LE Special Tests for Practical Flashcards
What is the anterior drawer for the ankle testing? What position should the foot be in?
-Anterior talofibular ligament (ATFL)
-Foot should be in 10-15° of plantar flexion
What is the medial talar tilt testing? What position should the foot be in?
-Calcaneofibular ligament
-Neutral position
What is the external rotation stress test/Kleiger test for the ankle testing? What does the therapist do in the test?
-Distal tibiofibular syndesmosis sprain or deltoid ligament
-Therapist places an external rotation force on a neutral positioned foot
What is the dorsiflexion external rotation test for the ankle testing?
Integrity of distal tubiofibular syndesmosis
What is the syndesmosis squeeze? What is it testing for?
-The therapist squeezes the lateral portions of the tibia and fibular together and moves down the leg
-Tests for syndesmosis
- + if pt experiences pain or separation of distal tib-fib joint
What is the Cotton Clunk test? What is it testing for?
-Lateral stress is placed on the talus by pushing the calcaneus laterally with the foot in plantar flexed position
-Tests for lateral translation of talus in the ankle mortise
What is the Thompson test? What is it testing for?
-Pt is prone, PT squeezes calf about halfway up
-Ankle should plantar flex
-Tests for Achilles tendon rupture
What is the 2 part Windlass test? What is it testing for?
-Pt is seated with knee flexed to 90 degrees w/ metatarsal heads just over the step, then the big toe is passively extended
-This is repeated in weight bearing
-Tests for plantar fasciitis related pain
What is the anterior drawer test in the knee for? What position should the patient be in?
-Integrity of ACL
-Pt in supine, hip flexed to 45 and knee flexed to 90
-PT quickly passively translates the tibia anteriorly
What is the Lachman’s test? What position should the patient be in?
-Integrity of ACL
-Pt’s knee is flexed to 20-30 degrees
-PT passively translates the tibia anteriorly
What is Lelli’s test for? What position should the patient be in?
-Tests for grade 3 ACL tear
-PT places hand under tibia about 1/3 to 1/2 down
-PT places downward pressure on the femur
-The test is + if the tibia does not move
What is the valgus stress test for in the knee? What position should the pt be in?
-Tests for integrity of MCL
-Pt should have a straight leg with slight ER, PT places valgus stress on the knee to assess MCL
-Pt then will have knee flexed to 30 degrees and the test is repeated
What is the varus stress test for the knee? What position should the patient be in?
-Tests for integrity of LCL
-Pt should have a straight leg with slight ER, PT places varus stress on the knee to assess LCL
-Pt then will have knee flexed to 30 degrees and the test is repeated
What is the pivot-shift test for? What should the PT do?
-Tests for anterior lateral instability of the knee and ACL tear
-PT holds the calcaneus and internally rotates the foot/tibia
-PT places valgus force on the fibula
-The PT then moves the knee from extension into flexion
-Test is + if there is a “clunk” at 30-40 degrees of knee flexion or “giving way” feeling
What is the McMurray test for? What should the PT do to perform this test?
-Tests for medial and lateral meniscus injuries/tears
-PT starts with pt’s knee maximally flexed and either IR (lateral meniscus) or ER (medial meniscus) the tibia and passively extends the knee
-The test is + if there is a click or reproduction of pain
What is the Thessaly test for? What should the PT do to perform the test?
-Tests for meniscal injuries
-Pt stands with knee flexed at 5 degrees and then at 20 degrees and rotates the body and leg to IR and ER
-The test is + if there is a click and/or pain in the knee joint
What is the patellar apprehension test for? What should the PT do to perform the test?
-Tests for apprehension or quad contraction to prevent patellar dislocation
-Pt is supine with knee flexed to 30 degrees and resting on a stool or the PT’s leg
-The PT passively translates the patella laterally
-The test is + if the pt contracts the quad or if the pt expresses apprehension
What is Clarke’s sign/Patellar grind test for? How should the PT perform the test?
-Tests for patellofemoral pain or grinding
-Pt has their knee extended
-PT uses the web space of their hand and places it at the superior portion of the patella
-PT asks pt to contact their quad
-The test is + if there is pain or inability to hold the contraction for 2 seconds
What is the Noble Compression test for? What should the PT do to perform the test?
-Tests for ITB friction syndrome
-Pt is supine with knee flexed to 90 degrees
-PT places pressure 1-2 cm proximal to the lateral femoral epicondyle and passively extends the knee
-The test is + if there is pain and/or a friction sensation
How would you assess for Achilles Tendon Dysfunction?
-Palpate Achilles Tendon
-Contraction/resistance of gastroc/soleus
-Stretch tendon into dorsiflexion
-Assess medial and lateral movement of the Achilles tendon
How would you assess for adductor strain?
-Ask if pt has groin pain
-Palpate muscle belly of adductors
-Contraction/resistance of adductors
-Stretch adductor group into abduction
How would you assess for medial hamstring strain?
-Ask if pt has pain in the back of the knee
-Palpate medial hamstrings
-Resist medial hamstrings by pulling down and laterally with tibia in IR
-Stretch the hamstrings into knee extension
What is the anterior labral test for? What should the PT do to perform the test?
-Tests for anterior labral tear for FAI
-Pt is supine, PT takes the hip into full passive flexion, abduction, and ER into flexion, adduction, and IR then passively extends the hip and knee
-The test is + if there is reproduction of pain and/or a click
What is the posterior labral test for? What should the PT do to perform the test?
-Tests for posterior labral tear and posterior inferior impingement
-Pt is supine, PT takes the hip into full passive flexion, adduction, and IR and moves into flexion, abduction, and ER then passively extends the hip and knee
-The test is + if there is reproduction of pain or apprehension
What is the FAIR test for? What should the PT do to perform the test?
-Tests for deep gluteal syndrome or piriformis syndrome
-Pt is sidelying with involved side up and pelvis level, hip and knee flexion at 90
-PT maximally adducts the hip and moves into IR to 45 degrees
-The test is + if there is pain in the buttock region (NOT GROIN AREA)
What is the Sign of the Buttock for? What should the PT do to perform the test?
-Indicates a lesion or cancer in the area of the hip
-PT tests passive hip flexion then asks pt to perform SLR
-The test is + if passive hip flexion is less or equal to than SLR motion
