Knee Sports Medicine Tests

Valgus Stress Test for Knee Instruct the athlete to lie down with the legs extended and relaxed. Place one hand on the medial aspect of the athlete’s ankle and the other hand on the lateral side of the knee. Simultaneously apply medial force to the knee and lateral force to the ankle to create tension on the MCL. Test the involved knee and compare. Test evaluates integrity of the MCL.

Varus Stress Test for Knee Instruct the athlete to lie down with the legs extended and relaxed. Place one hand on the lateral aspect of the athlete’s ankle and the other hand on the medial side of the knee. Extend the athlete’s leg so it is straight. Simultaneously apply lateral force to the knee and medial force to the ankle to create tension on the LCL. Repeat for the involved knee and compare sides. Test evaluates integrity of the LCL.

Anterior Drawer Test Application of anterior force to the proximal posterior aspect of the tibia to assess the stability of the ACL. Procedure: Instruct the athlete to lie in the supine position with legs extended. The hamstrings must be relaxed. Flex the uninvolved knee to approx 90 degrees, keeping the foot flat on the table. Stabilize the foot by gently sitting on it while performing the assessment. Place both hands behind the proximal end of the athlete’s tibia and pull anteriorly.

Anterior Drawer Test (Cont.) Watch to see if the tibial plateau pulls anterior to the patellar plane. Repeat for the involved knee and compare sides. Test evaluates the integrity of the ACL.

Posterior Drawer Test Application of posterior force to the proximal anterior aspect of the tibia to assess the stability of the PCL. Procedure: Place the client in the same position as with the anterior drawer test. Look at the proximal tibia for a dropping off of the tibial plateau where it meets the femur. This condition is known as posterior sag. After stabilizing the foot, place both hands at the proximal end of the tibia and push posteriorly. Watch to see if the tibial plateau pushes posterior to the patellar plane. Test the involved knee and compare sides. Test evaluates the integrity of the PCL.

Lachman Test Application of anterior and posterior force to the proximal posterior tibia to determine the stability of the ACL and PCL. Procedure: Instruct the athlete to lie in a supine position with the uninvolved knee flexed degrees, making sure the hamstring muscles are relaxed. Place one hand on the upper leg to stabilize the femur and place the other hand around the middle of the lower leg. Apply anterior force to assess the ACL and posterior force to check the PCL. Repeat for the involved side and compare.

McMurray Test Compression of the meniscus of the knee combined with internal and external rotation while the patient is face-up to assess the integrity of the meniscus. Procedure: Instruct the athlete to lie face-up with the legs extended and relaxed. Place one hand on the bottom of the athlete’s foot and the other hand on the anterior portion of the leg, slightly beneath the patella. Position the hand on the patella so that one finger can be used to feel the medial joint line and another finger can be used to fee the lateral joint line. The hand on the foot is used to rotate the ankle internally and externally and to flex and extend the leg.

McMurray Test (cont) Begin the test by fully flexing the knee and internally rotating the foot. Then, (in a fluid manner) extend the knee, keeping the foot internally rotated. Flex the knee again, externally rotating the foot at full flexion. Extend the knee once more with the foot externally rotated, and flex the knee again, internally rotating the foot at full flexion. A “pop” felt on the joint lines indicates a tear of a meniscus.

Apley Compression Test Compression of the meniscus of the knee combined with internal and external rotation on a patient who is face- down to assess the integrity of the meniscus. Procedure: Instruct the athlete to lie face-down, flexing the knee at a 90 degree angle. Place one hand on the bottom of the athlete’s foot, near the heel, and the other hand on the upper leg near the distal end of the femur. Push down on the foot while rotating it internally and externally. Compare on the involved side. Pain or an audible “clunk” will be felt or heard if there the meniscus is torn. Damage to the medial meniscus will cause S/S when the knee is internally rotated. Damage to the lateral meniscus will cause S/S when the knee is externally rotated.