Hips
Identifies dysfunction of the Hip such as mobility restriction
-passive flexion abduction and external rotation
-slowly lower testing leg towards plinth
Patrick (Faber) Test
identifies tightness in rectus femoris
patient prone with and knee of testing limb is flexed
-if hip of testing limb flexes then test is positive
Elys test
identifies ligament laxity or restrictions
lower limb is supported and stabilized and knee is placed in 20-30 degrees of flexion
valgus and varus force
primary finding is laxity but pain may be noted as well
knee Collateral ligament instability test
helps differentiate meniscal tears and ligamentous lesions
pt prone with knee at 90 degrees and your knee on their thigh
1. distract and internally and externally rotate tibia
2. compress and internally and externally rotate tibia
ligamentous dysfunction= pain or decreased motion during distraction
meniscal dysfunction=pain or decreased motion with compression
Apleys Test
2 questions
1. identifies dysfunction of common fibular nerve posterior to fibula head - tap wear fibular nerve runs
2. identifies dysfunction of posterior tibular nerve as it passes posterior to malleolus malleus
Tinels sign
identifies DJD (degenerative joint diseaese) of hip joint
hip 90 degrees flexion and knee maximally flexed
place compressive load into femur via knee
- may reproduce pain in hip joint
Grind (Scouring) Test
identifies rightness of hamstrings
patient supine and hip and knee of tested limb is 90degrees flexion
-extend knee passively until barrier is encountered
posisver if lacking 10 degrees of extension of knee
ACL ligament integrity
Knee flexed 20-30 degrees -stabilize femur and passively try to glide tibia anterior
-positive if excessive anterior glide of tibia
Lachman stress test
identifies dysfunction of the plica
pt supine with testing knee flexed and tibia internally rotated
-passivley glide the tibia medially while palpating the femoral condyle
- flex and extend the knee feeling for popping
Hughstons plica test
evaluates the integrity of the achilles tendon
patient prone with foot off edge of table
squeeze calf muscle
no movement of foot while squeezing is a positive sign
Thompson Test
identifies weakness of glut medius or unstable hip
stand on one leg and flex opposite knee
pelvis drops towards flexed knee side
weak glut medius on standing leg
Trendelenburg sign
identifies true leg length discrepancy
patient supine with pelvis balanced measure ASIS to lateral mallaulus one each limb several times
leg length test
indicates integrity of posterior cruciate ligament
hip flexed 45 degrees and knee flexed to 90 degrees
observe if tibia sags posteriorly
Posterior sag test
indicates past history of patella dislocation
patient is supine and patella is passively glided laterally
patient does not like this =positive test
patellar apprehension test
identifies stress fracture or neuroma in forefoot
patient supine with foot supported on table
grasp around metatarsal heads and squeeze
positive finding is pain in foot
Mortons test
identifies tightness of hip flexors
one hip and knee are maximally flexed to chest
opposite leg its kept straight on table
-observe if opposite leg flexes off the table
Thomas Test
identifies abnormal femoral ante version angle
patient prone with knee flexed 90 degrees
palpate greater tronchater and find its most lateral point
measure angle perfuciuals to table
normalm equals 8-15 degrees internal rotation
less than 8 retroverted more than 15 anteverted
Craigs test
indicates integrity of posterior cruciate ligament
knee flexed to 30 degrees -stabilize femur and passively glide tibia posterior
posterior drawer test
indicates patellafemoral dysfunction
patient supine with lower limb straight push posterior on superior pole or vice versa
ask patient to do an active contraction of quads
pain produced in knee as result of test is a positive test
Clarkes sign
identifies tightness in TFL or IT band
pt lies on side with lower limb flexed at hip and knee
passively extend and abduct testing hip with knee flexed to 90 degrees
-slowly lower testing limb and observe if it reaches table
positive if limb is unable to touch table
Obers test
patella femoral dysfunction
flex knee to 120 90 60 and full extension
pt isometrical contracts against your force (about 10 seconds)
if painful degree is found then passively position knee to painful degree and medially displace patella. if pain goes away then this is a positive test
mcconells test
measure angle between quadriceps muscle (ASIS?) and patellar tendon
normal 13 degrees for men and 18 degrees for women
angles more or less may be indicative of knee dysfunction
Q angle measurement