LE Special Tests for Practical

Question 1

What is the anterior drawer for the ankle testing? What position should the foot be in?

Answer 1

-Anterior talofibular ligament (ATFL)
-Foot should be in 10-15° of plantar flexion

Question 2

What is the medial talar tilt testing? What position should the foot be in?

Answer 2

-Calcaneofibular ligament
-Neutral position

Question 3

What is the external rotation stress test/Kleiger test for the ankle testing? What does the therapist do in the test?

Answer 3

-Distal tibiofibular syndesmosis sprain or deltoid ligament
-Therapist places an external rotation force on a neutral positioned foot

Question 4

What is the dorsiflexion external rotation test for the ankle testing?

Answer 4

Integrity of distal tubiofibular syndesmosis

Question 5

What is the syndesmosis squeeze? What is it testing for?

Answer 5

-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

Question 6

What is the Cotton Clunk test? What is it testing for?

Answer 6

-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

Question 7

What is the Thompson test? What is it testing for?

Answer 7

-Pt is prone, PT squeezes calf about halfway up
-Ankle should plantar flex
-Tests for Achilles tendon rupture

Question 8

What is the 2 part Windlass test? What is it testing for?

Answer 8

-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

Question 9

What is the anterior drawer test in the knee for? What position should the patient be in?

Answer 9

-Integrity of ACL
-Pt in supine, hip flexed to 45 and knee flexed to 90
-PT quickly passively translates the tibia anteriorly

Question 10

What is the Lachman’s test? What position should the patient be in?

Answer 10

-Integrity of ACL
-Pt’s knee is flexed to 20-30 degrees
-PT passively translates the tibia anteriorly

Question 11

What is Lelli’s test for? What position should the patient be in?

Answer 11

-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

Question 12

What is the valgus stress test for in the knee? What position should the pt be in?

Answer 12

-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

Question 13

What is the varus stress test for the knee? What position should the patient be in?

Answer 13

-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

Question 14

What is the pivot-shift test for? What should the PT do?

Answer 14

-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

Question 15

What is the McMurray test for? What should the PT do to perform this test?

Answer 15

-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

Question 16

What is the Thessaly test for? What should the PT do to perform the test?

Answer 16

-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

Question 17

What is the patellar apprehension test for? What should the PT do to perform the test?

Answer 17

-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

Question 18

What is Clarke’s sign/Patellar grind test for? How should the PT perform the test?

Answer 18

-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

Question 19

What is the Noble Compression test for? What should the PT do to perform the test?

Answer 19

-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

Question 20

How would you assess for Achilles Tendon Dysfunction?

Answer 20

-Palpate Achilles Tendon
-Contraction/resistance of gastroc/soleus
-Stretch tendon into dorsiflexion
-Assess medial and lateral movement of the Achilles tendon

Question 21

How would you assess for adductor strain?

Answer 21

-Ask if pt has groin pain
-Palpate muscle belly of adductors
-Contraction/resistance of adductors
-Stretch adductor group into abduction

Question 22

How would you assess for medial hamstring strain?

Answer 22

-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

Question 23

What is the anterior labral test for? What should the PT do to perform the test?

Answer 23

-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

Question 24

What is the posterior labral test for? What should the PT do to perform the test?

Answer 24

-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

Question 25

What is the FAIR test for? What should the PT do to perform the test?

Answer 25

-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)

Question 26

What is the Sign of the Buttock for? What should the PT do to perform the test?

Answer 26

-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