uninvolved limb
Anterior drawer test
Posterior drawer test
Patient in supine with knee flexed to 45 degrees; therapist passively translates tibia posteriorly
Tests the integrity of the posterior cruciate ligament
Positive: excessive posterior translation on the tibia compared to the uninvolved limb
Posterior drawer test
Valgus stress test
Patient supine with knee resting at the edge of the mat; therapist applies valgus stress to the knee with the knee flexed at 0 and 30 degrees
Tests the integrity of the medial collateral ligament
Positive: laxity and pain compared to the uninvolved side
Varus stress test
Patient supine with knee resting at the edge of the mat; therapist applies varus stress to the knee with the knee flexed at 0 and 30 degrees
Tests the integrity of the lateral collateral ligament
Positive: laxity and pain compared to the 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 one hand and the foot with the other applies valgus force through a flexed knee
Tests the integrity of the anterior cruciate ligament
Positive: tibia reduction during the test by the iliotibial band
Valgus test
McMurray test
Patient supine with knee maximally flexed; therapist passively internally rotates and extends the kne,- then moves to externally rotating and extending the knee
Test the lateral meniscus (internal rotation) and the medial meniscus (external rotation)
Positive: reproduction of click, popping, or pain in the knee
McMurray test
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 the menisci of the knee
Positive: reproduction of pain
Apley’s compression test
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 the lateral meniscus (internal rotation) and the medial meniscus (external rotation)
Positive: reproduction of click, popping, or pain in the knee
Thessaly test
Patellofemoral instability
Patient supine with knee flexed to 30 degrees and quadriceps 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 the lateral femoral epicondyle; with pressure maintained, the patient’s knee is passively extended
Tests the iliotibial band
Positive: patient experiences pain over the lateral femoral condyle
Noble compression test
Ottawa knee rules
Apply the Ottawa 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 the therapist answers yes to any of these questions, then imaging should be done to rule out a 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 the edge of the mat; ankle in 20 degrees of plantarflexion; therapist translates the talus anteriorly while stabilizing the lower leg
Tests the integrity of the anterior talofibular ligament
Patient side-lying with knee slightly flexed and ankle in neutral position; therapist moves foot into maximal adduction (calcaneofibular ligament) and abduction (deltoid ligament)
Tests the integrity of the calcaneofibular ligament
Positive: laxity and/or pain
Talar tilt
Thompson’s test
Patient prone with foot off the edge of the mat; therapists squeeze calf muscle (ankle should plantarflex)
Tests the integrity of the Achilles tendon
Positive: no movement of the foot
Immediate red flag if positive tests occur- send to emergency room
Thompson test
Windlass test
Weight bearing
Patient standing on the 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
Windlass test
Sign up for free to take 10 quiz questions on this topic
