Special tests

Question 1

What is trendelenburgs test used to identify and how is it done?

Answer 1

Hip abductor strength

Ask patient to stand on one leg
Negative = opposite side remains level
Positive = opposite side drops

Question 2

What is modified Thomas Test used to identify and how is it done?

Answer 2

Tightness in hip joint muscles

Patient supine with end of plinth level with knees. Flex both knees to chest, therapist guides other leg into hip extension.

Negative: 80-90 knee flexion
Positive: reduced knee flexion (tight rec fem), thigh abduction (short ITB), rotation (short int/ ext rotators)

Question 3

What is modified Ober’s test used to identify and how is it done?

Answer 3

Tightness in Gluteus maximus, TFL or ITB

Patient in side lying, lower leg flexed. Extend upper leg at hip and guide into adduction over edge of plinth.

Negative: The leg can be lowered to or below plinth level
Positive: ITB is shortened as hip remains in abduction

Question 4

What is the anterior draw test used to identify and how is it done?

Answer 4

Anterior talo-fibular ligament laxity

Patient supine with foot over edge of bed. Hold foot in 20 degrees plantarflexion and draw the talus forward in the ankle mortice.

Negative = no pain/ symptoms
Positive = Excessive movement, pain

Question 5

What is the talar tilt test used to identify and how is it done?

Answer 5

Calcaneo-fibular ligament injury

Patient supine with foot relaxed in anatomical position. Briskly invert and evert the foot.

Negative = no pain
Positive = excessive movement/ pain

Question 6

What is the Thompson Test used to identify and how is it done?

Answer 6

Complete achilles tendon rupture

Patient prone with leg relaxed, squeeze calf firmly.

Negative = plantarflexion
Positive = no movement into plantarflexion

Question 7

What is the Valgus stress test used to identify and how is it done?

Answer 7

Medial knee instability

Patient supine, valgus stress applied to lateral knee while ankle is stabilised in slight lateral rotation

Negative = no pain or laxity
Positive = pain and laxity

Question 8

What is the Varus stress test used to identify and how is it done?

Answer 8

Lateral knee instability

Patient supine, knee flexed 20-30 degrees. Apply varus stress with the ankle in lateral rotation.

Negative = no pain/ laxity
Positive = pain + laxity

Question 9

What is the anterior drawer test of knee used to identify and how is it done?

Answer 9

ACL instability

Patient supine, knee flexed to 90, hip to 45. Sit on foot and use both hands to pull proximal tibia forward

Negative = minimal tibial translation
Positive = excessive translation of tibia

Question 10

What is the Lachman’s test used to identify and how is it done?

Answer 10

ACL instability

Supine, knee in 30 degrees flexion. Use one hand to stabilise distal femur and one to apply an anterior translation to tibia.

Negative = little translation, firm end feel
Positive = soft end feel

Question 11

What is the posterior drawer test used to identify and how is it done?

Answer 11

PCL instability

Patient supine with hip flexed 45 and knee flexed 90. Apply posterior translation to proximal tibia.

Negative = little movement
Positive = Excessive movement

Question 12

What is McMurray’s test used to identify and how is it done?

Answer 12

Meniscal pathology

Patient supine. Grasp leg around heel or ankle and fully flex knee, palpating joint line with other hand. For medial meniscus, add lateral rotation and move knee from full - 90 degrees flexion, for lateral meniscus add medial rotation and repeat.

Negative = no click/ clunk
Positive = snap or click + pain, clunk felt by palpating hand