Podiatrist at Podiatry First
Here we are about to go through some common orthopaedic tests for knee injuries.
Please keep in mind these are purely for educational purposes. Assessing knee injuries without any kind of training and experience can result in further injury!
The knee is the largest and considered the most complex joint, in the human body. It acts as a hinge that allows your lower leg and foot to swing back and forth while walking. The knee continually accommodates impact as ground reaction forces are put through the joint. Subsequently, the knee is prone to patho-mechanical errors caused by factors such as malalignments, abnormal muscle health, foot type, genetics and even developmental issues.
A complete physical examination of the knee is always done for a knee complaint, whether the complaint is from a recent or sudden injury (acute) or from long-lasting or recurrent symptoms (chronic).
Due to its intricate nature, to correctly diagnose a knee injury several orthopaedic tests are utilized by health professionals to narrow the pathology or injury down and come up with a diagnosis. Some such tests are as follows.
1. Collateral Ligament Stress Test.
This test assesses the medial and lateral collateral ligaments. It is performed with the patient laying on the plinth in the supine position (facing up). The practitioner places their hands either side of the knee while locking the ankle in place and gently moves the knee side to side.
2. Posterior Draw Test.
This test assesses the condition of the posterior cruciate ligament (PCL).
The PCL is an important ligament that helps stabilize the knee. It prevents backward displacement of the bottom half of the leg (tibia) from the top half (femur).
For this examination the patient should be laying supine on the plinth, the knee is in the flexed position and the practitioner assesses the amount of posterior translocation (movement) of the tibia.
The health of the PCL is judged by the amount of movement and the ligaments end-feel while testing the joint.
3. Anterior Draw Test.
Like the posterior draw test, the anterior draw test is performed to assess the integrity of the anterior cruciate ligament (ACL) of the knee.
Similar to the PCL, the ACL prevents forward sliding of the tibia from under the femur, and also helps prevent hyperextension of the knee.
To perform this test the patient should be laying in the supine position, the knee is in the flexed position and the practitioner assesses the amount of anterior translocation of the tibia.
Like in the posterior draw test, the health of the ACL is judged by the amount of movement and the ligaments end-feel while testing the joint.
4. Lachman Test.
The Lachman test is used to assess the integrity of the ACL. It is performed very similar to the anterior draw test with the knee flexed to a lesser degree.
5. McMurray’s Test.
The McMurray’s test is a dynamic test performed to evaluate the health of the medial and lateral menisci of the knee.
The patient lays in the supine position with hip and knee flexed at 90°. The examiner stabilizes the patients knee and foot and applies opposing forces while taking the knee through its range of motion. A wee clunk here and a bit of a crunch there paints a pretty indicative picture of the integrity of the medial and lateral menisci.
This is definitely one of those tests that should be left to a professional!
6. Clarkes Sign.
Clarkes sign is a test that assesses the patellofemoral joint. A positive test can indicate signs of chondromalacia or degeneration to the patellofemoral joint such as osteoarthritis.
This test is performed in the supine position with leg straight. The practitioner compresses the quadriceps around 2 cm above the knee cap and asks the patient to then contract the quadricep.
I always start soft and slow with this test. A positive sign is pain or crepitus (crunch/grinding) and can be a very rude surprise for the patient.
7. Patella Stress Test.
Utilized to assess for “Runners Knee” AKA Patella Femoral Pain Syndrome, the patella stress test involves lateral displacement of the patella and is indicative of poor knee alignment. This is often due to poor biomechanics, muscle weakness or both.
These are all but a few of the tests utilized by health practitioners in assessing the integrity of the knee. There are many other tests as there are many other issues that occur at the knee.
A full assessment always incorporates a full gait analysis… We watch you walk. A biomechanical assessment where we assess joints, muscles, nerves and bone function and alignment (both static and dynamically) and we take a full history, looking at work loads and other contributing factors.
If you are suffering from knee pain, whether it is from a recent injury or you just have painful knees walking up or down stairs, you should always have it assessed!
You might get told you need to do some stretching, you might get told you have to get a massage. Not too bad…? However, if it is something more sinister, than it is always a good idea to catch things early before more serious intervention is needed such as continually needing pain medication or even surgery.
If any of these ring true and you would like to have yourself assessed, make an appointment to get yourself checked by CLICKING HERE.