ANKLE STRESS EXAMINATION TESTS

TESTS POSITION STRUCTURES DESCRIPTION OF TEST MOUSE OVER

OF THE INVOLVED BEING PERFORMED PICTURE TO VIEW
ANKLE MOVIE

Eversion Neutral Deltoid Knee is bent 900 and

Stress plantarflexion Ligament gastrocnemius is relaxed.
to eversion The heel is held from below
Medial by one hand while the other
Stress hand holds the lower leg. The
hand on the heel is placed
somewhat inferior medial and
is used to push the calcaneus
and talus into eversion while
the other hand grips the
lower leg laterally and pushes
medially.

Side to Neutral Anterior and Knee is flexed 900 and  

Side Test plantarflexion Posterior gastrocnemius is relaxed.
Move the calcaneus and
Transvers Inferior talus to each side as a unit.
e Tibiofibular Do not tilt the ankle. If
Ligaments mortise is widened, the talus
will be able to move
Drawer
sideways, producing a
Test Interosseous
definite thud as it hits the
Membrane
fibula, and when moved in
the opposite direction, it butts
against the tibia.

Anterior Slight Anterior Knee is flexed 900 and

Drawer plantarflexion Talofibular gastrocnemius is relaxed.
Ligament One hand holds the lower
tibia and exerts a slight
Anteromedial posterior force, and the other
Capsule hand is around the posterior
aspect of the calcaneus and
attempts to bring the
calcaneus and talus forward
on the tibia. Also done by
stabilization of foot and talus
on table and pushing tibia
and fibula posteriorly.
Inversion Neutral Calcaneofibula Knee is flexed 900 and
Stress Plantarflexio r Ligament gastrocnemius is relaxed.
n The heel is held from below
Lateral Calcaneofibula by one hand while the other
Stress 200 r Ligament and hand holds the lower leg. The
Plantarflexio Anterior hand on the heel is placed
n Talofibular somewhat inferior lateral and
Ligament is used to push the calcaneus
and talus into inversion while
the other hand grips the
lower leg medially and
pushes laterally. Note an end
point.

External From neutral Anterior Inferior Foot should be in neutral

Rotation to external Tibiofibular position with the lower leg
Test rotation of Ligament stabilized. Examiner should
foot then externally rotate the
Kleiger Interosseous foot. If this causes pain then
Test Membrane must consider a tear of the
anterior tibiofibular ligament.
Depending on severity the
interosseous membrane may
be involved. Pain will be at
site of the anterior tibiofibular
ligament.

Squeeze Below head Anterior Inferior Perform the squeeze test just
Test of fibular Tibiofibular above the anterior tibiofibular
Ligament ligament. Squeeze the bones
together firmly and slowly,
hold and then quickly
release. If there is pain upon
release at the area of the
anterior tibiofibular ligament,
then a sprain of that ligament
is highly suspected.

Squeeze Up and down Testing for Place the heel of each hand  
Test the shaft of fracture of tibia at equal height on the shaft of
the tibia and or fibular. the tibia and fibula, then push
fibula. Foot is or squeeze the bones
in a neutral, together. Pain above or
relaxed below the sight of the
position. squeeze is indicative of a
fracture. Test should be
repeated several times up
and down the shafts of both
bones.

Heel Tap Foot is Tibia and The foot is held relaxed by

Test relaxed and Fibula one hand in a somewhat
in a neutral neutral position, while the
position heel of the other hand is used
 to tap or lightly hit the bottom
of the heel from an inferior to
superior direction. Pain along
the lower leg may indicate a
fracture of the tibia or fibula.

Anterior Drawer Test (all motions)

Examination type Ligament Stress test.
Patient & Body Supine with the test hip flexed to 45 degrees, knee flexed to 90 degrees,
Segment and foot in a neutral position. 
Positioning
Examiner Position Sitting on subject's foot, with both hands behind the subject's proximal
& Hand Placement tibia and thumbs on the tibial plateau.
Tissues Being Anterior Cruciate Ligament (ACL)
Tested
Positive Test Increased anterior tibial displacement on the femur compared to the
uninvolved side along with end feels indicates partial to complete ACL
tear. 
Interpretation Degree of laxity, presence and quality of the endpoint compared bi-
laterally will determine the integrity of the ACL
Common errors in Examiner is in an inappropriate position and does not have correct hand
performing exam placement.

The patient may not be relaxed or comfortable.

 
Factors possibly A torn meniscus of the medial posterior horn wedged against the femoral
resulting in condoyle may impair movement. A muscular spasm of the hamstrings may also
misinterpretation prevent movement
Related tests Posterior Drawer Test, Lachman’s Test, Slocum Test, MacIntosh Test, 90-90
Anterior Drawer, Sitting Anterior Drawer Test, Active Drawer Test
References Hoppenfeld Physical Examination of the Spine & Extremities, Athletic Injury
Assessment Fourth Edition.  
Links: http://www.wheelessonline.com/ortho/anterior_drawer_testHow the Test is
Performed:  The examiner should always examine the uninjured side first so he
or she can better determine the amount of laxity in the patient’s knees. With the
patient in the appropriate position with his foot in a neutral position, the examiner
should then gently pull the tibia forward. He may also give the leg a good “jerk” if
he or she wants to. The examiner could then move the foot into inversion and
perform the test. The puts more stress on the posteriorlateral capsule of the
knee, the LCL, and the iliotibial band. If the foot is moved into eversion ,stress is
put on medial structures of knee joint
  

Apleys Grind Test

Examination type Cartligentous
Patient & Body Prone and knee flexed 90 degrees
Segment
Positioning
Examiner Position Beside the patient standing
Tissues Being Medial and lateral meniscus
Tested
Performing the Test Athlete is prone with knee flexed to 90 degrees. Downward pressure is then
applied to the heel while the tibia is internally and externally rotated.  The
examiner places the other hand on posterior side of the knee with the first and
second fingers resting in the medial and lateral joint line.
Positive Test Pain in either the lateral or medial side or a clicking or popping is felt with the
opposite hand
Interpretation Tear either lateral or medial menisci
Common errors in Not applying enough pressure or not rotating the tibia enough to get pain.
performing exam
Factors possibly Crepetius in the knee joint might be confused with a meniscus tear.  Test is
resulting in positive if clicking and pain is felt with movement.
misinterpretation
Related tests McMurray Test, Bounce Home Test,  Pivot Shift can also be used to find
a meniscus tears but is usually used for ACL.
References Magee, David J, Orthopedic Physical Assessment

Hoppenfield, Stanley, Physical Examination of the Spine Extremities.

http://www.whonamedit.com/synd.cfm/2371.html

 
 Apprehension Test
Examination type Ligamentous
Patient & Body Patient is supine with knee extended
Segment
Positioning
Examiner Position Examiner is on opposite side of the involved knee, facing the patient or examiner
sits in between the patients legs with their knee in between the examiners thighs.
Tissues Being Patella, quadriceps muscles and quadriceps tendon.
Tested
Performing the Test With examiner on opposite side of involved knee, get the patient to relax quad
and hamstring muscles.  With both thumbs on the medial aspect of patella, and
the fingers on the lateral side of patella, push patella laterally
Positive Test The athlete will express sudden apprehension at the point at which the patella
begins to dislocate or the patella will subluxe. 
Interpretation A positive test indicates that the patella can be easily dislocated or sublaxated
Common errors in Common errors made in this exam sometimes are: not getting the patient to relax
performing exam the leg and thigh muscles, wrong hand placement by the examiner, not watching
the athlete for apprehension
Factors possibly A patient with their knee flexed or quad muscles tightened.  If there is swelling of
resulting in the patella tendon
misinterpretation
Related tests Patella Compression and Patella Grinding
References Prentice, William E Principles of Athletic Training, p 590-591
 Bifurcate Ligament Stress Test
Examination type Ligamentous
Patient & Body The patient should be long sitting on a treatment table with the distal end of the
Segment gastrocnemius placed on the edge of the table so that the ankles are hanging off.
Positioning The ankle should be placed in a neutral or slightly plantar flexed position.
Examiner Position The examiner should stand in front of the patient. He/She should use one hand to
stabilize the talus while the other hand is used to grasp the forefoot. The
examiner’s thigh may also be used to stabilize the calcaneus which will aid in
keeping the patient’s foot from moving.
Tissues Being Bifurcate Ligament
Tested
Performing the To perform this test, the examiner should use the upper hand to stabilize the talus
Test as well as to aid in applying varus stress to the foot while using the other hand to
supinate the foot.
Positive Test Pain over the bifurcate ligament
Interpretation If the test is positive, the patient has a sprain of the bifurcate ligament
Common errors in Common errors performing this test may include examiners attempting inversion
performing exam of the subtalar joint instead of supination which will stress other ligaments and give
a false positive. Also if the foot is pulled into dorsi flexion instead of neutral to
slight plantar flexion, a false positive may appear because other ligaments are
being stressed here as well.
Factors possibly Sprains of the anterior talofibular ligament and bifurcate ligament sprains can often
resulting in be confused with one another because of their close anatomical proximity and
misinterpretation similarity in mechanism or injury.
Related tests  
References Bifurcate Ligament Anatomy:

Magee, David J. (2002). Orthopedic Physical Assessment. Philadelphia, PA:

Elsevier. 
Links: Bifurcate Ligament Anatomy:

http://www.anatomate.net/web/?p=453

http://www.wheelessonline.com/ortho/frx_of_the_anterior_calcaneal_process

http://bi-info.medicine-for-
you.com/404,66472253051234567890104804803411/bifurcate-ligament.htm  
 Bowstring Test (Cram Test)
Examination type neurological test
Patient & Body The Subject lies supine on flat surface.
Segment
Positioning
Examiner Position Examiner stands centered with the knee’s of the patient;one hand on the sole of
the foot and the other on the knee.
Tissues Being The popliteal fossa and the sciatic nerve.
Tested
Positive Test Painful radicular reproduction following popliteal compression indicates tension
on the sciatic nerve. 
Interpretation This could indicate that there is a disk bulging out putting pressure on the sciatic
nerve.
Common errors in Miss placed hands
performing exam
Factors possibly Pain maybe felt but in other areas besides the targeted area.  Ask the patient to
resulting in be very specific in order to get the point of pain exactly right.
misinterpretation
Related tests
Sitting Root Test
 
References Slack Books: Special Tests for Orthopedic Examination, Third Edition, 2006:
Konin, Wiksten, Isear, and Brader.
Links: www.slackbooks.com

How the Test is Performed

DESCRIPTION OF TEST BEING PERFORMED

The examiner performs a passive straight leg raise on the involved side.  The
examiner then passively flexes the leg to about 20 degrees and asks patient if
pain had been reduced.
 Craig's Test
Examination type Postural Assessment
Patient & Body lying prone with knee flexed at 90 degrees
Segment
Positioning
Examiner Position standing on affected side of patient
Tissues Being The degree of forward projection of the femoral neck from the coronal plane of the
Tested shaft.
Performing the Examiner palpates the posterior aspect of the greater trochanter The therapist
Test positions the lower extremity at the point in which the greater trochanter is most
prominent laterally (determined by internally or externally rotating the femur).
Using a goniometer with the stationery arm perpendicular to the floor
(representative of the femoral neck axis) and the moving arm in line with the shaft
of the tibia (representative of the line between the femoral condyles) the therapist
can determine the angle of torsion. The degree of anteversion can then be
estimated, based on the lower leg's angle with the vertical.
Positive Test If measures femoral anteversion or forward torsion of the femoral neck.
Interpretation Decreases with age from about 300 at birth to about 80 to 150 at adulthood.
Increased anteversion leads to squinting patellae & pigeon toed walking. Twice as
common in girls. Common to also find excessive hip internal rotation (>60 0) &
decreased external rotation.
Common errors in  
performing exam
Factors possibly If neurological signs (i.e., pain, paresthesia) occur during test, consider pathology
resulting in affecting the femoral nerve.  Also, if tenderness over the greater trochanter exists,
misinterpretation consider possible trochanteric bursitis.
 Ely Test
Examinatio Muscle tightness and/or Neurological lesions
n type
Patient & The patient lies prone on the table.
Body
Segment
Positioning
Examiner Examiner stands over the patient with one hand on the patient’s lower back and the other
Position holding the foot
Tissues Evaluates rectus femoris tightness and/or irritation of the femoral nerve
Being
Tested
Performing The examiner passively flexes the leg upon the thigh, making the heel touch the buttock. 
the Test Compare bilaterally.
Positive During the flexion, patient is unable to flex heel to buttock, if hip raises off table on side
Test being tested, or extreme pain or tingling in back or legs indicates a positive test.

Interpretati A positive test indicates tightness in rectus femoris,  or femoral nerve irritation due to
on lumbo-sacral lesion or hip lesion. It can also be a sign of protruding or bulging disc.  Make
sure the the patient is very specific in telling the examiner where the pain is.  
Common  
errors in
performing
exam
Factors Ask patient to thoroughly describe pain so that the examiner may differ between rectus
possibly femoris tightness or a femoral nerve lesion.  The pain maybe in the low back if there is a
resulting in pelvic or SI joint dysfunction.  This is due to the prone position they are lying in.     
misinterpre
tation
Related Femoral nerve Stretch Test, Femoral Nerve Traction test
tests
References Ely’s Test.  Glossary of Special Tests. MES Solutions Inc.  2005. 
http://www.mesgroup.com/glossary/tests.asp

Ely’s Test.  Chiropractic Exams and Accompaning Neurological, Orthopeadic

Tests and Indications.  Independent Medical Evaluations, Inc.
http://www.imei.com/connections/exam.html

 
Links: http://www.mhhe.com/catalogs/sem/hhp/faculty/labs/index.mhtml?
file=/catalogs/sem/hhp/labs/activity/02

Eversion Stress Test

Examination type Ligamentous Stability
Patient & Body The patient is short sitting at the edge of the table with the ankle in a neutral
Segment planter flexion to eversion positioning.
Positioning
Examiner Position The examiner, sitting in front of the athlete, will stabilize the lower leg with one
hand by grasping the tibia and grasp the calcaneus while holding the foot in
neutral with the other hand.
Tissues Being deltoid ligament
Tested
Performing the Knee is bent 900 and gastrocnemius is relaxed. The heel is held from below by
Test one hand while the other hand holds the lower leg. The hand on the heel is placed
somewhat inferior medial and is used to push the calcaneus and talus into
eversion while the other hand grips the lower leg laterally and pushes medially.
Positive Test The talus tilts excessively as compared with the uninjured side or pain is
produced.
Interpretation  If the injured ankle is more loose when passively everted then a Ligamentous
sprain to the medial side is prevalent
Common errors in Bad hand placement, absence of proper medical history, not performing the test in
performing exam neural, plantarflexion and dorsiflexion to stress each deltoid ligament. 
Factors possibly If the examiner dose not perform the test with proper hand placement or passive
resulting in ankle movement then misinterpretation can become a factor.
misinterpretation
Related tests Talar tilt test, and medial stress test
References  http://www.natareview.com/AnkleSpecialTest.html
http://www.qualitymedeval.com/Webcomponents/FAQ/index.asp?det=131  
Links:  http://www.natareview.com/AnkleSpecialTest.html
http://www.qualitymedeval.com/Webcomponents/FAQ/index.asp?det=131
 External Rotation Recurvatum Test
Examination type ligamentous and joint instability
Patient & Body Patient lies supine and relaxed on exam table
Segment
Positioning
Examiner Examiner holds the both big toes in their hands. 
Position
Tissues Being PCL, LCL and other posteriorlateral knee structures. 
Tested
Performing the The great toe is lifted up so that knees come up off of the table.  The examiner
Test looks for the amount of recurvatum (hyperextension), varus, and tibial external
rotation of the knee.  The test should be done bilaterally at the same time to see if
hyperextension and rotary instability is the normal pattern for the patient.
Positive Test The amount of hyperextension, varus, and tibial external rotation of the injured knee
must be unequal on for on leg to another.  If a difference is noted when comparing
bilaterally then this indicates a positive test.
Interpretation  Indicates posterolateral rotary instability.
Common errors Incorrect hand placement.  Not comparing bilaterally to see if this is amount of
in performing hyperextension is normal for that person. 
exam
Factors possibly   Tight or spasming hamstrings, gastrocnemius, and soleus muscles, ligamentous
resulting in laxity in ankle.
misinterpretation
Related tests Posterolateral drawer tests
References Muché.  Julie A.  Posterior knee pain and its causes.  Physicians and Sport
Medicine Journal. Vol. 32. No. 3.  March 2004. 
http://www.physsportsmed.com/issues/2004/0304/muche.htm
Links: http://www.sportsdoc.umn.edu/Clinical_Folder/Knee_Folder/Knee_
Exam/ext%20rotation%20recurvatum.htm
 FABER, FABERE, Jansen, or Patrick’s Test
Examination type Muscle and boney integrity
Patient & Body Patient lies supine; Knee on affected side flexed to 90 degrees with the
Segment foot on affected side rests on opposite knee in the figure four position.
Positioning

 
Examiner Position Examiner standing on affected side, places one hand on opposite iliac
crest, stabilizing pelvis against table. Examiner places one hand on knee
of affected side.
Tissues Being Groin, hip, Sacro-Iliac, iliopsoas abnormalities
Tested
Performing the Test  Examiner pushes the knee  laterally and down, examiner asks the patient
about the area in which they experience pain.
Positive Test Pain in the groin area indicates a problem with the hip and not the spine.
Pain in the sacroiliac area indicates a problem with the sacroiliac joints.
Interpretation Sacroiliitis, Low back pain, Osteoarthritis, groin, hip or iliopsas muscle strain.
Common errors in The examiner does not know exactly where the pain is taking place so the
performing exam examiner will misinterpret the injury.
Factors possibly Pain occur in a different place then what the test is suppose to look for like
resulting in in the knee.
misinterpretation
Related tests Gapping test, Squish test
 Flamingo Maneuver
Examination type Joint stability
Patient & Body Patient stands on one leg with back to examiner
Segment
Positioning
Examiner Position Standing behind patient
Tissues Being symphysis pubis,  SI joint,
Tested
Performing the Test  Patient standing on one leg which should cause the sacrum to shift forward &
distally with forward rotation. The Ilium moves in opposite direction.  On the non-
weight bearing side the opposite occurs but stressed less than the weight
bearing side
Positive Test Pain in the symphysis pubis or SI joint indicates a positive test for lesions of the
painful structure.
Interpretation Pain in the symphysis pubis or SI joint indicates a positive test for lesions of the
painful structure
Common errors in Not standing properly, bad posture, not looking at PSIS to see shifts from one
performing exam side to other, not asking for patient to be specfic with pain.
Factors possibly Not standing properly, bad posture, not looking at PSIS to see shifts from one
resulting in side to other.  Being unfamiliar with the rotation of the pelvis, and having pain
misinterpretation other than the SI  joint or the symphysis.
Related tests  Gillet’s test
References Orthopedic Physical Assessment, 4th edition. David J. Magee, PhD, BPT,
Links:  
 Gravity Sign (Godfrey 90/90 Test)
Examinatio Ligamentous Stability Test
n type
 
Patient & The patient lies supine on a table with both the knee and hip of the involved side
Body flexed to 90 degrees.      
Segment
Positioning
 
Examiner The examiner should position themselves to the side of the patient at eye level
Position with the knee so that they are able to observe if there is any posterior sag.  The
examiner holds on to the patients toes with one hand.
Tissues  Posterior Cruciate Ligament (PCL)  
Being
Tested
Performing  The examiner passively holds the patients toes and notes the position of the
the Test patients tibia.  The examiner should note if the patient has any difference in the
position the tibia is sitting bilaterally.     
Positive The recognition of one tibia resting more inferiorly than the contralateral side may
Test indicate a posterior sag or instability. This may be related to the posterior cruciate
ligament.
Interpretati A positive test is present when there is a tear in the posterior cruciate ligament
on causing posterior knee instability.
Common The tibia must be maintained in neutral rotation and the test must be done
errors in bilaterally.  The test must be done passively so the that muscle contractions of the
performing
exam
leg do not pull the tibia into a different position.

Factors If the tibia is not maintained in neutral rotation then a positive finding may be a
possibly result of a capsular extensibility instead of a posterior cruciate ligament tear.
resulting in
misinterpre
tation
Related Posterior Sag Test (Gravity Drawer Test)
tests
 Reverse Pivot Shift (Jakob Test)

Posterior Drawer Test

Hughston Posteromedial Drawer Test

Hughston Posterolateral Drawer Test

Posterior Lachman’s Test

External Rotation Recurvatum Test 

References Brader, Holly, Isear, Jerome, Konin, Jeff, & Wisten, Denise    

     (2002). Special Test for Orthopedic Examination (2nd ed.).

     Thorofare: SLACK Inc.

Magee, David (2002). Orthopedic Physical       

     Assessment. Philadelphia: Saunders.      

Prentice, William E. (2003). Arnheim’s Principles of Athletic

     Training: A Competency-Based Approach (11th ed.).  St. Louis:     

     McGraw Hill.

 
Links: http://www.physsportsmed.com/issues/1997/11nov/morgan.htm

http://www.emedicine.com/SPORTS/fulltopic/topic105.htm

http://www.maitrise-
orthop.com/corpusmaitri/orthopaedic/mo56_knee_joint/knee_joint.shtml

http://www.athleticadvisor.com/Injuries/LE/Knee/pcl_injuries.htm

http://www.emedx.com/emedx/diagnosis_information/knee_disorders/posterior_cr
uciate_ligament_tear_outline.htm

 
 Heel Tap Test
Examination type Bony Integrity
Patient & Body Patient should be lying on their back on a table with their feet and legs relaxed
Segment
Positioning
Examiner Position At the end of the table holding the patients toes with one hand and the other
ready to strike the heel of the foot in hand
Tissues Being Integrity of the tibia and the fibula.
Tested
Positive Test If pain occurs in the lower leg, it is a positive test
Interpretation This could mean that there is a fracture of the either the fibula or the tibia.
Common errors in The examiner needs to make sure that the patient is in the correct position to be
performing exam relaxed.  This means the patient can not be sitting up or have their head bent up,
this could give the examiner a false positive test. Examiner needs to tell the
patient to be specific in telling where the pain is.
Factors possibly Some very sensitive people might feel pain with only an ankle sprain.  They
resulting in might feel pain if a ligament is torn or a contusion to the fat pad on the heel
misinterpretation exists.  They might also feel pain with the test if the interosseous membrane
between the tibia and fibula is torn or stretched.
Related tests Compression test, Hoffa’s test & Squeeze test
References Booher, James M., & Thibodeau Gary A. (2000). Athletic Injury Assessment
Fourth Edition. U.S.A.: McGraw-Hill Companies, INC.

Magee, David J. (2002). Orthopedic Physical Assessment. Philadelphia, PA:

Elsevier. 
Links: http://www.kaganorthopedic.com/safety8.htm

http://distanceeducation.ua.edu/hat257/Chapter6Final.htm

How the Test is Performed

DESCRIPTION OF TEST BEING PERFORMED

 The patient should be completely relaxed with their head back and their hands
on their chest.  The examiner should grab the toe of the foot of the injured leg
with one hand.  The examiner should then use the heel of the other hand to hit
the heel of the foot being held and the examiner should strike with varying
degrees of firmness.

Homans' Sign
Examination type Vascular
Patient & Body The patient should be short sitting on the table. The patients knee needs to go
Segment into extension and the foot go into dorsiflexion.
Positioning
Examiner Position The examiner will be standing in front of the patient.
Tissues Being The muscles in the lower leg will push on the veins, so the veins are being
Tested stressed secondary to the stress applied to the muscles around them.
Performing the Test In performing this test the patient will need to actively extend his knee. Once the
knee is extended the examiner will then passively dorsiflex the patients foot.
After the foot is dorsiflexed the examiner will then reach around with his free
hand and palpate the belly of the calf in between the two heads of the
gastrocnemius and ask the patient about tenderness.
Positive Test When deep pain is enlisted with doriflexion and palpation.
Interpretation A positive Homans’ Sign test means that the patient has deep vein
Thrombophlebitis.
Common errors in One error that may occur is that the examiner will not dorsiflex the patient’s foot
performing exam enough to get a correct interpretation. The knee of the patient must also be in full
extension. T
Factors possibly If the patient does not know the difference between pain and a stretch. When
resulting in the knee is extended and the foot dorsiflexed there will be a stretching of the calf
misinterpretation muscle. If the patient does not know the difference between pain and a good
stretch this could lead to a misinterpretation. There could also be a bruise on the
back of the leg that could led to some misinterpretation
Related tests There are no related tests to the Homans’ Sign
References Magee, David J, Orthopedic Physical Assessment

Hoppenfield, Stanley, Physical Examination of the Spine Extremities.

http://www.whonamedit.com/synd.cfm/2371.html

 
Links: http://www.whonamedit.com/synd.cfm/2371.html

Inversion Stress Test or Lateral Stress

Examination type ligamentous, joint stability.
Patient & Body The knee is flexed at 90 degrees while hanging over the edge of the table, and
Segment the gastrocnemius is relaxed.  Patient is short sitting.
Positioning
Examiner Position The heel is held by one hand and the tibia and fibula are held with the other
hand. The hand on the heel is placed somewhat inferior lateral to push the
calcaneus and talus into inversion. The other hand is on the medial side of the
lower leg.
Tissues Being  Calcaneofibular ligament or anterior talofibular ligament.
Tested
Performing the Test Provide an inversion stress by pushing the calcaneus and talus inward while
pushing the lower leg laterally. Repeat with the ankle plantar flexed.
Positive Test When the talus tilts excessively on the injured side more than the uninjured side.
Pain can also be associated on the injured side.
Interpretation Injury to the calcaneofibular ligament or the anterior talofibular ligament.
Common errors in A common error would be not pushing on the calcaneus medially enough.
performing exam Another mistake would be pushing the wrong way on the calcaneus.
Factors possibly The examiner could miss the ligament that is torn by not putting enough stress
resulting in while inverting the calcaneus. Another misinterpretation would be when the
misinterpretation examiner performs the wrong test.
Related tests  Talar Tilt test
References Ankle Special Test; Orthopedic Physical Assessment;
Links: http://www.natareview.com/AnkleSpecialTest.html

 
 McMurray's Test
Examin Menisci test
ation
type
Patient The patient lies supine with the knee and hip fully flexed.  The patient should not contract the
& Body leg muscles.  This test will be done passively by the examiner.
Segme
nt
Positio
ning
Examin One of the examiner’s hands holds the heel of the  ankle, while the other hand holds the knee,
er with the first and long finger in the medial and lateral joint lines.
Positio
n
Tissue Medial and lateral meniscus of the knee
s Being
Tested
Perfor The examiner palpates the joint lines with one hand while taking the knee of the patient into
ming full flexion & extension with it internally rotated & externally rotated with the other hand.  This
the should be done passively by the examiner.  It should be performed at different angles.  Flexion
Test & external rotation with valgus force draws the medial meniscus anteriorly and the lateral
meniscus posteriorly.  Flexion and internal rotation with varus force draws the lateral meniscus
anteriorly and the medial meniscus posteriorly.  Extension and internal rotation with varus
force compresses the lateral meniscus.  Extension and external rotation with valgus force
compresses the medial meniscus.
Positiv Click" heard or palpated while doing the test or joint line tenderness or pain upon palpation
e Test
Interpr If this test is positive, the patient has a meniscal tear or irritation
etation
Comm  The examiner must have his/her hands in the right place to move the knee better and to feel
on for a click.
errors
in
perfor
ming
exam
Factors If the patient is not fully relaxed, the test may taken as negative.  If the examiner does not go
possibl through the whole range of motion such as extreme flexion or extreme extension.
y
resultin
g in
misinte
rpretati
on
Related Medial & Lateral Compression (Grind) tests, Apley's compression test, Bounce Home Test,
tests O'Donohue's Test, Modified Helfet Test, Test for Retreating or Retracting Meniscus,
Steidman's Tenderness Displacement Test, Payr's Test, Bohler's Sign, Bragard's Sign,
Kromer's Sign, Childress Sign, Anderson Medial-Lateral Grind Test, Passler Rotational Grind
Test, Cabot's Popliteal Sign, Ege’s test

 
Refere McMurray Test. http://www.fpnotebook.com/ORT97.htm
nces
Comparison of Three Tests for Meniscal Tear
http://www.eorthopod.com/eorthopodV2/index.php/fuseaction/news.detail/ID/3
a680c091a62a9749e0730167371c81b/NewsID/0af4382371fb3198c85349675
587c1d9/area/17

 
Links: http://www.healthcentral.com/ency/408/001071.html

http://www.latrobe.edu.au/podiatry/Knee.html

LOW BACK STRESS EXAMINATION TESTS

TESTS POSITION OF STRUCTURES DESCRIPTION OF TEST BEING MOUSE

BACK INVOLVED PERFORMED OVER
PICTURE
TO VIEW
MOVIE
Straight Leg Patient is Hamstring Examiner lifts patient’s leg upward by  
Test supine. Leg is Muscle Sciatic supporting the foot around the calcaneus.
extended and Nerve At the point where the patient experiences
relaxed. Knee is pain, lower the leg slightly and then
 straight. dorsiflex the foot to stretch the sciatic
nerve and reproduce sciatic pain. If
patient does not experience pain when
you dorsiflex his foot, then the pain is
probably due to tight hamstrings
Hip Flexor Knees flexed 90 Sartorius Muscle Patient flexes, abducts, and laterally  
Strength and hamstrings rotates hip and flexes knee. Resistance to
off edge of table hip flexion and abduction is given with
one hand above knee joint. This tests for
strength and need to compare with the
opposite leg.
Psoas Patient is supine Psoas Muscle Patient pulls one knee to chest, if opposite  
Strength with lower legs leg raises off table, the Psoas muscle is
Test hanging over tight on that side. Repeat test with
edge of table. opposite leg.
Rectus Patient is seated Rectus Femoris Patient is allowed to grasp sides of table  
Femoris with legs over Muscle to stabilize trunk. Examiner stabilizes
Test edge of table. thigh without pressure over quadriceps.
Patient extends knee through range of
motion without terminal locking.
Resistance is given above ankle joint.
Compare with opposite leg.
Sciatic Patient lies on Sciatic Nerve Sciatic nerve is located midway between  
Nerve side with back to the greater trochanter and the ischial
Palpation examiner tuberosity. Knee is flexed and hip is
extended to move gluteus maximus
muscle out of the way of the sciatic nerve.
If you press firmly into the soft tissue
depression between greater trochanter
and the ischial tuberosity you may be able
to feel the nerve.
Bowstring Knee flexed 90 Sciatic Nerve Patient is supine with knee flexed 90 and
Test or and patient’s leg Root his leg placed on examiners shoulder.
Cramm is placed on Impingement. Place fingers in the popliteal space
Maneuver examiner’s behind the knee and apply pressure. If
shoulder. test is positive there should be a tingling,
burning sensation in the hip and buttocks.
 Jerk Test
Examination type Ligamnetous
Patient & Body Patient is spuine with hip at 45 degrees of flexion, and the knee at 80 to 90 degrees of
Segment flexion.
Positioning
Examiner Position Standing on the side of the patient; with one hand on the patients heel and the
other on the lateral aspect of the knee.
 
Tissues Being ACL
Tested
Positive Test Positive test is when a jerk is felt and patient has apprehension or pain.
Interpretation This indicates a torn ACL
Common errors in Wrong hand placement, starting in wrong position, not applying enough stress or rotary
performing exam force. 
Factors possibly A torn MCL might make the jerk larger than normal to watch for that injury as well. 
resulting in Make sure to check bilaterally because that shift maybe normal for them.
misinterpretation
Related tests Pivot shift,  Anterior drawer, Lachman
References  
Links: What the Results Suggest

How the Test is Performed

DESCRIPTION OF TEST BEING PERFORMED

The tests starts with knee at 90 degrees of flexion, then the examiner applies
 medial rotation and valgus stress.  At 20 or 30 degrees the lateral tibia plateau
will sublux causing a jerk.  Then as leg goes further into extension the
subluxation will reduce.  The feel of this jerk indicates a positive test.

Kleiger’s Test
Examination type ligamentous
Patient & Body The subject is short sitting at the end of the examining table with the legs over
Segment the edge of the table.
Positioning
Examiner Position Sitting beside involved side lower leg of patient
Tissues Being  Deltoid ligament and distal syndesmosis
Tested
Performing the Test The examiner stabilizes the lower leg with one hand, and the other hand grasps
the medial aspect of the foot while supporting the ankle in a neutral position. The
foot is externally rotated and dorsiflexed to stress the syndesmosis or the deltoid
ligament.
Positive Test Medial pain indicates trauma to the deltoid ligament. Pain in the anterolateral
ankle should be considered syndesmosis pathology unless otherwise stated.
Interpretation Distal tibiofibular syndesmosis or deltoid ligament sprain.
Common errors in not stabilizing lower leg effectively, not giving enough eversion or dorsiflexion. 
performing exam Starting with the foot not in neural. 
Factors possibly Swelling, pain, not asking the patient to be specific enough as to where the pain
resulting in is located. 
misinterpretation
Related tests Eversion stress test
 KNEE EXAMINATION STRESS TESTS

TESTS POSITION STRUCTURES DESCRIPTION OF MOUSE OVER

OF THE INVOLVED TEST BEING PICTURE TO VIEW
KNEE PERFORMED MOVIE
Gravity Knees and Posterior Cruciate Patient lies supine with
Sign/Gravity hips flexed and/or Posterior hip flexed to 45 degrees
Test 90 degrees. Oblique Ligament and the knee to 90
Held by and/or Fibular degrees. The tibia will
examiner. Collateral "drop back" or sag back
Ligament, Popliteus on the femur if the
Tendon, Arcuate posterior cruciate is
Ligament. torn. Must observe both
knees, because if the
sag isn’t noticed, it could
give you a false positive
anterior drawer.
 
Posterolateral Knee flexed Popliteus Tendon, Patient lies supine with
Drawer Test 90 degrees. Fibula Collateral knee flexed 80-90
Lower leg in Ligament, Arcuate degrees, and hip to 45
neutral Ligament degrees. Examiner
rotation. medially rotates the
patients foot slightly and
sits on the foot to
stabilize it. Examiner
pushes tibia posteriorly.
If tibia moves or rotates
posteriorly on the medial
 aspect an excessive
amount compared to the
normal knee, the test is
positive.
Figure 4 Leg flexed Fibula Collateral Patient is supine with  
Palpation and crossed Ligament affected leg flexed and
over the crossed with affected
opposite foot across other knee.
knee Observe area around
the medial joint line for
any indentions that
would reflect ligament
damage.
Lateral From flexion Lateral meniscus Flexing and extending  
Compression to extension and/or Lateral Joint the knee while apply
internal valgus stress. Repeat
derangement such with lower leg held in
as osteochondritis internal rotation and
dessicans or then external rotation.
osteochondral
fractures.
Medial From flexion Medial meniscus Flexing and extending  
Compression to extension and/or Medial joint the knee while applying
internal various stress. Repeat
derangement, such with the lower leg held
as osteochrondritis in internal rotation and
dessicans or then external rotation.
osteochondral
fracture.
Jerk Test of Hip flexed Anterior Cruciate Knee is flexed to 80
Hughston 30-35 and/or Lateral degrees and the foot is
degrees, Capsular internally rotated. Apply
knee flexed ligaments. a valgus force while
about 80 attempting to rotate the
degrees. fibula medially as the
Knee goes knee is being
from flexion straightened. The jerk
to full test takes place at
extension. approximately 20
degrees of flexion.

Hyperextension Legs are Anterior Cruciate The foot is raised to  

External fully ligament. It may or allow the knee to drop
Rotation extended may not involve the back into
recurvatum and are held posterior cruciate hyperextension; this is
up from the ligament. Rotary compared with the
toes by the instability may be opposite side.
examiner. present. Fibula
Collateral Arcuate
Ligament.
McMurray’s Fully flexed Lateral Meniscus, The foot is held in one
Medial Meniscus hand while the other
hand palpates the joint
line on both sides of the
knee. A click or grinding
may indicate a tear of
the posterior segment of
the meniscus while
flexing and extending
the knee.

Apley’s Grind Flexed to 90 Medial or lateral Athlete is prone with

Test degrees menisci and/or knee flexed to 90
other internal degrees. Pressure is
derangement, such then applied to the heel
as osteochondritis while the foot is rotated.
dessicans or This suggests a
osteochondral posterior horn injury
fractures.

Medial Compression Test

Examination type medial menisci
Patient & Body The patient is instructed to lie in a supine position. First, the patient will be tested
Segment in hip flexion at 90 degrees and knee flexion at 90 degrees, internally and
Positioning externally rotated. Then the patient will be further tested in hip flexion at about 45
degrees and full knee extension, internally and externally rotated
Examiner Position The examiner will be standing on the side of the injured knee. The hand closes to
the body will grasp the knee at the medial joint line, and the hand closes to the
ankle will grasp the foot. From this position the examiner should be able to
manipulate the movement of the joint.
Tissues Being medial meniscus
Tested
Performing the The examiner will actively apply pressure to the knee joint while internally and
Test externally rotating the knee in flexion and extension.
Positive Test   While performing the test you will feel a click with the hand on the knee. The
patient will also feel pain in the medial aspect of the knee.
Interpretation If the medial compression test is positive the patient has a medial meniscus tear.
Common errors in Wrong positioning or bad hand placement by the examiner.  Examiner may not
performing exam go through the full range of motion, which may result in missing a tear in either
extreme flexion or extreme extension.
Factors possibly While performing the test the examiner is putting a compression force on the joint
resulting in so there is always a possibility of other injured structures giving the examiner a
misinterpretation false positive test, make sure to ask patient to be specific about pain.
Related tests Apley’s Compression Test, Merke’s Test, Bohler’s Test, Payr’s Test, Apley’s
Test.
References  
Links: http://medicine.ucsd.edu/clinicalmed/Joints.html

http://www.nlm.nih.gov/medlineplus/ency/article/001071.htm

http://jaapa.com/issues/j20050701/articles/knee0705.htm

http://abc.eznettools.net/pob-usa/pob/2001/1001_meniscus.html

Ober's Test
Examination type  
Patient & Body Side lying towards the edge of the table with lower leg flexed at the hip and the
Segment knee for stability
Positioning
Examiner Behind patient.  Right hand stabilizing the pelvis. Left hand grasping the knee
Position while supporting the lower leg with forearm.
Tissues Being Iliotibial Band, Tensor Fasciae Latae
Tested
Performing the Examiner passively abducts and extends the patient's upper leg with the knee
Test flexed to 900.   Examiner slowly lowers the upper limb and watches for returning
of upper leg to the table.
Positive Test If upper leg remains abducted and does not fall to the table
Interpretation Contracture, tightness of the Iliotibial Band/Tensor Fasciae Latae

Common errors Not extending the hip and/or stabilizing the pelvis.
in performing
exam
Factors possibly If neurological signs (i.e., pain, paresthesia) occur during test, consider pathology
resulting in affecting the femoral nerve.  Also, if tenderness over the greater trochanter exists,
misinterpretation
consider possible trochanteric bursitis

Ober's Test
Examination type Flexability
Patient & Body Side lying towards the edge of the table with lower leg flexed at the hip and the
Segment knee for stability
Positioning
Examiner Position Behind patient.  Right hand stabilizing the pelvis. Left hand grasping the knee
while supporting the lower leg with forearm.
Tissues Being Iliotibial Band, Tensor Fasciae Latae
Tested
Performing the Test Examiner passively abducts and extends the patient's upper leg with the knee
flexed to 900.   Examiner slowly lowers the upper limb and watches for returning
of upper leg to the table.
Positive Test If upper leg remains abducted and does not fall to the table
Interpretation Contracture, tightness of the Iliotibial Band/Tensor Fasciae Latae
Common errors in Not extending the hip and/or stabilizing the pelvis.
performing exam
Factors possibly If neurological signs (i.e., pain, paresthesia) occur during test, consider pathology
resulting in affecting the femoral nerve.  Also, if tenderness over the greater trochanter
misinterpretation exists, consider possible trochanteric bursitis.
Related tests  
References Bernier, Julie N. Quick Reference Dictionary for Athletic Training.
SLACK Incorporated 2002.
Links:  

Pelvic Rocking Test

Examination type Joint stability
Patient & Body The patient will lie supine on the examination table. The hips of the patient need
Segment to be exposed. The shirt will be rolled up just a little and the pants will be rolled
Positioning down a little. The patient’s iliac crests need to be exposed.
Examiner Position The examiner is standing over the patient. The examiner’s hands will be on the
iliac crests with his thumbs on the anterior superior iliac spines. The palms of the
examiner will be on the iliac tubercles
Tissues Being The pelvis is being stressed. The iliac crest is being pushed in on. Both ASIS’s
Tested are being stressed. This is testing the sacroiliac joint.
Performing the With the hands in the correct position. With palms on both ASIS. You will then
Test push/compress them towards each other. The will be pushed towards the midline
of the body.
Positive Test  With a positive test there will be pain around the sacroiliac joint. A positive test
may also be positive if there is increased or decreased motion on the injured
side.
Interpretation When there is pain on the sacroiliac joint this indicates a problem. This may
mean there is a trauma to the sacroiliac joint. There may also be an infection to
the sacroiliac joint.
Common errors in When performing the rocking test common errors may be easily performed. The
performing exam incorrect hand placement is the most common error people make when
performing this test. When doing this test it is also important to use the correct
amount of pressure. People will often not put enough pressure on the ASIS.
Examiners must also make sure they push toward the inline of the body and not
directly down.
Factors possibly A misinterpretation may be found when the examiner pushed to hard and the
resulting in patient complains of pain. The pain may be caused by the pushing and not the
misinterpretation sacroiliac joint problems.
Related tests Gapping Test, Prone Gapping Test, Squish Test
References  Hoppenfield, Stanley, Physical Examination of the Spine Extremities.

Pinch Test
Examination type Syndesmosis diastasis
Patient & Body Have the patient position short sitting on the end of the table .
Segment
Positioning
Examiner The examiner will stand to side of the patient in a anterior view of the patient.
Position

Tissues Being Syndesmosis diastasis, the anterior inferior ligaments, anterior tibiofibular ligament.
Tested
Performing the  Examiner has the patient knee flex, use the index finger and thumb of one hand to
Test pinch the anteromedial malleolus toward the posterolateral malleolus to appreciate
reduction of the syndesmosis diastasis, should not spread more than other side
appreciably unless anterior inferior ligaments is sprain..
Positive Test  + sign is the tibia and fibula spreads apart with pain over the space of between the
tibia and fibula
  
Interpretation The examiner should be sure to check bilaterally because the amount of
opening might be normal for that patient.  If there is an increased opening
from one side to the other and pain during test then this indicates a
syndesmosis sprain.   
                                               

 
 
Common errors Common errors in performing this test would be wrong hand       placement and not
in performing pinching hard enough
exam
Factors possibly Damage to other ligaments in the ankle that can lead to a false positive test
resulting in or a fracture over the site of pressure.
misinterpretation
Related tests  Squeeze  Test
References  Magee, David J. Orthopedic Physical Assessment 4th Ed. Saunders Company,
New York 1997. (Pg 522)

 
Links: <www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=  

Piriformis Test
Examination type Muscle tightness and neurological test
Patient & Body The patient lies on the unaffected side with the affected leg in 60° of hip flexion. 
Segment The knee should be bent and relaxed with the foot on the unaffected leg.
Positioning
Examiner Position One of the examiner’s hands should be placed on the hip to stabilize the joint. 
The other hand should be placed on the patient’s knee to put pressure on it.

Tissues Being Piriformis muscle and sciatic nerve

Tested
Performing the Test The examiner should stabilize the pelvis and apply pressure downward on the
knee, while rotating the hip internally.
Positive Test Test is positive if pain or tightness is present.

 
Interpretation  If pain is in the buttocks with shooting pain down the posterior thigh, the
 piriformis is pinching the sciatic nerve.  If pain is just felt in the butt with no
shooting pain then the piriformis muscle is tight.                            

 
 
Common errors in Make sure that the hip is in 60° of hip flexion or you may not get a good stretch. 
performing exam Make sure to push downward on the knee to get a good stretch.  Stabilize the
hips to get a better stretch
Factors possibly You must know where the piriformis is to correctly diagnose this problem.  Also
resulting in make sure to ask about the type of pain because this is the difference between a
misinterpretation sciatic nerve and tight piriformis.
Related tests Seated Piriformis Test
References  

Magee, D.J.  (2002).  Orthopedic Physical Assessment.  Saunders: 

Philadelphia.

Prentice, W.E.  (2003).  Arnheim’s Principles of Athletic Training.  McGraw Hill: 

New York.  

Pivot Shift Test – Lateral Pivot Shift Maneuver Test of Machintosh –

Pivot-Jerk Test
Examination Ligamentous Stability
type
Patient & Patient should lie supine, and be completely relaxed on the exam table
Body
Segment
Positioning
Examiner The examiner will grasp the patient’s ankle with one hand, and also grasp the
Position lateral side of the leg level with the fibular head.

Tissues Being Anterior Cruciate Ligament

Tested
Performing Examiner will passively move the patient’s hip into 30 degrees of abduction and
the Test flexion. The examiner will then medially rotate the leg slightly. Next, the
 examiner will axial load the leg and flex the knee with the lower hand while
applying valgus stress to the knee with the upper hand. Once the subluxation is
felt the examiner will then extend the leg 30 – 40 degrees to reduce the
subluxation.
Positive Test If an anterolateral subluxation of the tibia occurs along with a reduction of the
lateral femoral condyle the test is positive.
Interpretation  Anterolateral Rotary Instability; ACL Sprain or Tear

Common Possible errors in performing this test can include but are not limited to:
errors in improper patient positioning, improper examiner positioning, having active
performing
exam
participation from the patient, and not allowing the patient to fully relax before
and during the examination.
Factors Several factors can cause the examiner to read a false negative for this test. If
possibly the IT Band is sprained or torn or if excessive swelling is present, the examiner
resulting in
misinterpretat
may have a false negative test. Also, if the patient is apprehensive, the
ion protective muscle contractions produced will cause a false negative by not
allowing the tibia to slip backwards.
Related tests Soft Pivot Shift Test; Active Pivot Shift Test; Jerk Test of Hughston; Losee
Test; Slocum ALRI Test; Crossover Test of Arnold; Noyes Flexion-Rotation
Drawer Test; Lemaire’s Jolt Test; Flexion-Extension Valgus Test; Nakajima
Test; Marten’s Test
References  Booher,James M., & Thibodeau Gary A. (2000). Athletic Injury Assessment
Fourth Edition. U.S.A.: McGraw-Hill.

Magee, David J. (2002). Orthopedic Physical Assessment. Philadelphia, PA:

Elsevier.

Prentice, William E. (2003). Arnheim’s Principles of Athletic Training A

Competency-Based Approach. U.S.A.: McGraw-Hill Companies, INC. 
Links: http://www.sportsdoc.umn.edu/Clinical_Folder/Knee_Folder/Knee_Exam/pivot
%20shift.htm

http://www.wheelessonline.com/ortho/pivot_shift_test

http://www.mmsfitness.com/steroid_newsletter/kneeinjury/acute_knee_injuries.
htm

http://www.mayoclinic.com/health/acl-injury/AC99999/PAGE=AC00005

http://www.geocities.com/schach23/ACL/ACLtear.html?200622
  Hughston’s Plica test
Examination  
type
Patient & Body The patient is lies in supine position.
Segment
Positioning
Examiner Examiner on lateral side of affected side, with one hand on heel and the other
Position on lateral aspect of the knee.

Tissues Being Plica 

Tested
Performing the The patient is lies in supine position. While the examiner flexes the knee and medially
Test rotates the tibia with one are and hand pressing the patella medially with the heel of
the other hand and palpating the medial femoral condyle with the fingers of the same
hand. The patient knee is passively flexed and extended while the examiners flees for
‘popping’ of the plical band under the fingers.
Positive Test Popping indicates a positive test.
 Interpretation  + or – test is based on popping as the knee is passively flexed and extended while
medially rotating tibia and patella

Common Not palpating while test is being preformed.  Not fully internally rotating tibia or not
errors in pressing patella medially.  
performing
exam
Factors The examiner may feel get crepitis confused with the popping.
possibly
resulting in
misinterpretati
on
Related tests Suprapatella plica snap test
References  Magee D. ‘ Orthopedic Physical Examination

Ellen Becker TS. (editor)- Knee ligament rehabilitation

Links: http://www.hsedu.com/therapysourcespecialtest.pdf#search=`jerk
%20test%20

of%hughston’

 http:www.cup.edu/nu_upload/27%20knee%20special
%20tests.pdf#search

=`knee%plicia%test’

 Posterior Sag Test

Examination type Ligamentous special test

Patient & Body Segment Patient lies supine with hip flexed to 90 degrees and the knee to 90 degrees. Held by examiner.
Positioning
Examiner Position Standing beside the examination table near the knee with head in position to visualize both knees
and proximal tibias just inferior to the anterior joint line.  Examiner must use one hand to maintain
both the hips and knees flexed at 90 degrees. (May use an assistant to hold the position of the
knees and hips.
Tissues Being Tested Primarily the Posterior Cruciate Ligament (PCL) and secondarily the Posterior Oblique Ligament
and/or Fibular Collateral Ligament, Popliteus Tendon, Arcuate Ligament.

Positive Test Note the amount of posterior sag relative to uninvolved side. The tibia will "drop back" or sag
back on the femur if the Posterior Cruciate Ligament is torn. Must observe both knees, because if
the sag isn’t noticed, it could give you a false positive anterior drawer.
Interpretation Positive test or an increased sag suggests PCL rupture 
Common errors in performing Athlete is not completely relaxed
exam
Factors possibly resulting in Enlarged tibial tubercle on one knee secondary to Osgood-Schlatter
misinterpretation
Related tests Gravity Sign/Gravity Test, Godfrey 90-90 Test, Quadriceps Active Test
References Magee, David J.; Orthopedic Physical Assessment, 4th Edition. Pg.704- 705
Links: What the Results Suggest

How the Test is Performed

DESCRIPTION OF TEST BEING PERFORMED

Patient lies supine with hip flexed to 45 degrees and the knee to 90 degrees. Must observe both
knees, look for one tibia to sag or be lower than the other one.  If the sag is noticed, it could give
you a false positive anterior drawer.

Posterolateral Drawer Test

Examination Ligamentous
type
Patient & Patient lies supine with the involved knee flexed 90 degrees and foot rotated 15
Body degrees externally, hip flexed at 45 degrees.
Segment
Positioning
 
Examiner Examiner sits on patients involved leg with hands going around the proximal tibia and
Position thumbs resting in the joint line on the tibia plateau.
Tissues Being   Posterior cruciate ligament
Tested
Performing Examiner applies posterior force to the knee
the Test
Positive Test When there is a posterior shift and a posterior lateral rotary force. 
Interpretation Torn or damaged PCL
Common Not having quads and hamstring relaxation, not applying enough posterior
errors in
performing force, not having the tibia externally rotated enough.
exam
Factors If there is an LCL tear the tibia might rotate laterally due to the lack of lateral stability. 
possibly Also applying more lateral force then posterior force might give you a false postive test.
resulting in
misinterpretat
ion
Related tests external rotation recurvatum test and the reverse pivot shift test
References  
Links: http://www.sportsdoc.umn.edu/Clinical_Folder/Knee_Folder/Knee_Exam/posterolateral
%20drawer.htm

http://www.emedicine.com/sports/topic105-Clinical.htm

Sit up Test
Examination type Sacroiliac Joint
Patient & Body Patient lies supine with body straight and legs symmetric
Segment
Positioning  
Examiner Position Standing to the side of the patient
Tissues Being Sacroiliac Joint
Tested
Performing the Test Actively flex knees, lift pelvis off table about 4 inches, then drop pelvis to table.
Passively extend knees and lower legs one at a time to table. Then roll the legs
medially and release. Palpate and observe level of medial malleoli, then athlete
sits up and malleoli are rechecked.
Positive Test  If one SI joint is hypomobile and blocked in posterior rotation, the sacrum and
ilium will move together as a unit, making the leg appear longer when sitting up
compared to it appearing shorter in supine. If one SI joint is in anterior rotation
that leg may appear longer or same length when supine, but get shorter when
sitting up.
Interpretation  
Common errors in Knees are not extended one at a time, patient is not instructed to drop
performing exam pelvis to table.
Factors possibly  Miscommunication between patient and examiner.
resulting in
misinterpretation
Related tests  
References Orthopedic Physical Assessment. 4th Ed.

Special Test for Orthopedic Examination, 2nd Ed. 

STRAIGHT LEG RAISE TEST

Examination type Neurological test
Patient & Body Patient lies supine on a table
Segment
Positioning
Examiner Position Examiner places one hand on the anterior aspect of the uninvolved leg slightly
superior to the knee and the other hand around the heel of the ipsilateral
calcaneus

Tissues Being Lumbar Spine

Tested
Performing the Test The examiner passively flexes the subject’s uninvolved hip while maintaining the
knee in an extended position.
Positive Test Complaints of pain on the involved side indicate a positive test
Interpretation Positive test may be related to vertebral disk damage
Common errors in   The examiner must utilize proper body mechanics when performing this test.
performing exam The examiner must also note any excessive pelvic motion that may indicate the
patient’s discomfort and/or mechanical compensation
Factors possibly The patient must be completely relaxed, as contraction of the hip flexor muscles
resulting in could increase the stress placed on the lumbar spine and sacroiliac joint, thus
misinterpretation creating false positive findings
Related tests Unilateral Straight Leg Raise Test (Lasegue Test), Bilateral Straight Leg Raise
Test
References  http://www.gpnotebook.co.uk/cache/-1308229618.htm
Links: http://www.silcom.com/~dwsmith/lbpqf2.html

Slump Test
Examination type Neurological test
Patient & Body The subject sits on the end of the table and leans forward.
Segment
Positioning
Examiner Position The examiner stands and holds the patient’s head and chin upright.
Tissues Being Thoracic spine, lumbar spine, sciatic nerve
Tested
Performing the The examiner flexes the subject’s neck and assesses for any changes in
Test symptoms. If no changes are noted, the examiner passively extends one of the
patient’s knees. Symptomatic changes are assessed. The examiner then passively
dorsiflexes the subject’s ankle while the knee remains extended. The patient is
then returned to the original “slump” position and the test is repeated for the other
leg.
Positive Test A complaint of sciatic-type pain or any reproduction of symptom is indicative of a
 positive test.
Interpretation When doing the slump test, the examiner is looking for reproduction of the patient’s
pathological symptoms not just the production of symptoms.
Common errors in Not asking about pain before moving on the each step.  If patient has pain
performing exam after the first part going on with the test will only aggravate that person
more and cause more pain.
Factors possibly  Tight hamstrings, or other muscular tightness. 
resulting in
misinterpretation
Related tests Thomas test
References Special Test for Orthopedic Examination. 2nd Ed. Pp.

Athletic Injury Assessment. 4th Ed. Pp. 239

Orthopedic Physical Assessment. 4th Ed. Pp. 452, 509

Links: http://www.injuryfree.com/research/research_topics_vascular_claudication.htm

http://members.optusnet.com.au/physio/slump.html

http://www.sportsinjurybulletin.com/archive/hamstring-rehabilitation.html

Squeeze Test (Lower Leg)

Examination type Ligamentous stress and boney integrity
Patient & Body To perform this test the examiner will have the patient short sit on the side of a
Segment table with the edge under their knees and their legs hanging off the table.
Positioning
Examiner Position Kneeled on the floor facing the patient
Tissues Being Tibia, fibula, syndesmosis, and the anterior inferior tibiofibular ligament.
Tested
Positive Test Pain above or below the sight of the squeeze is indicative of a fracture of the tibia
or fibula, or sprain of the syndesmosis or the anterior talofibular ligament.
Interpretation Interpreted as a fracture of the tibia or fibula, or a sprain of the syndesmosis, or
anterior inferior talofibular ligament sprain.
Common errors in Improper performance of test, improper hand placement, improper patient or
performing exam examiner positioning.
Factors possibly If patient complains of pain at site where hands are applying pressure instead of
resulting in referred pain.  Patient is not short sitting and lower leg is not relaxed.
misinterpretation
Related tests Distal Tibiofibular Compression Test, Heel tap test, Kleiger's test
References Magee, David J., Orthopedic Physical Assessment, 4th Edition, pg.803.;
Links: What the Results Suggest

How the Test is Performed

DESCRIPTION OF TEST BEING PERFORMED

Place the heel of each hand at equal height on the shaft of the tibia and fibula,
Squeeze the bones together firmly and slowly, hold and then quickly release.
Pain above or below the sight of the squeeze is indicative of a fracture. Test
should be repeated several times up and down the shafts of both bones, and
over the maleoli.

Squish Test
Examination type Ligamentous instability
Patient & Body Patient lies in a supine position
Segment
Positioning
Examiner Position Examiner stands beside the patient with hands on the patient’s ASISs and iliac
crests
Tissues Being Posterior sacroiliac ligaments
Tested
Performing the Test Examiner pushes down and in at a 45 degree angle bilaterally.
Positive Test Indicated by pain
Interpretation Any pain felt anterior or posterior in pelvic or low back area.
Common errors in Pressing down in the wrong area, or not pushing down hard enough. 
performing exam
Factors possibly  The test assesses the stability of the posterior sacroiliac ligaments but also
resulting in directly applies compressive forces to the anterior sacroiliac joint. Thus, the
misinterpretation location of the pain should be noted and correlated with any additional findings.
Related tests Sacroliliac Joint Stress Test; Gillet Test; Yeoman’s Test; Gaenslen’s Test
References Special Test for Orthopedic Examination. 2nd Ed. Pp.

Orthopedic Physical Assessment. 4th Ed. Pp. 452, 509

Links: http://www.spineuniversity.com/public/spinesub.asp?id=89

Stinchfield Test
Examination type Ligamentous and boney stability
Patient & Body The patient lies supine on the examination table with both his hip, knee, and
Segment ankle joints in their neutral positions.
Positioning
Examiner Position The examiner should be positioned on the side of the table beside the patients
injured hip.
Tissues Being The test the femurs integrity. The will also test the strength and flexibility of the
Tested hip extensors and the integrity of their tendons.
Performing the Test The patient flexes his hip with his knee straight and hip in 30 degrees of flexion
first against gravity then with the examiner applying resistance. The examiner
 could also perform the test passively.
Positive Test If groin or thigh pain is elicited during either of the exercises the test is positive.
The test performed passively could elicit pain in the sacroiliac region.
Interpretation A positive test could possibly indicates that there is a fracture to the proximal
femur. Iliopsoas tendonitis or abscess can also be found in a positive test.
Common errors in Improper positioning of the patient. The examiner positioning could also be
performing exam incorrect. Misinterpretation of where the pain is felt could also mislead the
examiner in his findings
Factors possibly  Patients own tolerance of pain. Muscular inflexibility of the hamstring muscle
resulting in group. Muscular strength in the quad muscle group may be insufficient to lift the
misinterpretation leg. This is when age could become a factor.
Related tests Straight Leg Raise Test, Thomas Test
References Hoppenfeld Physical Examination of the Spine & Extremities, Athletic In jury
Assessment Fourth Edition.  
Links: http://www.orthoassociates.com/hipfx.htm,

Talar Tilt Test

Examination ligamentous stress
type
Patient & The subject is short sitting on a table with the involved foot relaxed and the knee flexed
Body to 90 degrees.
Segment
Positioning
Examiner The examiner stabilizes the distal tibia with one hand while grasping the talus with the
Position other hand.

Tissues calcaneofibular ligament, peroneal tendons, syndesmosis.

Being Tested
Performing The examiner first places the foot in the anatomical position. The examiner then inverts
the Test the talus until pain or apprehension is showed by the athlete.  The test should be done
bilaterally to see if ligamentous stability is the same on each side.
Positive Test If the range of motion in the adducted position on the involved foot greater than that of
the noninvolved foot reveals a positive test. This may be indicative for a tear of the
calcaneofibular ligament of the ankle.
Interpretatio The talar tilt test is performed by tilting the foot and looking for a suction sign or
n asymmetrical movement.

Common Not performing the test in all the different ranges of motion plantarflexion,
errors in dorsiflexion, and neural. 
performing
exam
Factors The knee is flexed to 90 degrees to reduce the tension on the gastrocnemuis muscle.
possibly This test should be performed bilaterally for comparison. Performing this test with a foot
resulting in in a more plantar flexed position places less stress on the calcaneofibular ligament and
misinterpret instead may stress the anterior talofibular ligament. Swelling within the ankle joint may
ation reduce the ability to translate the talus anteriorly
Related tests  Anterior draw test
References  Hockenbury, Todd R., MD; G. James Sammarco, MD. " Evaluation and Treatment of
Ankle Sprains."  THE PHYSICIAN AND SPORTSMEDICINE. Vol. 29 No. 2.  February
2001. 12 February  2006. <
http://www.physsportsmed.com/issues/2001/02_01/hockenbury.htm>.
Links: http://www.hope.edu/academic/kinesiology/athtrain/program/studentprojects/Ldornbos2/
ankleandfoot/sld008.htm

http://www.blackburnfeet.org.uk/hyperbook/trauma/ankle%20ligament%20injuries.htm

http://www.physsportsmed.com/issues/2001/02_01/hockenbury.htm

Thompson Test
Examination Muscle Integrity Test
type
Patient & Body The patient lies prone on a table with the heels placed over the edge of the table.
Segment
Positioning
Examiner The examiner should position themselves at the side of the lower leg to be tested.
Position Their hand should be wrapped around the belly of the gastrocnemius and soleus
Tissues Being Achilles Tendon
Tested
Positive Test When squeezing the muscles a normal response would be to have the foot plantar
 flex. Therefore, an absence of plantar flexion upon squeezing would be a positive
test, indicating a possible rupture of the Achilles Tendon.
Interpretation A positive test is present when there is a tear in the Achilles Tendon causing there to
be no plantar flexion.
Common errors A common error may be not comparing bilaterally because the amount of plantar
in performing flexion will vary in degrees from one person to another.
exam
Factors possibly If the gastrocnemius and soleus are not relaxed then the squeeze will not cause the
resulting in foot to go into more plantar flexion because it will already be in a degree of plantar
misinterpretatio flexion
n
Related tests No related test
References Brader, Holly, Isear, Jerome, Konin, Jeff, & Wisten, Denise    

    (2002). Special Test for Orthopedic Examination (2nd ed.).

     Thorofare: SLACK Inc.

Magee, David (2002). Orthopedic Physical        

     Assessment. Philadelphia: Saunders.      

Prentice, William E. (2003). Arnheim’s Principles of Athletic

     Training: A Competency-Based Approach (11th ed.).  St. Louis:     

     McGraw Hill.  

 Torsion Stress Test

Examination type Joint Stability
Patient & Body Patient lies prone
Segment
Positioning
Examiner Position The examiner places one thumb over the L5 spinous process.  The other hand
grabs the anterior ilium of the the opposite side.

Tissues Being Lumboscacral junction, iliolumbar ligaments, anterior sacroiliac ligaments, and
Tested the S-I joints.
Performing the Test Examiner takes the hand on the ilium and pulls the ilium up or posterior. 
Then questions the patien about pain.
Positive Test  + sign is pain in the anterior aspect of the pelvis, pain in the lower back, and
pain in the S-I joints.

 
Interpretation   Distinguishing what is hurting as the examiner does this test is very Important
and also knowing which tissues being stressed. In this case it could be a S-I joint
problem but, which one? Thats why the test needs to performed bilaterally and
ask the patient "tell me where does it hurt" "Does hurt down in the S-I joint or
does it feel like a stress on the ligaments." Or does it hurt in the lower back which
could indicate a lumbar problem. These ideas should be in the examiners head
in fining the interpretation of this test.

Common errors in   Common errors in performing this test would be wrong hand       placement and
performing exam not stressing the joint enough to get the results that are desired.
Factors possibly The factors include not asking specifically where pain is so that is is
resulting in unclear of the actual problem.  A tight rectus femoris might keep the ilium
misinterpretation
from moving the motion that it should. 
Related tests Specific Lumbar Spine Torsion Test
References  Magee, David J. Orthopedic Physical Assessment 4th Ed. Saunders Company,
New York 1997. (Pg 522)
Links:  

Trendelenburg Test
Examination type Muscle weakness
Patient & Body Patient standing
Segment
Positioning
Examiner While standing behind the patient, the examiner’s hands are resting on the
Position top of each iliac crest
Tissues Being Gluteus Medius and Hip Joint
Tested
Performing the The patient is asked to stand unassisted on each leg in turn. The foot on the
Test contra lateral side is elevated from the floor by bending at the knee.

An alternative approach is to have the patient undertake this maneuver

facing the examiner and supported only by the index fingers of the
outstretched hands; this accentuates any instability of balance shown during
a positive test.
Positive Test The pelvis will sag downwards and to the opposite side
Interpretation The hip abductors are weak; the hip is dislocated; the head of femur has
been excised; subluxation or dislocation of the hip; coxa vara; greater
trochanter fractures; slipped upper femoral epiphysis; polio; root lesion;
post-operative nerve damage; muscle-wasting disease
Common errors Having the patient stand on a step or other object; observing the patient from
in performing the front instead of the back
exam
Factors possibly If side of the pelvis naturally sits higher than the other, due to limb length
resulting in discrepancy.
misinterpretation
Related tests Trendelenburg Gait; Sign of the Buttock Test; Single-leg Squat Test
References Special Test for Orthopedic Examination. 2nd Ed. Pp. 200-202.

Athletic Injury Assessment. 4th Ed. Pp.379

Physical Examination of the Spine and Extremities. 1st Ed. Pp. 164

Orthopedic Physical Assessment. 4th Ed. Pp.491, 592.      

Marshall. “The Hip #2.” Patient Care. Vol. 13. Iss. 1. Pp. S1. January 2002.
Links: http://www.qmseminars.co.nz/PDF/CampbellEponym.pdf

http://www.dartmouth.edu/~anatomy/hip/hip%20clin%20correl/corr6.html

Waldron Test
Examination type Cartilage integrity
Patient & Body  The patient stands. The patient must extend the knee through full range of
Segment motion. The knee bends must be slow and deep.
Positioning
Examiner Position The examiner sits beside the patient and palpates the patella while the patient
goes through the full ROM.
Tissues Being The patella and the patella tendon.
Tested
Performing the Test While the patient actively goes through full ROM the examiner palpates the
patella and listens and feels for crepitus.
Positive Test If pain and crepitus occur together during the ROM.

Interpretation The amount of pain during the ROM, and whether there is poor tracking of the
patella.
Common errors in Not allowing the patient going through full ROM, or asking where the pain is
performing exam specifically.
Factors possibly Pain in the patient while walking or doing anything when the knee is extending.
resulting in
misinterpretation
Related tests Active Patellar Grind Test, Step Up Test, and Frund’s Sign
References Orthopedic Physical Assessment. Magee, David. c. 2002. P.727.
Links: http://www.muse-consulting.net/Charts/KJ/Files/CTP%20Tests.xls

Yeoman’s Test
Examination type Joint stability and neurological
Patient & Body  Prone
Segment
Positioning
Examiner Position On the side with the involved leg
Tissues Being SI Joint and lower back
Tested
Performing the Test The patient is placed prone. With one hand, firm pressure is applied by the
examiner over the suspected sacroiliac joint, fixing the patient's anterior pelvis to
the table. With the other hand, the patient's leg is flexed on the affected side to
the physiologic limit, and the thigh is hyper extended by the examiner lifting the
knee from the examining table.
Positive Test Pain in SI joint indicates pathology in the anterior portion of the SI joint; pain in
the lumbar indicates lumbar involvement and anterior thigh paresthesia indicates
femoral nerve stretch.
Interpretation This should be down bilaterally because at times people might not be flexible
resulting in a false positive test.
Common errors in Not stabilizing the pelvis, not lifting the leg high enough, not ask the patient to
performing exam specify the area of pain, not asking about other sensations felt. 
Factors possibly Tight rectus femoris
resulting in
misinterpretation
Related tests Squish test, prone gapping, pheasant test,
References  
Links: http://sheelychiro.com/testspi.html;
http://www.hughston.com/hha/a_15_1_1b.htm;
http://www.shawchiropractic.com/attorneys/MORE_glossary.htm

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